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Noninvasive Screening for Pulmonary Hypertension by Exercise Testing in Congenital Heart Disease Diagnosis and management of acute deep vein thrombosis: a joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function Microvascular disease in chronic thromboembolic pulmonary hypertension: a role for pulmonary veins and systemic vasculature Medical Therapy for CTEPH: Is There Still Space for More? Haemodynamic definitions and updated clinical classification of pulmonary hypertension Active and Passive Vaccination for Pulmonary Arterial Hypertension: A Novel Therapeutic Paradigm Stress Echocardiography and PH: What Do the Findings Mean? Genetic analyses in a cohort of 191 pulmonary arterial hypertension patients Circulating Plasma microRNAs In Systemic Sclerosis-Associated Pulmonary Arterial Hypertension Will Pulmonary Artery Denervation Really Have a Place in the Armamentarium of the Pulmonary Hypertension Specialist?

Original Research1993 Mar;103(3):685-92.

JOURNAL:Chest. Article Link

Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension

Moser KM, Bloor CM. Keywords: CTEPH;

ABSTRACT


The status of small pulmonary arteries may influence diagnosis, surgical selection and postoperative outcome of patients with chronic major vessel thromboembolic pulmonary hypertension (CTEPH). Therefore, in patients with the established diagnosis of CTEPH, lung tissue was obtained by biopsy (15 patients) or at autopsy (16 patients) to assess the histopathologic composition of small pulmonary arteries. Pathologic examination disclosed the full range of pulmonary hypertensive lesions in the small arteries, including plexogenic lesions. The type and extent of hypertensive lesions did not relate to preoperative hemodynamic values, to patient age, or to symptom duration. The findings indicate that primary pulmonary hypertension cannot be differentiated from potentially correctable CTEPH on the basis of histopathologic findings in small pulmonary arteries. Furthermore, none of the histologic findings preclude a positive hemodynamic and clinical result from pulmonary thromboendarterectomy. However, development of these hypertensive changes may explain the deterioration which these patients experience preoperatively over time.