Chronic thromboembolic pulmonary hypertension: clinical case and problem review

Main Article Content

G. D. Radchenko
O. O. Torbas
Yu. M. Sirenko

Abstract

In this article there was presented a clinical case of the chronic thromboembolic pulmonary hypertension (CTEPH) in the patient with small arteries damage. The thromb visualization was done by the lung perfusion multispiral computer tomography. The general positions of the definition, the diagnosis and treatment of the CTEPH were elucidated too. It was stated the CTEPH is a potential curable disease in case of the surgery in time. But there are some situations when it is not possible to provide the surgery and, in this case, the CTEPH treatment by specific pulmonary hypertension drugs could be used

Article Details

Keywords:

chronic thromboembolic pulmonary hypertension, diagnosis, treatment, clinical case

References

About Rare Diseases [http://www.eurordis.org] – Rare Diseases Europe (EURORDIS); European Union Committee of Experts on Rare Diseases [http://www.eucerd.eu/].

Andreassen AK, Ragnarsson A, Gude E, et al. Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Heart. 2013;99:1415-20. https://doi.org/10.1136/heartjnl-2012-303549.

Auger WR, Kim N, Kerr K, Test V, Fedullo P. Chronic thromboembolic pulmonary hypertension. Clin Chest Med. 2007;28(1):255-69. https://doi.org/10.1016/j.ccm.2006.11.009.

Berman M, Hardman G, Sharples L, et al. Pulmonary endarterectomy: Outcomes in patients > 70. Eur J Cardio-Thorac Surg. 2012;41(6):e154-e160. https://doi.org/10.1093/ejcts/ezs188.

Bouvaist H, Thony F, Jondot M, et al. Balloon pulmonary angioplasty in a patient with chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2014;23:393-5. https://doi.org/0.1183/13993003.01915-2018.

Dalen JE, Alpert JS. Natural history of pulmonary embolism. Progress in Cardiovascular Dis. 1975;17(4):259-70. https://doi.org/10.1016/S0033-0620(75)80017-X.

Delcroix M, Kerr K, Fedullo P. Chronic thromboembolic pulmonary hypertension: Epidemiology and risk factors. Ann Am Thorac Soc. 2016;13(3):S201-S206. https://doi.org/10.1513/AnnalsATS.201509-621AS.

Delcroix M, Lang I, Pepke-Zaba J, et al. Long-term outcome of patients with chronic thromboembolic pulmonary hypertension (CTEPH): Results from an international prospective registry. Circulation. 2016;133(9):859-71. https://doi.org/10.1161/CIRCULATIONAHA.115.016522.

Fedullo PF, Auger W, Kerr K, Rubin L. Chronic thromboembolic pulmonary hypertension. N Engl J of Med. 2001;345 (20):1465-72. https://doi.org/10.1056/NEJMra010902.

Feinstein JA, Goldhaber SZ, Lock JE, Ferndandes S, Landzberg M. Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation. 2001;103:0-13. https://doi.org/10.1161/01.cir.103.1.10

Fukui S, Ogo T, Goto Y, et al. Exercise intolerance and ventilatory inefficiency improve early after balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Int J Cardiol. 2015;180:66-8. doi: 10.1016/j.ijcard.2014.11.187.

Fukui S, Ogo T, Morita Y, et al. Right ventricular reverse remodelling after balloon pulmonary angioplasty. Eur Respir J. 2014; 43: 1394-402. https://doi.org/10.1183/09031936.00012914.

Galiè N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Eur Respir J. 2015;46:903-75. https://doi.org/10.1183/13993003.01032-2015.

Guérin L, Couturaud F, Parent F, et al. Prevalence of chronic thromboembolic pulmonary hypertension after acute pul- monary embolism Prevalence of CTEPH after pulmonary embolism. Thrombosis and Haemostasis. 2014;112:598-605. https://doi.org/10.1160/TH13-07-0538.

Humbert M, Kovacs G, Hoeper M, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2023;61(1):2200879. https://doi.org/10.1183/13993003.00879-2022.

Inami T, Kataoka M, Yanagisawa R, et al. Long-term outcomes after percutaneous transluminal pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Circulation. 2016;134:2030-2. https://doi.org/10.1161/CIRCULATIONAHA.116.024201.

Jamieson SW, Kapelanski D, Sakakibara N, et al. Pulmonary endarterectomy: Experience and lessons learned in 1,500 cases. Ann Thorac Surg. 2003;76(5):1457-62. https://doi.org/10.1016/s0003-4975(03)00828-2.

Jenkins D, Madani M, Fadel E, D'Armini A, Eckhard Mayer E. Pulmonary endarterectomy in the management of chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2017;26(143):160111. https://doi.org/10.1183/16000617.0111-2016.

Kataoka M, Inami T, Hayashida K, et al. Percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv. 2012;5:756-62. https://doi.org/10.1161/CIRCINTERVENTIONS.112.971390.

Kawakami T, Ogawa A, Miyaji K, et al. Novel angiographic classification of each vascular lesion in chronic thromboembolic pulmonary hypertension based on selective angiogram and results of balloon pulmonary angioplasty. Circ Cardiovasc Interv. 2016;9:e003318. https://doi.org/10.1161/CIRCINTERVENTIONS.115.003318.

Kim N, Delcroix M, Jais X, et al. Chronic thromboembolic pulmonary hypertension. Eur Respir J. 2019;53:1801915. https://doi.org/10.1183/13993003.01915-2018.

Kim NH, Fesler P, Channick R, et al. Preoperative partitioning of pulmonary vascular resistance correlates with early outcome after thromboendarterectomy for chronic thromboembolic pulmonary hypertension. Circulation. 2004; 109(1):18-22. https://doi.org/10.1161/01.CIR.0000111841.28126.D4.

Lang IM, Madani M. Update on chronic thromboembolic pulmonary hypertension. Circulation. 2014;130(6):508-18. https://doi.org/10.1161/CIRCULATIONAHA.114.009309.

Lang IM. Advances in understanding the pathogenesis of chronic thromboembolic pulmonary hypertension. Brit J Haematol. 2010;149(4):478-83. https://doi.org/10.1111/j.1365-2141.2010.08142.x.

Lang IM, Pesavento R, Bonderman D, Yuan J. Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: A current understanding. Eur Respir J. 2013;41(2):462-8. https://doi.org/10.1183/09031936.00049312.

Madani MM. Surgical treatment of chronic thromboembolic pulmonary hypertension: Pulmonary thromboendarterectomy. Methodist DeBakey Cardiovascular J. 2016;12(4):213-8. https://doi.org/10.14797/mdcj-12-4-213.

Madani MM, Auger W, Pretorius V, et al. Pulmonary endarterectomy: Recent changes in a single institution’s experience of more than 2,700 patients. Ann Thorac Surg. 2012;94(1):97-103. https://doi.org/10.1016/j.athoracsur.2012.04.004.

Martin-Suarez S, Gliozzi G, Pacini D, et al. Pulmonary Endarterectomy in Chronic Thromboembolic Pulmonary Hypertension: «State of the Art» and New Therapeutic Options. EC Pulmonology and Resp Med. 2018;7.4:182-4.

Mikus PM, Dell'Amore A, Pastore S, Galiè N. Pulmonary endarterectomy: Is there an alternative to profound hypothermia with cardiocirculatory arrest? Eur J Cardio-Thoracic Surgery. 2006;30(3):563-5. https://doi.org/10.1016/j.ejcts.2006.06.016.

Miniati M, Fiorillo C, Becatti M, et al. Fibrinresistance to lysis in patients with pulmonary hypertension other than thromboembolic. Am J Respir Crit Care Med. 2001;181(9):992-6. https://doi.org/10.1164/rccm.200907-1135OC.

Mizoguchi H, Ogawa A, Munemasa M, Mikouchi Н, Ito Н, Matsubara Н. Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv. 2012;5:748-55. https://doi.org/10.1161/CIRCINTERVENTIONS.112.971077.

Morris TA. Why acute pulmonary embolism becomes chronic thromboembolic pulmonary hypertension: Clinical and genetic insights. Curr Opin Pulm Med. 2013;19(5):422-9. doi: 10.1097/MCP.0b013e328364379f.

Moser KM, Bloor CM. Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension. Chest. 1993;103(3):685-92. https://doi.org/10.1378/chest.103.3.685.

Ogawa A, Matsubara H. Balloon pulmonary angioplasty: a treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension. Front Cardiovasc Med. 2015;2:4. https://doi.org/10.3389/fcvm.2015.00004.

Ogo T. Balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension. Curr Opin Pulm Med. 2015;21:425-31. https://doi.org/10.1097/MCP.0000000000000188.

Pacini D, Leone A, Di Marco L, et al. Antegrade selective cerebral perfusion in thoracic aorta surgery: Safety of moderate hypothermia. Eur J Cardio-Thorac Surg. 2007;31(4): 618-22. doi: 10.1016/j.ejcts.2006.12.032.

Pengo V, Lensing AW, Prins MH, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004;350(22):2257-64. https://doi.org/10.1056/NEJMoa032274.

Pepke-Zaba J, Delcroix M, Lang I, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): Results from an international prospective registry. Circulation. 2011;124(18):1973-81. https://doi.org/10.1161/CIRCULATIONAHA.110.015008.

Poli D, Miniati M. The incidence of recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension following a first episode of pulmonary embolism. Curr Opin Pulm Med. 2011;17(5):392-7 doi: 10.1097/MCP.0b013e328349289a.

Pretorius V, Poch DS, Auger WR. et al. Should we offer pulmonary endarterectomy to octogenarians? 5th World Symposium on Pulmonary Hypertension. 2013: CTEPH Nice, France (2013): 54-58.

Pulmonary hypertension 2011 Updated recommendations of the Cologne Consensus Conference. Int J Cardiol. 2011;154,Suppl 1:1-60.

Roik M, Wretowski D, Labyk A, et al. Refined balloon pulmonary angioplasty driven by combined assessment of intra-arterial anatomy and physiology – multimodal approach to treated lesions in patients with non-operable distal chronic thromboembolic pulmonary hypertension – technique, safety and efficacy of 50 consecutive angioplasties. Int J Cardiol 2016;15:228-35. https://doi.org/10.1016/j.ijcard.2015.10.116.

Roik M, Wretowski D, Rowinski O, et al. Refined balloon pulmonary angioplasty in inoperable chronic thromboembolic pulmonary hypertension – a multi-modality approach to the treated lesion. Int J Cardiol. 2014;177(3): e139-e141. https://doi.org/10.1016/j.ijcard.2014.09.051.

Simonneau G, Torbicki A, Dorfmüller P, Kim N. The pathophysiology of chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2017;26(143):160112. https://doi.org/10.1183/16000617.0112-2016.

Skoro-Sajer N, Hack N, Sadushi-Koliçi R, et al. Pulmonary vascular reactivity and prognosis in patients with chronic thromboembolic pulmonary hypertension: a pilot study. Circulation. 2009;119(2):298-305. https://doi.org/10.1161/CIRCULATIONAHA.108.794610.

Sugimura K, Fukumoto Y, Satoh K, et al. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J. 2012;76:485-8. https://doi.org/10.1253/circj.cj-11-1217.

Taboada D, Pepke-Zaba J, Jenkins DP, et al. Outcome of pulmonary endarterectomy in symptomatic chronic thromboembolic disease. Eur Respir J. 2014;44(6):1635-45. https://doi.org/10.1183/09031936.00050114.

Wiedenroth CB, Liebetrau C, Breitheckeret A, et al. Combined pulmonary endarterectomy and balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension. J Heart Lung Transplant. 2016;35(5): 591-6. https://doi.org/10.1016/j.healun.2015.10.030.

Most read articles by the same author(s)

<< < 1 2 3 > >>