Chronic thromboembolic pulmonary hypertension: detection, medical and surgical treatment approach, and current outcomes
V/Q remains the most widely sensitive test for the detection of chronic thromboembolic pulmonary hypertension (CTEPH). The combination of an abnormal V/Q scan and confirmatory digital substraction pulmonary angiography (DSPA) is the current gold standard for the detection of CTEPH and for operability assessment respectively. Although previous studies showed a wide gap between the sensitivity of V/Q (96%) and CTPA (51%), CTPA imaging has advanced with recent study showing that CTPA had a sensitivity of 92% in 114 consecutive patients being evaluated for CTEPH. Nonetheless, the simplicity of interpretation inherent with a V/Q scan along with the difficulties to recognise findings of CTEPH on CTPA makes perfusion scan the ideal screening study in the evaluation of patients for CTEPH.
Heart Fail Rev 2016; 21(3): 309-322