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Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT) 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society Door to Balloon Time: Is There a Point That Is Too Short? Successful catheter ablation of electrical storm after myocardial infarction Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients Mode of Death in Heart Failure With Preserved Ejection Fraction Is Acute heart failure a distinctive disorder? An analysis from BIOSTAT-CHF

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

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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.