Open AccessChronic Thromboembolic Pulmonary Hypertension Medical Management
Author(s) -
R. Bruce Logue,
Zeenat Safdar
Publication year - 2021
Publication title -
methodist debakey cardiovascular journal
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.552
H-Index - 23
eISSN - 1947-6094
pISSN - 1947-6108
DOI - 10.14797/ichn7633
Subject(s) - medicine , riociguat , chronic thromboembolic pulmonary hypertension , pulmonary hypertension , pulmonary embolism , pulmonary angiography , endarterectomy , cardiology , complication , angioplasty , stenosis
Chronic thromboembolic pulmonary hypertension (CTEPH) is a common long-term complication of pulmonary embolism characterized by thromboembolic obstruction of the pulmonary arteries, vascular arteriopathy, vascular remodeling, and ultimately pulmonary hypertension (PH). Although pulmonary endarterectomy (PEA) surgery is the standard of care, approximately 40% of patients in the international CTEPH registry were deemed inoperable. In addition to lifelong anticoagulation, the cornerstone of PH-specific medical management is riociguat, a soluble guanylate cyclase stimulator. Medical management should be started early in CTEPH patients and may be used as a bridge to PEA surgery or balloon pulmonary angiography. Medical management is indicated for inoperable CTEPH patients and patients who have recurrence of PH after PEA surgery.