title: [Thrombo-embolic pulmonary hypertension--do not spoil a chance for effective surgery!].
abstract: Chronic thromboembolic pulmonary hypertension (CTEPH) can be defined as pulmonary hypertension with persistent pulmonary perfusion defects causes by unresolved thrombi. All symptomatic CTEPH patients with documented pulmonary vascular resistance > 300 dyn*sec*cm(-5) and proximal lesions should be considered for surgical treatment--pulmonary endarterectomy. The role of pharmacological treatment remains controversial and should be restricted to inoperable cases and persistent pulmonary hypertension after pulmonary endarterectomy. Every year about 30 procedures is performed in two specialised centers in Poland with 1 year mortality at 8-9%. Number of procedures done gives the frequency of pulmonary endarterectomy at 0.7/million of population/year. Current data from UK indicate the actual ratio of surgical treatment of CTPH at 2/million/year. The article discusses reasons for CTEPH is underdiagnosed and why rate of surgical therapy in Poland is too low.
authors.affiliation: Klinika Chorób Wewnętrznych Klatki Piersiowej, Instytut Gruźlicy i Chorób Płuc, Warszawa. m.kurzyna@igichp.edu.pl
authors.forename: Marcin
authors.initials: M
authors.lastname: Kurzyna
authors.forename: Adam
authors.initials: A
authors.lastname: Torbicki
authors.forename: Lech
authors.initials: L
authors.lastname: Poloński
authors.forename: Ilona
authors.initials: I
authors.lastname: Skoczylas
authors.forename: Roman
authors.initials: R
authors.lastname: Przybylski
authors.forename: Maria
authors.initials: M
authors.lastname: Wieteska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Dyk
authors.forename: Andrzej
authors.initials: A
authors.lastname: Biederman
authors.forename: Marian
authors.initials: M
authors.lastname: Zembala
mesh_terms: D004691:Endarterectomy / Q000379:methods* / Q000401:mortality / Q000592:standards; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology / Q000601:surgery*; D011044:Poland; D013923:Thromboembolism / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome