摘要
慢性,大血管血栓栓塞性肺动脉高压(CTEPH),是一种不常见的情况,在过去,是一个尸检珍品。诊断方法、手术技术和术后管理的进步已经将这种疾病转变为一种可能治愈的肺动脉高压形式。主要症状是用力时无法解释的呼吸困难。对于有此症状的患者,应考虑CTEPH。在诊断过程中存在着许多缺陷。灌注肺扫描有助于诊断,但往往低估了中央动脉阻塞的程度。肺血管造影是关键的诊断程序,但血栓组织-再通的许多模式需要一个经验的基础来正确的解释。选择手术患者的标准在不断发展,但确保血栓对手术的可及性至关重要。外科血栓内膜切除术与急性肺栓塞切除术没有相似之处。对血栓(相对于正常内膜)的识别、细致的解剖和无血的手术野是充分恢复肺血管通畅的必要条件。 Multiple complications may arise postoperatively, and detailed attention to these is required for patient survival. With a co-ordinated, multi-specialty team effort, however, haemodynamic and clinical outcomes have been rewarding and persist long-term. Surgical mortality should steadily decline with such a co-ordinated effort, as well as earlier diagnosis and advances in surgical and postoperative management techniques.