[Pulmonary arterial hypertension of chronic thromboembolic origin; therapeutic indications].
Chronic thromboembolic pulmonary hypertension is a rare complication of acute pulmonary embolism. The therapeutic approach to the disease is addressed, based on a series of 81 patients referred to our department between 1984 and 1993. Medical treatment associates long-term anticoagulant therapy and, in some cases, inferior vena cava interruption. Two surgical procedures are available in selected patients: lung transplantation and pulmonary thrombo-endareterectomy. Lung transplantation has been performed in 8 patients since 1988 with 6 survivors with a maximal follow-up of 5 years. Twelve patients underwent pulmonary thromboendareterectomy with in 9 patients a dramatic functional and haemodynamic improvement. Chronic thromboembolism should be systematically investigated as the cause of pulmonary hypertension considering that in selected cases, curative surgery is possible.
Azarian
R
R
Service de pneumologie, hôpital Antoine-Béclère, Clamart.
Brenot
F
F
Sitbon
O
O
Parent
F
F
Petitpretz
P
P
Musset
D
D
Grimon
G
G
Dartevelle
P
P
Simonneau
G
G
Duroux
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D013923:Thromboembolism / Q000150:complications* / Q000503:physiopathology / Q000628:therapy
Hypertension artérielle pulmonaire d'origine thrombo-embolique chronique; indications thérapeutiques.