Department of Cardiovascular Medicine, Faculty of Life Science, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan.
Cardiovasc Interv Ther. 2022 Jan;37(1):60-65. doi: 10.1007/s12928-021-00775-6. Epub 2021 Apr 29.
Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by chronic stenosis or obstruction of the pulmonary arteries due to thromboembolism. Although previous studies have shown untreated CTEPH has a poor prognosis, the establishment of gold-standard therapies including pulmonary endarterectomy, balloon pulmonary angioplasty (BPA), and medical therapy has improved hemodynamics and right ventricular function, leading to good long-term survival. BPA is an important therapy for patients with inoperable CTEPH, although the procedure is currently limited to specific institutions and operators. This review discusses the development of the rapidly evolving field of CTEPH that includes improvements in imaging modalities and advances in surgical and interventional techniques.
慢性血栓栓塞性肺动脉高压(CTEPH)是由血栓栓塞引起的肺动脉慢性狭窄或阻塞所致。尽管之前的研究表明未经治疗的 CTEPH 预后较差,但肺动脉内膜切除术、球囊肺动脉成形术(BPA)和药物治疗等金标准疗法的确立改善了血液动力学和右心室功能,从而提高了长期生存率。BPA 是无法手术的 CTEPH 患者的重要治疗方法,尽管该手术目前仅限于特定的机构和操作人员。本文综述了 CTEPH 领域的快速发展,包括成像方式的改进和手术及介入技术的进步。