Right Heart Catheterization
Right heart catheterization (RHC) is mandatory in the diagnosis of pulmonary hypertension (PH)
In CTEPH, the RHC has additional importance, as pulmonary vascular resistance is the most important determinant of prognosis and the risk associated with pulmonary endarterectomy (PTE) (also called pulmonary endarterectomy [PEA])1
CTEPH is defined as precapillary PH as assessed by RHC (mean pulmonary arterial pressure [PAP] ≥25 mm Hg, pulmonary capillary wedge pressure [PCWP] ≤15 mm Hg) in the presence of multiple chronic/organized occlusive thrombi/emboli in the elastic pulmonary arteries (main, lobar, segmental, subsegmental) after at least 3 months of effective anticoagulation 2
1. Jenkins D, Mayer E, Screaton N, Madani M. State-of-the-art chronic thromboembolic pulmonary hypertension diagnosis and management. Eur Respir Rev. 2012;21(123):32-39. 2. Wilkens H, Lang I, Behr J, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): updated recommendations of the Cologne Consensus Conference 2011. Int J Cardiol. 2011;154(Suppl 1):S54-S60. 3. Mathier M. The nuts and bolts of interpreting hemodynamics in pulmonary hypertension associated with diastolic heart failure. Advances in PH. 2011;10(1):33-40.