title: [Surgical treatment of chronic thromboembolic pulmonary hypertension with pulmonary endarterectomy].
abstract: Acute pulmonary embolism is the third most common cardiovascular disease in Italy with approximately 65 000 new cases a year. Appropriate medical therapy does not necessarily prevent evolution of acute pulmonary embolism into chronic thromboembolic pulmonary hypertension (CTEPH), which occurs in 0.1-4.0% of cases. In our country, there are approximately up to 2600 new CTEPH patients a year. CTEPH is a progressive and potentially lethal disease. Medical therapy is palliative and only surgery can modify its natural history. Pulmonary endarterectomy (PEA) is the treatment of choice and lung transplantation should be considered only when PEA is contraindicated. Currently, nearly 4000 PEAs have been performed worldwide. Approximately ten centers are able to carry out this intervention with excellent and permanent results. Solid experience and close multidisciplinary collaboration allow appropriate patient selection, rigorous surgical technique, and adequate postoperative management. All these aspects represent the key to the success in the treatment of CTEPH. After PEA, quality and expected length of life are similar to the age-matched general population and the only therapy required is oral anticoagulation.
authors.affiliation: Cattedra e Divisione di Cardiochirurgia, Università degli Studi di Pavia, IRCCS Policlinico San Matteo, Pavia. darmini@smatteo.pv.it
authors.forename: Andrea Maria
authors.initials: AM
authors.lastname: D'Armini
authors.forename: Giorgio
authors.initials: G
authors.lastname: Zanotti
authors.forename: Matteo
authors.initials: M
authors.lastname: Pozzi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Nicolardi
authors.forename: Corrado
authors.initials: C
authors.lastname: Tramontin
authors.forename: Vito G
authors.initials: VG
authors.lastname: Ruggieri
authors.forename: Marco
authors.initials: M
authors.lastname: Morsolini
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Tancredi
authors.forename: Cristian
authors.initials: C
authors.lastname: Monterosso
authors.forename: Mario
authors.initials: M
authors.lastname: Viganò
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D004691:Endarterectomy; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D018579:Patient Selection; D011651:Pulmonary Artery / Q000601:surgery*; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012307:Risk Factors