ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Raising the bar to ultradisciplinary collaborations in management of chronic thromboembolic pulmonary hypertension
Tankut Akay1, Cihangir Kaymaz2, Ahmet Rüçhan Akar3, Gökçen Orhan4, Mehmed Yanartaş5, Bahadır Gültekin1, Mustafa Şırlak3, Ümit Kervan6, Serpil Gezer Taş7, Murat Biçer8, Tahir Yağdı9, Selim İspir10, Rıza Doğan11
1Department of Cardiovascular Surgery, Başkent University Faculty of Medicine Ankara Hospital, Ankara, Turkey
2Department of Cardiology, University of Health Sciences, Hamidiye Medical Faculty, Koşuyolu Heart Center, Istanbul, Turkey
3Department of Cardiovascular Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
4Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
5Department of Cardiovascular Surgery, Çam ve Sakura Hospital, Istanbul, Turkey
6Department of Cardiovascular Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
7Department of Cardiovascular Surgery, University of Health Sciences Hamidiye Medical Faculty, Koşuyolu Heart Center, İstanbul, Turkey
8Department of Cardiovascular Surgery, Uludağ University Faculty of Medicine, Bursa, Turkey
9Department of Cardiovascular Surgery, Ege University Faculty of Medicine, Izmir, Turkey
10Department of Cardiovascular Surgery, Acıbadem University Faculty of Medicine, Istanbul, Turkey
11Department of Cardiovascular Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2021.21284
Chronic thromboembolic pulmonary hypertension is an underdiagnosed and potentially fatal subgroup of pulmonary hypertension, if left untreated. Clinical signs include exertional dyspnea and non-specific symptoms. Diagnosis requires multimodality imaging and heart catheterization. Pulmonary endarterectomy, an open heart surgery, is the gold standard treatment of choice in selected patients in specialized centers. Targeted medical therapy and balloon pulmonary angioplasty can be effective in high-risk patients with significant comorbidities, distal pulmonary vascular obstructions, or recurrent/persistent pulmonary hypertension after pulmonary endarterectomy. Currently, there is a limited number of data regarding novel coronavirus-2019 infection in patients with chronic thromboembolic pulmonary hypertension and the changing spectrum of the disease during the pandemic. Challenging times during this outbreak due to healthcare crisis and relatively higher case-fatality rates require convergence; that is an ultradisciplinary collaboration, which crosses disciplinary and sectorial boundaries to develop integrated knowledge and new paradigms. Management strategies for the "new normal" such as virtual care, preparedness for further threats, redesigned standards and working conditions, reevaluation of specific recommendations, and online collaborations for optimal decisions for chronic thromboembolic pulmonary hypertension patients may change the poor outcomes.
Keywords : Balloon pulmonary angioplasty, chronic thromboembolic pulmonary hypertension, pulmonary endarterectomy, pulmonary thromboembolism, targeted medical therapy
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