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 Ronald J. Oudiz, MD
Associate Professor of Medicine
UCLA School of Medicine
Director, Liu Center for Pulmonary Hypertension
Division of Cardiology
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
Torrance, California
Immediate Past Editor Vallerie V. McLaughlin, MD
Associate Professor of Medicine
Director, Pulmonary Hypertension Program
University of Michigan Health System
Ann Arbor, Michigan
Editor-in-Chief Elect Richard Channick, MD
Professor of Clinical Medicine
Pulmonary and Critical Care Division
University of California, San Diego Medical Center
San Diego, California
Associate Editors Erika Berman Rosenzweig, MD
Assistant Professor of Pediatrics
Department of Pediatrics
Columbia College of Physicians and Surgeons
New York, New York
Robert Frantz, MD
Consultant in Cardiovascular
Diseases and Internal Medicine
Assistant Professor of Medicine
Mayo Clinic College of Medicine
Rochester, Minnesota
Srinivas Murali, MD, FACC
Professor of Medicine
Drexel University College of Medicine
Director, Division of Cardiovascular Medicine
Medical Director, Gerald McGinnis Cardiovascular Institute
Allegheny General Hospital
Pittsburgh, Pennsylvania
Publisher
Pulmonary Hypertension Association
Jack Stibbs, Board Chair
Rino Aldrighetti, President
Rachel Pokorney, Medical Services Associate Director
Publishing Staff
Stu Chapman, Executive Editor
Susan Chapman, Managing Editor
Heidi Green, Associate Editor
Gloria Catalano, Production Director
Michael McClain, Design Director
Editorial Offices
Advances in Pulmonary Hypertension
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Tel: 631-288-7733
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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 ly 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
Todd Bull, MD
Division of Pulmonary Sciences and Critical Care Medicine
University of Colorado Health Sciences Center
Denver, Colorado
Murali Chakinala, MD
Director, Pulmonary Hypertension Clinic
Washington University School of Medicine
St. Louis, Missouri
Kristin Highland, MD
Assistant Professor
Division of Pulmonary and Critical Care
Director, Pulmonary Hypertension Clinic
Medical University of South Carolina
Charleston, South Carolina
Jim Maloney, MD
Associate Professor of Pulmonary and Critical Care Medicine
University of Colorado Health Sciences Center
Denver, Colorado
Ioana Preston, MD
Assistant Professor of Medicine
Tufts - New England Medical Center
Boston, Massachusetts
Zeenat Safdar, MD
Assistant Professor of Medicine
Department of Medicine, Pulmonary & Critical Care Section
Pulmonary Hypertension Center
Baylor College of Medicine
Houston, Texas
Rajan Saggar, MD
Assistant Professor
Division of Pulmonary and Critical Care
Medicine and Hospitalists
David Geffen School of Medicine
UCLA
Los Angeles, California
Robert Schilz, DO, PhD
Medical Director of Lung
Transplantation and Pulmonary Vascular Disease
University Hospital of Cleveland
Case Western Reserve University
Cleveland, Ohio
Francisco Soto, MD, MS
Assistant Professor
Director, Pulmonary Hypertension Program
Medical College of Wisconsin
Milwaukee, Wisconsin
Roxana Sulica, MD
Assistant Professor of Medicine
Albert Einstein College of Medicine
Director, Beth Israel Pulmonary Hypertension Program
Beth Israel Medical Center
New York, New York
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Inside
the Surgical Suite: Meeting the Challenges of CTEPH
