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01-12-2014 | Review Article | Uitgave 12/2014 Open Access

Netherlands Heart Journal 12/2014

Chronic thromboembolic pulmonary hypertension

Tijdschrift:
Netherlands Heart Journal > Uitgave 12/2014
Auteurs:
B. E. Schölzel, R. J. Snijder, J. J. Mager, H W. van Es, H. W. M. Plokker, H. J. Reesink, W. J. Morshuis, M. C. Post
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Electronic supplementary material

The online version of this article (doi:10.​1007/​s12471-014-0592-2) contains supplementary material, which is available to authorized users.

Abstract

Chronic pulmonary thromboembolic disease is an important cause of severe pulmonary hypertension, and as such is associated with significant morbidity and mortality. The prognosis of this condition reflects the degree of associated right ventricular dysfunction, with predictable mortality related to the severity of the underlying pulmonary hypertension. Left untreated, the prognosis is poor. Pulmonary endarterectomy is the treatment of choice to relieve pulmonary artery obstruction in patients with chronic thromboembolic pulmonary hypertension and has been remarkably successful. Advances in surgical techniques along with the introduction of pulmonary hypertension-specific medication provide therapeutic options for the majority of patients afflicted with the disease. However, a substantial number of patients are not candidates for pulmonary endarterectomy due to either distal pulmonary vascular obstruction or significant comorbidities. Therefore, careful selection of surgical candidates in expert centres is paramount. The current review focuses on the diagnostic approach to chronic thromboembolic pulmonary hypertension and the available surgical and medical therapeutic options.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Extra materiaal
Video 1
Transthoracic echocardiogram. Parasternal short axis at the level of the papillary muscles. There is systolic and diastolic flattening of the interventricular septum which suggests pressure and volume overload of the right ventricle. (AVI 17,846 kb)
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