Long term outcome, aetiological factors and predictors of mortality in chronic thromboembolic pulmonary hypertension

Chronic thromboembolic pulmonary hypertension occurs when blood clots in the lungs do not resolve. This causes the pressure in the lungs to rise and without treatment it is a serious condition which reduces life expectancy. It occurs in approximately 1 in 20 patients who have had a lung clot (also known as a pulmonary embolism). The condition can be potentially cured by an operation called pulmonary endarterectomy where the chronic lung clots are removed. However, not all patients are suitable for the operation and some patients who are suitable for the operation decline surgery. This study identifies a number of tests that can be used to identify patients at highest risk of dying and shows that surgery provides very good long term results which are superior to those who decline surgery. The results of this study will help doctors and patients with CTEPH when discussing treatment options. The authors conclude that more work is required to ensure that patients are counselled and supported to make informed decisions.