Chronic thromboembolic pulmonary hypertension is a rare condition. There are two forms of that disease: major vessel thromboembolic pulmonary hypertension (CTEPH) and a "silent form": recurrent microembolism leading to extensive obstruction of the peripheral pulmonary vasculature and resulting also in severe pulmonary hypertension. On the base of case report the new approaches to the management of patients with two mentioned subgroups of thromboembolic pulmonary hypertension are discussed.