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Pulmonary endarterectomy: the lancet first, tears for pills

, : Pulmonary endarterectomy: the lancet first, tears for pills. Minerva Medica 105(5 Suppl 1): 7-13

Chronic thromboembolic pulmonary hypertension (CTEPH) is a progressive disease due to the incomplete resolution of pulmonary emboli, leading to right heart failure, with a poor survival. Pulmonary endarterectomy (PEA) is the operation of choice for CTEPH. As there are no well-defined criteria to discriminate surgically accessible from inaccessible obstructive lesions, the operability assessment relies on the surgeon's experience. The recommended algorithms to perform a correct diagnosis of CTEPH still suggest the lung ventilation/perfusion scan, despite advances in computed tomography with 3-D reconstruction and magnetic resonance imaging. Selective pulmonary angiography is the gold standard to assess operability in CTEPH. Medical therapy should not be considered an alternative to PEA, as it should be reserved to patients with either peripheral disease, deemed inoperable by an experienced PEA surgeon, or persistent/recurrent pulmonary hypertension after PEA. Lung transplantation, when indicated, still represents a viable option for patients with either inoperable CTEPH or CTEPH with concomitant severe parenchymal lung disease that contraindicates PEA. The outcome of operable CTEPH is still best predicted after surgery. Remarkably, the recovery of exercise capacity is not as immediate as hemodynamic improvement, underlining the importance of early identification of surgical candidates before physical deconditioning.


PMID: 25396687

Other references

Lohnes R.A.; Demirel T., 1975: Relationship of mineralogy to soil strength in severely weathered tropical soils. Abstracts with Programs Geological Society of America: Pages 1175. 1975.

Radgill, S.C.; Fox, A.D.; Hill, D., R., 1992: Cold weather movements of waterfowl in Western Europe (book review). The Journal of Animal Ecology 61(1 ): 8-9

Hashimoto, H.; Yamamura, M.; Nishiya, K.; Ota, Z., 1994: Impaired interleukin-8-dependent chemotaxis by synovial fluid polymorphonuclear leukocytes in rheumatoid arthritis. The accumulation of polymorphonuclear leukocytes (PMN) in synovial fluid is a common feature of rheumatoid arthritis (RA). We studied the chemotactic response of PMN obtained from the synovial fluid and from the peripheral blood of patients with R...

Stephenson, M., 2013: Gardens that heal. Beginnings 33(3): 4-7

Bertero, R.; Saracco, C.; Bruno, G., 1963: Clinical Evaluation Of A New Anti-Ulcer Product (Geranyl Farnesylacetate). Minerva Gastroenterologica 18: 158-165

Rieke, F.E., 1976: On industry's financial stake in manpower. Environmental Research 11(2): 151-155

Rao, Q.; Zheng, G-Guang.; Li, G.; Lin, Y-Min.; Wu, K-Fu., 2004: Membrane-bound macrophage colony-stimulating factor mediated auto-juxtacrine downregulates matrix metalloproteinase-9 release on J6-1 leukemic cell. Earlier studies indicate that J6-1 human leukemic cells proliferate and propagate via the membrane-bound macrophage colony-stimulating factor (M-CSF)-mediated auto-juxtacrine mechanism. Matrix metalloproteinases (MMPs) can modulate the activity of...

Abuladze, T.Z.; Nemsadze, G.G.; Gersamiia, G.K., 2006: The role of definition of receptor status in the prognosis and the choice of adequate treatment tactics of breast tumors. Georgian Medical News: 22-24

Warren, B.A., 1966: The ultrastructure of capillary sprouts induced by melanoma transplants in the golden hamster. Journal. Royal Microscopical Society 86(2): 177-187

Dutrillaux, B.; Rumpler, Y., 1987: The role of chromosomes in speciation: a new interpretation. Chromosomes Today 9: 75-90