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- W1485383984 abstract "Chronic thromboembolic pulmonary hypertension (CTEPH) is an increasingly recognized complication of venous thromboembolic disease. Prior to the availability of effective treatment, survival was poor, but this situation appears to have improved over recent years. Surgical disobliteration of the pulmonary arterial bed via pulmonary endarterectomy leads to marked haemodynamic and functional improvements. For a minority of patients there is a discrepancy between the degree of pulmonary haemodynamic abnormality and the thromboembolic load identified at radiological investigation. These patients do not benefit from surgery and are increasingly treated with the targeted therapies used in other forms of pulmonary hypertension. A systematic diagnostic evaluation of patients with suspected CTEPH is therefore essential to allow the most appropriate management. Echocardiography is the initial investigation of choice and may have a role in screening of patients during follow-up following an acute pulmonary embolism. Right heart catheterization is mandatory for the confirmation of the presence and severity of pulmonary hypertension and may be helpful in defining the relative contribution from proximal and distal thromboembolic disease. Isotope perfusion scanning can effectively exclude the diagnosis, although with the more widespread availability of multidetector row scanners, CT pulmonary angiography has an increasingly central role in the radiological evaluation of these patients. Magnetic resonance angiography provides a complementary evaluation of the pulmonary vasculature and can now provide images rivalling those produced by formal pulmonary angiography. Future developments in the assessment of patients will focus on the improved identification of those patients who will and will not benefit from surgery." @default.
- W1485383984 created "2016-06-24" @default.
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- W1485383984 date "2009-04-01" @default.
- W1485383984 modified "2023-09-26" @default.
- W1485383984 title "Management of Suspected Chronic Thromboembolic Pulmonary Hypertension" @default.
- W1485383984 doi "https://doi.org/10.1002/9780470745007.ch18" @default.
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