Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) IS defined as pulmonary hypertension (PH) caused by single or recurrent pulmonary emboli arising from deep vein thrombosis (DVT). This observational study was carried out from Sep 2018 to August 2019. The diagnosis of Chronic PTE was confirmed in 4 patients by computed tomography pulmonary angiography (CTPA) . After confirming the diagnosis, the patients were started anticoagulation therapy and planned for surgical endarterectomy. CT angio was also performed in post op period which suggested no residual thrombus in 2 pts while mild- moderate distal residual segmental artery thrombus in 2 patients. Our Experience suggests surgical intervention rather than anti coagulation is effective definitive and ideal management for pateints of CTEPH. Early recognition, aggressive appropriate treatment and systematic follow-up can improve the outcome of this potentially fatal condition.
References
- Parakh R, Kapadia SR, Sen I, Agarwal S, Grover T, Yadav A, et al. Pulmonary embolism: a frequent occurrence in Indian patients with symptomatic lower limb venous thrombosis. Asian J Surg 2006; 29:86-91.
- Moor GF, Sabiston DC Jr. Embolectomy for chronic PE and pulmonary hypertension. Rev Surg1969;26:449-51.
- Piazza G, Goldhaber SZ. Chronic thromboembolic pulmonary hypertension. N Engl J Med 2011;364:351-60.
- Nakajima N, Masuda M. The surgical treatment for chronic pulmonary thrombo-embolism: our experience and current review of the literature. Ann Thorac Cardiovasc Surg1997;3:15-21
- Fedullo PF, Auger WR, Kerr KM, Rubin LJ. Chronic thromboembolic pulmonary hypertension. N Engl J Med 2001; 345:1465-72.
- Becattini C, Agnelli G, Pesavento R, Sillingardi M, Poggio R, Taliani MR, et al. Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism. Chest 2006;130:172-5.
- Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzot F, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 2004;350:2257-64.
- Wilkens H, Lang I, Behr J, Grohe C, Guth S, Hoeper MN, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): Updated Recommendations of the Cologne Consensus Conference 2011. Int J Cardiol 2011;154 (Suppl.): 554-60.
- Hoeper MM, Mayer E, Simonneau G, et al. Chronic thromboembolic pulmonary hypertension. Circulation 2006;113:2011-20.
- Azarian R, Wartski M, Collingnon MA, Parent F, Herve P, Sors H, et al. Lung perfusion scans and hemodynamics in acute and chronic pulmonary embolism. J Nucl Med 1997;38:980-3.
Corresponding Author
Dr Rahul Bhushan
MCh Resident, Dept of CTVS, Dr RML Hospital, New Delhi