Severe Dyspnea Hampers Healthy Fire Chief
While under the care of a regional medical practice, the patient experienced sudden respiratory decline at home. He was taken to a local hospital emergency department where he was diagnosed with 4 pulmonary emboli, 2 in each lung. He was treated with supplementary oxygen and a blood thinner and released from the hospital following a short stay.
A month after discharge, he experienced another embolism and was referred to a trauma center where the medical team diagnosed chronic thromboembolic pulmonary hypertension (CTEPH). The patient began a course of oral sildenafil. He continued his workouts, but the medical therapy and conditioning did not relieve the worsening dyspnea. The patient sought consultations with a cardiologist, a pulmonologist, and other specialists to discuss options. He was referred to Victor J. Test, MD, a Duke pulmonologist who specializes in surgery to treat pulmonary hypertension (PH).
Question: After work-up and evaluation, what did Duke pulmonologists and thoracic surgeons recommend as the most effective option?