Expert consensus on approaches to risk stratification and choice of therapy in patients with inoperable and residual chronic thromboembolic pulmonary hypertension

On December 13, 2024, the final working group meeting was held, the purpose of which was to discuss the common position of experts on the problem of chronic thromboembolic pulmonary hypertension of various specialties: cardiologists, cardiac surgeons, pulmonologists, on issues of assessing the operability of patients, risk stratification and choice of therapy in patients with inoperable and residual forms of pathology. The discussion field included a wide range of issues that often arise in real clinical practice, but specific answers to them are not given in national and foreign guidelines. On November 8, 2024, at the preparatory stage, 16 experts under the leadership of Academician of the Russian Academy of Sciences I.E. Chazova (chairman) formulated questions for the preparation of a consensus document (without discussion), consistently discussing the feasibility of including each issue in the document and distributing tasks for the final session. Then, at the intermediate stage, experts searched and systematized scientific information on the formulated questions in the PubMed and eLIBRARY systems to prepare sections of the document in accordance with the established tasks. When finalizing the document, experts answered 28 questions: during anonymous voting an individual score was determined for each block from 1 - completely disagree, to 5 - completely agree. It was considered that a strong consensus was achieved with a mean score of M±m 2.5±2, and with a mean score below 2.5, consensus was not achieved. A strong consensus was reached on all issues.