Mercier O, Sage E, de Perrot M et al.
Laboratoire de Chirurgie Expérimentale, Université Paris XI Hôpital Marie Lannelongue, Le Plessis-Robinson, France.
J Thorac Cardiovasc Surg 2009;137:1538–46.
Editor’s note: High pulmonary blood flow is recognized as a cause of pulmonary hypertension (PH) in e.g. congenital heart disease with a left-to-right shunt, and chronic thromboebolic PH (CTEPH). In the latter, high pulmonary blood flow in the non-obstructed areas results in an elevation of pulmonary vascular resistance due to distal arteriopathy and vascular remodeling. CTEPH is a life-threatening disease thought to occur in up to 3.8% of patients with acute pulmonary embolism (
N Engl J Med 2004;350:2257–64) and overall 5-year survival rates have been reported to be 10% in those with a mean PA pressure >50 mmHg (
Chest 1982;81:151–8). Pulmonary thromboendarterectomy (PTE) provides long-term hemodynamic and functional benefits, as well as an increased life expectancy, but is associated with a 5–23% mortality rate (
Ann Thorac Surg 2003;76:1457–62,
Eur J Cardiothorac Surg 1999;16:38–43,
Ann Thorac Surg 1996;62:1255–9). The objective of the current study was to investigate whether the vasculopathy caused by chronic high pulmonary blood flow could be reversed following a return to normal blood flow, as might be the case in CTEPH after a thromboendarterectomy.