Publication: Manejo de la hipertensión pulmonar tromboembólica crónica: nuevas líneas de trabajo
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2019-02-04
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Universidad Complutense de Madrid
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Abstract
La hipertensión pulmonar tromboembólica crónica es una patología rara que consiste en una enfermedad vascular pulmonar progresiva. El tromboembolismo pulmonar, no resuelto completamente, es su causa más frecuente; la oclusión crónica del árbol vascular pulmonar conduce a insuficiencia respiratoria y cardiaca. El pronóstico sin tratamiento es nefasto; con una supervivencia del 30% a los 5 años cuando la presión media en arteria pulmonar es mayor de 40 mmHg. El tratamiento de elección y potencialmente curativo es la cirugía de tromboendartetectomía pulmonar. El procedimiento ha demostrado ser seguro y eficaz; en la mayoría de los pacientes intervenidos desaparecen los síntomas y se normalizan los parámetros hemodinámicos. Este tratamiento puede indicarse en, al menos, un 60% de los pacientes con hipertensión pulmonar tromboembólica crónica. La alternativa terapéutica para los pacientes inoperables ha sido, hasta hace poco, el tratamiento médico específico para hipertensión pulmonar, sustentando su uso en la eficacia demostrada en otros tipos de hipertensión pulmonar...
Chronic thromboembolic pulmonary hypertension is a rare disease that consists of a progressive illness of the vessels of the lungs. A pulmonary thromboembolism, not entirely cured, is its most frequent cause; the chronic occlusion of the pulmonary vascular tree leads to respiratory and heart failure. Prognosis without treatment is disastrous, with a 5-year survival rate of 30% when the mean pressure in the pulmonary artery is higher than 40mmHg. The treatment chosen, and potentially curative, is pulmonary thromboendarterectomy surgery. The procedure has proven to be safe and efficient; in most intervened patients, symptoms disappear and hemodynamic parameters are normalized. This treatment can be proposed to at least 60% of patients with chronic thromboembolic pulmonary hypertension. The therapeutic alternative for inoperable patients has been, until recently, the specific medical treatment for pulmonary hypertension, supporting its use with the efficiency proven in other types of pulmonary hypertension...
Chronic thromboembolic pulmonary hypertension is a rare disease that consists of a progressive illness of the vessels of the lungs. A pulmonary thromboembolism, not entirely cured, is its most frequent cause; the chronic occlusion of the pulmonary vascular tree leads to respiratory and heart failure. Prognosis without treatment is disastrous, with a 5-year survival rate of 30% when the mean pressure in the pulmonary artery is higher than 40mmHg. The treatment chosen, and potentially curative, is pulmonary thromboendarterectomy surgery. The procedure has proven to be safe and efficient; in most intervened patients, symptoms disappear and hemodynamic parameters are normalized. This treatment can be proposed to at least 60% of patients with chronic thromboembolic pulmonary hypertension. The therapeutic alternative for inoperable patients has been, until recently, the specific medical treatment for pulmonary hypertension, supporting its use with the efficiency proven in other types of pulmonary hypertension...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 13-06-2018