Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension

1255 May 2014 C HRONIC thromboembolic pulmonary disease is an important cause of severe pulmonary hypertension and is associated with significant morbidity and mortality. At 2-yr follow-up, 3.8% of survivors of an acute pulmonary embolic event develop chronic thromboembolic pulmonary hypertension (CTEPH) defined as a persistent mean pulmonary arterial pressure greater than 25 mmHg for 6 months after the inciting event.1,2 Chronic thromboembolic pulmonary hypertension is progressive in nature and carries a poor prognosis due to the limited efficacy of medical therapy. Surgical intervention by pulmonary thromboendarterectomy (PTE) or lung transplantation is the only effective cure.1 However, because the mortality rate of untreated CTEPH approaches 90% after 3 yr, the scarcity of available organs limits the viability of transplantation as a therapeutic option.3 Therefore, PTE has become the therapy of choice for patients with CTEPH, and a thorough understanding of the procedure and the medical management of these patients is necessary. We now review the anesthetic management and perioperative outcomes of the patients undergoing PTE.