Bypass, circulatory arrest, and pulmonary endarterectomy.

摘要

Severe pulmonary hypertension as a result of chronic thromboembolic disease is a common disorder, but one that is often unappreciated. It results from the failure of resolution of episodes of acute pulmonary emboli, which are often missed clinically, even though acute pulmonary embolism is the third most common cause of death (after heart disease and cancer). The incidence of chronic thromboembolic disease has been estimated to be more than 3% after acute pulmonary embolism,1 although, partly for the reasons stated above, its true incidence is unknown. Considering that acute embolic events often occur without symptoms, and that even symptomatic pulmonary embolism is often overlooked or misdiagnosed in clinical practice, an estimate of more than 5000 new cases of chronic thromboembolic pulmonary hypertension in the UK every year is probably conservative.