TY - T1的肺部动脉内膜切除术和有限公司st of patient refusal JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01581-2018 VL - 52 IS - 3 SP - 1801581 AU - Kim, Nick H. AU - Mayer, Eckhard Y1 - 2018/09/01 UR - //www.qdcxjkg.com/content/52/3/1801581.abstract N2 - Without effective treatment, patients with chronic thromboembolic pulmonary hypertension (CTEPH) will struggle and ultimately die of right heart failure [1]. The key pathological features of CTEPH consist of obstructive chronic thrombi (resistant to thrombolysis and despite adherence to anticoagulation) in the proximal elastic pulmonary arteries combined with varying degrees of microvascular remodelling [2, 3]. Both processes contribute to pulmonary hypertension, but the successful removal of the proximal mechanical component with pulmonary endarterectomy (PEA) often leads to dramatic improvement in pulmonary hypertension with improved quality of life and better long-term survival [4–6]. Accordingly, the treatment of choice for patients suffering from CTEPH remains PEA to remove all accessible obstructive disease within the pulmonary arteries thereby improving pulmonary circulation [5, 7]. The report by Quadery et al. [8] in this issue of the European Respiratory Journal is a timely reminder regarding the importance and benefits of PEA, and the risk patients take when an offer of PEA is refused.The recommended treatment for operable chronic thromboembolic pulmonary hypertension is pulmonary endarterectomy, and patients who refused surgery in the current study had worse long-term survival than those who underwent surgery http://ow.ly/WJ0P30lBxY9 ER -