Subscribe to RSS
DOI: 10.1055/s-0030-1253688
© Georg Thieme Verlag KG Stuttgart · New York
Chronisch thromboembolische pulmonale Hypertension (CTPH)
Krankheitsbild und chirurgische BehandlungsmöglichkeitenChronic thromboembolic pulmonary hypertension (CTPH)Disease pattern and surgical optionsPublication History
eingereicht: 21.10.2009
akzeptiert: 18.3.2010
Publication Date:
05 May 2010 (online)

Zusammenfassung
Die chronisch thromboembolisch pulmonale Hypertension (CTPH) ist ein häufig unterschätztes Krankheitsbild, welches ursächlich für eine schwere pulmonale Hypertonie und Rechtsherzversagen ist. Gegenwärtig entwickelt sich bei 1 % bis 4 % der Patienten, die eine Lungenembolie überlebt haben, eine CTPH. Für den Großteil dieser Patienten stellt die pulmonale Endarteriektomie (PEA) die einzige kurative Behandlung dar. Diagnostik und Behandlung sollten aufgrund der Komplexität der Erkrankung in einem erfahrenen Zentrum durchgeführt werden.
Abstract
Chronic thromboembolic pulmonary hypertension CTPH is an important cause of severe pulmonary hypertension and right-sided heart failure, which has been under recognised in the past. Current estimates indicate that 1 % to 4 % of patients who survive a pulmonary embolus will develop CTPH. Appropriate diagnosis and assessment are vital as the majority of patients with this condition can be effectively cured with pulmonary endarterectomy (PEA). Assessment and surgical treatment of these patients should only be carried out in a centre with significant experience in treating this condition.
Schlüsselwörter
chronisch thromboembolische pulmonale Hypertension - CTPH - pulmonale Hypertonie - pulmonale Endarteriektomie - PEA
Keywords
chronic thromboembolic pulmonary hypertension - CTPH - pulmonary endarterectomy - PEA
Literatur
- 1
Blazquez J A, Escribano P, Perez E. et al .
Chronic thrombombolic pulmonary
hypertension: Surgical treatment with thromboenderterectomy.
Arch
Bronconeumol.
2009;
45
496-501
MissingFormLabel
- 2
D’Armini A M, Cattadori B, Monterosso C. et al .
Pulmonary thromboendarteriectomy
in patients with chronic thromboembolic pulmonary hypertension:
hemodynamic characteristics and changes.
Eur J Cardiothorac
Surg.
2000;
18
696-701
MissingFormLabel
- 3
Dittrich H C, Chow L C, Nicod P H.
Early improvement in left ventricular diastolic
function after relief of chronic right ventricular pressure overload.
Circulation.
1989;
80
823-830
MissingFormLabel
- 4
Doyle R L, McCrory D, Channick R N. et al .
Surgical treatments/interventions
for pulmonary arterial hypertension: ACCP evidence-based clinical
practice guidelines.
Chest.
2004;
1126
63S-71S
MissingFormLabel
- 5
Dumitrescu D, Ghofrani H A, Grimminger F. et al .
Update: Current clinical
developments in pulmonary hypertension.
Dtsch Med Wochenschr.
2009;
134
S160-S163
MissingFormLabel
- 6
Fedullo P F, Auger W R, Kerr K M, Rubin L J.
Chronic
thromboembolic pulmonary hypertension. Current concept.
N
Engl J Med.
2001;
345
1465-1472
MissingFormLabel
- 7
Fedullo P F, Auger W R, Dembitsky W P.
Postoperative management of the patient
undergoing pulmonary artery thromboendarterectomy.
Semin
Thorac Cardiovasc Surg.
1999;
11
172-178
MissingFormLabel
- 8
Gilbert T B, Gaine S P, Rubin L J, Sequeira A J.
Short-term
outcome and predictors of adverse events following pulmonary thromboendarterectomy.
World J Surg.
1998;
22
1029-1032
MissingFormLabel
- 9
Hartz R S, Byrne J G, Levitsky S. et al .
Predictors of mortality in pulmonary thromboendarterectomy.
Ann Thorac Surg.
1996;
62
1255-1260
MissingFormLabel
- 10
Iversen S, Felderhoff T.
Chirurgie der chronischen
pulmonalen Druckerhöhung.
Herz.
2005;
30
274-280
MissingFormLabel
- 11
Jamieson S W, Kapelanski D P, Sakakibara N. et al .
Pulmonary endarteriectomy:
experience and lessons learned in 1500 cases.
Ann Thorac Surg.
2003;
76
1457-1462
MissingFormLabel
- 12
Lang I.
Chronische thromboembolische pulmonale Hypertension: Eine interdisziplinäre
Herausforderung.
Clinicum pneumo.
2008;
5
1-4
MissingFormLabel
- 13
Lang I, Bonderman D, Klepetko W, Kneussl M P.
Pulmonale
Hypertension, Pathologie, Diagnose, Therapie.
J Hyperton.
2001;
5
38-47
MissingFormLabel
- 14
Menzel T, Wagner S, Kramm T. et al .
Pathophysiology of impaired right and left
ventricular function in chronic pulmonary hypertension: changes
after pulmonary thromboendarterectomy.
Chest.
2000;
118
897-903
MissingFormLabel
- 15
Mo M, Kapelanski D P, Mitruka S N. et al .
Reoperative pulmonary thromboendarterectomy.
Ann Thorac Surg.
1999;
68
1770-1776
MissingFormLabel
- 16
Pengo V, Lensing A W, Prins M H. et al .
Incidence of chronic thromboembolic
pulmonary hypertension after pulmonary embolism.
N Engl J
Med.
2004;
350
2257-2264
MissingFormLabel
- 17
Presti B, Berthrong M, Sherwin R M.
Chronic thrombosis of major pulmonary arteries.
Ilum
Pathol.
1990;
21
601-606
MissingFormLabel
- 18
Rich S, Levitsky S, Brundage B H.
Pulmonary hypertension from chronic pulmonary thrombembolism.
Ann Intern Med.
1988;
108
425-434
MissingFormLabel
- 19
Rubens F, Wells P, Benze S, Bourke M.
Surgical treatment of chronic thromboembolic
pulmonary hypertension.
Can Respir J.
2000;
7
49-57
MissingFormLabel
- 20
Thistlethwaite P A, Mo M, Madani M M. et al .
Operative classification
of thromboembolic disease determines outcome after pulmonary endarterectomy.
J Thorac Cardiovasc Surg.
2002;
123
1203-1211
MissingFormLabel
- 21
Trulock E P, Edwards L B, Taylor D O. et al .
Registry of the international society
for heart and lung transplantation: 22. official adult lung and heart-lung
transplant report 2005.
J Heart Lung transplant.
2005;
24
956-967
MissingFormLabel
- 22
Tscholl D, Langer F, Wendler O. et al .
Pulmonary thromboendarterectomy-risk factors
for early survival and hemodynamic improvement.
Eur J
Cardiothorac Surg.
2001;
19
771-776
MissingFormLabel
- 23
Wahlers T.
Chirurgische Therapie der pulmonalen Hypertonie.
Dtsch Med
Wochenschr.
2006;
131
S315-S318
MissingFormLabel
PD Dr. med. Jens Wippermann
Herzzentrum der Universität zu Köln
Kerpener Str. 62
50924 Köln
Phone: 0221/478-32406
Fax: 0221/478-32648
Email: jens.wippermann@uk-koeln.de