Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Technical challenges and controversies
Chronic thromboembolic pulmonary hypertension requires referral to an expert center for final diagnosis and assessment of treatment possibilities by a multidisciplinary team. Pulmonary endarterectomy is the only potentially curative therapy and therefore remains the treatment of choice. However, man...
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| Language: | English |
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Elsevier
2025-11-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133425001521 |
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| author | Tom Verbelen, MD, PhD Elie Fadel, MD, PhD Christoph B. Wiedenroth, MD, PhD David P. Jenkins, MS (Lond), FRCS (CTh) Michael M. Madani, MD, PhD |
| author_facet | Tom Verbelen, MD, PhD Elie Fadel, MD, PhD Christoph B. Wiedenroth, MD, PhD David P. Jenkins, MS (Lond), FRCS (CTh) Michael M. Madani, MD, PhD |
| author_sort | Tom Verbelen, MD, PhD |
| collection | DOAJ |
| description | Chronic thromboembolic pulmonary hypertension requires referral to an expert center for final diagnosis and assessment of treatment possibilities by a multidisciplinary team. Pulmonary endarterectomy is the only potentially curative therapy and therefore remains the treatment of choice. However, many practices and minor technical aspects of this procedure may still provoke controversy. Based on the most recent literature and the author’s own experiences and opinions, and in lack of clear guidelines, this review discusses the rationale for blood management strategies; practices during deep hypothermic circulatory arrest; concomitant surgical procedures; pulmonary endarterectomy in specific patient populations, in redo setting and for other diseases; the role of balloon pulmonary angioplasty and of minimal access techniques; and the required surgical expertise. Well-founded recommendations can only be made for a few of them. |
| format | Article |
| id | doaj-art-2fc427ed87d74c41bc0f5cf959cad19f |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-2fc427ed87d74c41bc0f5cf959cad19f2025-08-20T05:08:33ZengElsevierJHLT Open2950-13342025-11-011010035710.1016/j.jhlto.2025.100357Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Technical challenges and controversiesTom Verbelen, MD, PhD0Elie Fadel, MD, PhD1Christoph B. Wiedenroth, MD, PhD2David P. Jenkins, MS (Lond), FRCS (CTh)3Michael M. Madani, MD, PhD4Department of Cardiac Surgery, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven-University of Leuven, Leuven, Belgium; Corresponding author: Tom Verbelen, MD, PhD, Department of Cardiac Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.Thoracic Surgery, Marie Lannelongue Hospital, Paris-Saclay University, Le Plessis Robinson, FranceKerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, GermanyCardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United KingdomCardiovascular and Thoracic Surgery, University of California San Diego, La Jolla, CaliforniaChronic thromboembolic pulmonary hypertension requires referral to an expert center for final diagnosis and assessment of treatment possibilities by a multidisciplinary team. Pulmonary endarterectomy is the only potentially curative therapy and therefore remains the treatment of choice. However, many practices and minor technical aspects of this procedure may still provoke controversy. Based on the most recent literature and the author’s own experiences and opinions, and in lack of clear guidelines, this review discusses the rationale for blood management strategies; practices during deep hypothermic circulatory arrest; concomitant surgical procedures; pulmonary endarterectomy in specific patient populations, in redo setting and for other diseases; the role of balloon pulmonary angioplasty and of minimal access techniques; and the required surgical expertise. Well-founded recommendations can only be made for a few of them.http://www.sciencedirect.com/science/article/pii/S2950133425001521chronic thromboembolic pulmonary hypertension (CTEPH)pulmonary endarterectomy (PEA)deep hypothermic circulatory arrest (DHCA)multimodality treatmentsurgical expertise |
| spellingShingle | Tom Verbelen, MD, PhD Elie Fadel, MD, PhD Christoph B. Wiedenroth, MD, PhD David P. Jenkins, MS (Lond), FRCS (CTh) Michael M. Madani, MD, PhD Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Technical challenges and controversies JHLT Open chronic thromboembolic pulmonary hypertension (CTEPH) pulmonary endarterectomy (PEA) deep hypothermic circulatory arrest (DHCA) multimodality treatment surgical expertise |
| title | Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Technical challenges and controversies |
| title_full | Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Technical challenges and controversies |
| title_fullStr | Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Technical challenges and controversies |
| title_full_unstemmed | Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Technical challenges and controversies |
| title_short | Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Technical challenges and controversies |
| title_sort | pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension technical challenges and controversies |
| topic | chronic thromboembolic pulmonary hypertension (CTEPH) pulmonary endarterectomy (PEA) deep hypothermic circulatory arrest (DHCA) multimodality treatment surgical expertise |
| url | http://www.sciencedirect.com/science/article/pii/S2950133425001521 |
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