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Chronic thromboembolic pulmonary hypertension—medical, interventional, and surgical therapy

Chronische thromboembolische pulmonale Hypertonie – medikamentöse, interventionelle und chirurgische Behandlung

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Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is an important late sequela of pulmonary embolism and a common form of pulmonary hypertension. Currently, three specific treatment modalities are available: pulmonary endarterectomy, balloon pulmonary angioplasty, and targeted medical therapy. The treatment decision depends mainly on the exact localization of the underlying pulmonary arterial obstructions. Pulmonary endarterectomy is the gold standard treatment of CTEPH. For inoperable patients, riociguat and treprostinil are approved. In addition, interventional therapy is recommended if appropriate target lesions are proven. Evaluation and treatment of patients with CTEPH in experienced centers are mandatory.

Zusammenfassung

Die chronische thromboembolische pulmonale Hypertonie (CTEPH) stellt eine wichtige Spätkomplikation der akuten Lungenembolie und eine häufige Form von pulmonaler Hypertonie dar. Es stehen derzeit 3 Therapiemodalitäten zur Verfügung: die pulmonale Endarteriektomie, die pulmonale Ballonangioplastie und die gezielte medikamentöse Behandlung. Das therapeutische Konzept orientiert sich maßgeblich an der Lokalisation der pulmonalarteriellen Obstruktionen. Die pulmonale Endarteriektomie ist die Behandlung der Wahl bei CTEPH. Für inoperable Patienten sind Riociguat und Treprostinil zugelassene Therapien. Daneben wird bei Vorhandensein entsprechender Zielläsionen die interventionelle Behandlung empfohlen. Evaluation und Therapie von CTEPH-Patienten sollte in entsprechend erfahrenen Zentren erfolgen.

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Change history

  • 27 May 2023

    The second sentence in the abstract should have read ‘Currently, three specific treatmentmodalities are available: pulmonary endarterectomy, balloon pulmonary angioplasty, and targeted medical therapy.’ instead of ‘Currently, three specific treatmentmodalities are available: pulmonary endarterectomy, pulmonary balloon angioplasty, and targeted medical therapy.’

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Authors and Affiliations

  1. Department of Thoracic Surgery, Kerckhoff Heart and Thorax Center, Benekestr. 2–8, 61231, Bad Nauheim, Germany

    Christoph B. Wiedenroth, Diethard Pruefer, Miriam S. D. Adameit, Eckhard Mayer & Stefan Guth

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Correspondence to Christoph B. Wiedenroth.

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Conflict of interest

C.B. Wiedenroth has received speaker fees and/or consultant honoraria from Actelion, AOP Orphan Pharmaceuticals AG, Bayer AG, BTG, MSD, OrphaCare GmbH, and Pfizer. D. Pruefer has received speaker fees and/or consultant honoraria from AstraZeneca, Johnson&Johnson, and Bayer AG. E. Mayer has received speaker fees and/or consultant honoraria from Actelion, Janssen, Bayer AG, and MSD. S. Guth has received speaker fees and/or consultant honoraria from Actelion, Bayer AG, MSD, and Pfizer. M.S. D. Adameit declares that she has no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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The second sentence in the abstract should have read: “Currently, three specific treatment modalities are available: pulmonary endarterectomy, balloon pulmonary angioplasty, and targeted medical therapy.” instead of “Currently, three specific treatment modalities are available: pulmonary endarterectomy, pulmonary balloon angioplasty, and targeted medical therapy.”

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Wiedenroth, C.B., Pruefer, D., Adameit, M.S.D. et al. Chronic thromboembolic pulmonary hypertension—medical, interventional, and surgical therapy. Herz 48, 280–284 (2023). https://doi.org/10.1007/s00059-023-05172-8

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