Guth Stefan, Wiedenroth Christoph B, Kramm Thorsten, Mayer Eckhard
a Department of Thoracic Surgery , Kerckhoff Heart and Lung Center , Bad Nauheim , Germany.
Expert Rev Respir Med. 2016 Jun;10(6):673-84. doi: 10.1080/17476348.2016.1176915. Epub 2016 May 3.
Pulmonary endarterectomy is a curative treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). There is a growing body of evidence suggesting that not only patients with CTEPH but also patients with pulmonary arterial obstructions and mean pulmonary artery pressures < 25 mmHg should be offered surgery. In this review, the recent literature regarding pathophysiology, diagnostic methods, decision making by an expert CTEPH team, and surgical techniques will be summarized. Novel alternative treatment options for inoperable CTEPH patients will be discussed, i.e. targeted medical therapy and balloon pulmonary angioplasty. For the future the major task will be to define a clear selection process for the optimal treatment of the individual CTEPH patient.
肺动脉内膜剥脱术是慢性血栓栓塞性肺动脉高压（CTEPH）患者的一种治愈性治疗选择。越来越多的证据表明，不仅CTEPH患者，而且肺动脉阻塞且平均肺动脉压<25 mmHg的患者也应接受手术治疗。在本综述中，将总结有关病理生理学、诊断方法、CTEPH专家团队的决策以及手术技术的最新文献。还将讨论针对无法手术的CTEPH患者的新型替代治疗选择，即靶向药物治疗和球囊肺动脉血管成形术。未来的主要任务将是为个体CTEPH患者的最佳治疗确定一个明确的选择过程。
