A tiny sensor inside the lung could reveal hidden pressure problems after Life-Saving surgery

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Given the exploratory proof-of-concept nature of the study and the limited sample, a risk enrichment strategy will be applied. Whenever possible, patient selection will preferentially include individuals considered to be at increased risk of residual pulmonary hypertension after PEA. High-risk features include severe preoperative haemodynamic impairment (pulmonary vascular resistance ≥8 Wood units/645dyn.s.cm-5), predominantly distal thromboembolic disease on preoperative imaging, delayed referral for PEA (\>2 years from diagnosis), or clinical characteristics associated with pulmonary microvascular disease (including antiphospholipid syndrome, splenectomy, chronic inflammatory or haematological disorders, or previous malignancy). These features are intended to enrich the study population with patients more likely to develop clinically relevant haemodynamic trajectories and should not be interpreted as validated predictors of residual pulmonary hypertension. In addition, the multidisciplinary CTEPH team may recommend inclusion of patients who do not strictly fulfil the above enrichment features but are considered, based on an integrated assessment of clinical characteristics, imaging findings, haemodynamic profile and surgical considerations, to be at increased risk of residual pulmonary hypertension or likely to derive particular benefit from continuous haemodynamic monitoring. This decision will be made by consensus and documented prospectively before study inclusion. Inclusion criteria 1. Age ≥18 years. 2. Confirmed diagnosis of CTEPH according to current international guidelines. 3. Multidisciplinary indication for pulmonary endarterectomy. 4. Considered suitable for intraoperative CardioMEMS™ implantation. 5. Ability to comply with remote monitoring and scheduled follow-up. 6. Written informed consent. Exclusion criteria 1. Age \<18 years. 2. Inability or unwillingness to provide written informed consent. 3. Contraindication to CardioMEMS™ implantation according to the manufacturer's instructions for use or investigator judgement. 4. Life expectancy \<1 year due to a non-cardiopulmonary comorbidity. 5. Inability to perform remote transmissions or comply with scheduled follow-up. 6. Any condition that, in the opinion of the investigators, may compromise patient safety, study participation or data quality. \-