Surgical management of pulmonary endarterectomy avoiding deep hypothermia: the Pavia experience

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease included in group 4 of the pulmonary hypertension (PH) clinical classification system (1). CTEPH is characterized by the presence of obstructed pulmonary arteries by thromboembolic material and the remodeling of the remaining patent vessels (2). These vascular changes lead to PH, decreased right ventricular function and subsequent right heart failure, clinical deterioration and premature mortality (3). Although the actual incidence of CTEPH is unknown, a cumulative incidence of 0.1–9.1% within the first two years after a symptomatic pulmonary embolism event, has been reported (2).