Inside
the Surgical Suite: Meeting the Challenges of CTEPH
It is so rare to find a curable cause
of pul-monary arterial hypertension (PAH). In preparing
the topics to be covered for this issue we decided
that surgically curable PAH is one of
the most challenging situations we face, particularly
in terms of appropriate selection of patients and
in our preoperative preparation. One of the major
challenges confronting us is bringing the right patient
into the operating room suite and addressing all of
the issues impinging on our decision to perform surgery
as we determine whether the chronic thromboembolic
pulmonary hypertension (CTEPH) is surgically accessible
and to what extent we can make a correlation between
angiographic and hemodynamic findings. This is one
of the critical issues we addressed in our Roundtable
Discussion as we touched on a broad range of topics
related to thromboendarterectomy to bring you the
latest thinking from preeminent experts in the United
States and abroad.
As we consulted these experts, we
turned to the University of California, San Diego,
because this center is so widely recog-nized as the
world’s leading referral center for pulmonary thromboendarterectomy
surgery. Beginning with the pioneering work of Ken
Moser, MD, UCSD has contributed enormously to developing
guidelines for the evaluation of patients to determine
their surgical candidacy and for performance of the
procedure itself. Continuing the theme of this issue,
two articles written by UCSD investigators provide
an in-depth analysis of preoperative and operative
considerations. The first begins with the subtle and
nonspecific symptoms that may provide the first clues
of CTEPH and offers important insights on confirmatory
catheterization studies. The second article is an
insider’s view of thromboendarterectomy, information
that anyone would want to retain as an essential reference
for one’s files. The wealth of information presented
here highlights how far we have come in the evolution
of our thinking about throm-boembolic disease in the
setting of PAH. We have made dra-matic strides, moving
away from the earlier and simplistic view of its being
merely a mechanical obstruction of the major pulmonary
arteries. The experience at major centers has redefined
our approach and given us important new tools with
which to achieve that rare cure in many patients with
this disease.
Editor-in-Chief Richard Channick, MD
Professor of Clinical Medicine
Pulmonary and Critical Care Division
University of California, San Diego Medical Center
San Diego, California
Immediate Past Editor Ronald J. Oudiz, MD
Associate Professor of Medicine
The David Geffen School of Medicine at UCLA
Director, Liu Center for Pulmonary Hypertension
LA Biomedical Research Institute at Harbor-UCLA Medical Center
Editor-in-Chief Elect Erika Berman Rosenzweig, MD
Director, Pulmonary
Hypertension Center, Columbia University Medical Center Associate
Professor of Clinical Pediatrics (in Medicine)
Associate Editors
Kristin Highland, MD
Assistant Professor of Medicine
Division of Pulmonary, Critical Care, Allergy and Sleep Medicine
Medical University Of Carolina
Francisco Soto, MD, MS
Director, Pulmonary Hypertension Program
Pulmonary and Critical Care Medicine
Medical College of Wisconsin
Todd Bull, MD
Associate Professor of Medicine
Division of Pulmonary Sciences and Critical Care Medicine
University of Colorado Health Sciences Center
Robert Schilz, DO, PhD
Medical Director of Lung
Transplantation and Pulmonary Vascular Disease
University Hospital of Cleveland
Case Western Reserve University
Cleveland, Ohio
Publisher
Pulmonary Hypertension Association
Carl Hicks, Board Chair
Rino Aldrighetti, President
Sherrie Borden, Vice President, Medical and Patient Education
Publishing Staff Managing Editor
Deborah L. McBride
McBride Strategic Services
mcbridedeb@aol.com
P: 773-348-5455
C: 312-307-5455
Design Director
Michael McClain
Advances in Pulmonary Hypertension is circulated to
cardiologists, pulmonologists, rheumatologists and other selected
physicians by the Pulmonary Hypertension Association. The contents of the articles are independently determined by the Editor
and the Editorial Advisory Board.
Editorial Mission Advances in Pulmonary Hypertension is committed
to help physicians in their clinical decision
making by informing them of important
trends affecting their practice. Analyzing the
impact of new findings and covering current
information in the peer-reviewed literature,
Advances in Pulmonary Hypertension is published
four times a year. Advances in Pulmonary
Hypertension is the official journal
of the Pulmonary Hypertension Association.
Each article in this journal has been reviewed
and approved by members of the Editorial
Advisory Board.
Editorial Board
Charles Burger, MD
Medical Director, PH Clinic
Mayo Clinic
Jacksonville, FL
Karen Fagan, M.D. Chief, Division of Pulmonary and Critical Care Medicine University of South Alabama
Eli Gabbay, MD
Lung Transplant Unit
Royal Perth Hospital
Nick Kim, M.D.
Associate Clinical Professor of Medicine
University of California San Diego
Deborah Jo Levine, M.D.
University of Texas Health Science Center at San Antonio
San Antonio, TX
Omar Minai, MD
Dept of Pulmonary, Allergy and Critical Care Medicine
Myung Park, MD
Associate Professor of Medicine
Division of Pulmonary Sciences and Critical Care Medicine
University of Colorado Health Sciences Center
Fernando Torres, MD Director Pulmonary Hypertension Clinic
UTSW Medical Center Dallas
University Hospital
Glenna Traiger, RN, MSN
Pulmonary & Critical Care
Pulmonary Hypertension CNS
University of California Los Angeles
Los Angeles, CA
R. James White, MD, PhD
Assistant Professor of Medicine, Pharmacology & Physiology
University of Rochester, Division of Pulmonary and CCM
Roham Zamanian, MD
Division of Pulmonary and Critical Care Medicine
Stanford University Medical Center
The
information provided on the PHA website is provided for general information
only. It is not intended as legal, medical or other professional
advice, and should not be relied upon as a substitute for consultations
with qualified professionals who are familiar with your individual
needs.
Inside
the Surgical Suite: Meeting the Challenges of CTEPH
