Frachon I, Jaïs X, Leroyer C, Jobic Y, Huchot E, Simonneau G, Dartevelle P
Equipe d'accueil 3878, groupe HTAP de Bretagne occidentale, département de médecine interne et pneumologie, hôpital de la Cavale-Blanche, 29609 Brest, France.
Rev Pneumol Clin. 2008 Dec;64(6):316-24. doi: 10.1016/j.pneumo.2008.09.009. Epub 2008 Nov 26.
The prognosis of postembolic pulmonary hypertension, a rare and serious disease, has been transformed with the curative intervention of pulmonary endarteriectomy. The screening is based on two key non invasive examinations, the cardiac ultrasound and ventilation-perfusion scintigraphy. The confirmation of the diagnosis and the determination of the best therapeutic options then relies on the expertise of the national reference centre, based on the haemodynamics and the morphological data provided by pulmonary angiography and spiral computerised tomography. Although the technique of endarteriectomy is fully validated, a drug approach is in the assessment process, both in the inoperable forms or when confronted with persistent postsurgical pulmonary hypertension.
血栓栓塞后肺动脉高压是一种罕见的严重疾病，肺内膜剥脱术这一治愈性干预措施改变了其预后。筛查基于两项关键的非侵入性检查，即心脏超声和通气灌注闪烁扫描。然后，诊断的确认以及最佳治疗方案的确定依赖于国家参考中心的专业知识，该中心依据肺血管造影和螺旋计算机断层扫描提供的血流动力学和形态学数据进行判断。尽管肺内膜剥脱术技术已得到充分验证，但对于无法手术的病例或术后持续性肺动脉高压的情况，药物治疗方法仍处于评估过程中。
