In chronic thromboembolic pulmonary hypertension (CTEPH), when fibrotic obstructions within the pulmonary arteries are surgically accessible, the clinical pathway is well-defined and guides selection of the appropriate intervention.
This protocol applies to patients with CTEPH who have fibrotic obstructions within the pulmonary arteries that are accessible by surgery — an operable presentation. The location and nature of the lesions make a surgical approach feasible and, per current evidence, the preferred strategy.
For this operable population, a specific surgical procedure targeting the pulmonary arteries bilaterally is the treatment of choice. The precise technique, operative steps, and full procedural requirements are detailed in the complete protocol.
The primary goals are achieving a good functional class (WHO-FC I–II) and normalization or near-normalization of resting haemodynamics. These are evaluated by right heart catheterisation 3–6 months after the procedure.