Pulmonary Hypertension and CTEPH Research Program, Temple Heart and Vascular Institute, Temple University, Lewis Katz School of Medicine, 3401 North Broad Street, Philadelphia, PA 19140, USA.
Cardiol Clin. 2020 May;38(2):257-268. doi: 10.1016/j.ccl.2020.01.003. Epub 2020 Mar 5.
The treatment of chronic thromboembolic pulmonary hypertension has expanded considerably. The ability to endarterectomize chronic thromboembolic material, the availability of pulmonary hypertension medical therapy to treat inoperable chronic thromboembolic pulmonary hypertension and/or residual pulmonary hypertension, and the rebirth of pulmonary balloon angioplasty have changed the management landscape. Patient selection requires a multidisciplinary evaluation at an experienced center. What is inoperable chronic thromboembolic pulmonary hypertension to one group may be operable chronic thromboembolic pulmonary hypertension to another. The ultimate challenge then becomes which intervention provides the optimal long-term outcome for any individual patient.
慢性血栓栓塞性肺动脉高压的治疗已经有了很大的进展。能够进行动脉内膜切除术来清除慢性血栓栓塞物质，以及肺动脉高压药物治疗可用于治疗不可手术的慢性血栓栓塞性肺动脉高压和/或残余肺动脉高压，以及肺动脉球囊血管成形术的复兴，这些都改变了管理格局。患者的选择需要在有经验的中心进行多学科评估。对一组患者来说是不可手术的慢性血栓栓塞性肺动脉高压，对另一组患者来说可能是可手术的慢性血栓栓塞性肺动脉高压。那么，最终的挑战就变成了哪种干预措施能为任何特定患者提供最佳的长期结果。
