Balloon Pulmonary Angioplasty for the Treatment of Nonoperable Chronic Thromboembolic Pulmonary Hypertension: Single-Center Experience with Low Initial Complication Rate期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

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Balloon Pulmonary Angioplasty for the Treatment of Nonoperable Chronic Thromboembolic Pulmonary Hypertension: Single-Center Experience with Low Initial Complication Rate

Institution:	1. Department of Pneumology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium;2. Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium;3. Division of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium;4. Department of Cardiovascular Sciences, Catholic University Leuven, Leuven, Belgium;5. Department CHROMETA, Division of Pneumology, KU Leuven, Leuven, Belgium;1. Department of Rehabilitation, Tokyo Women''s Medical University, Tokyo, Japan;2. Department of Cardiology, Tokyo Women''s Medical University, Tokyo, Japan;3. Department of Internal Medicine and Rehabilitation, Science Disability Science, Tohoku University Graduate School of Medicine, Sendai, Japan;1. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN;2. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN;3. Kyorin University, Tokyo, Japan;1. Departments of Cardiology;2. Radiology and Nuclear Medicine;3. Cardiothoracic Surgery, Oslo University Hospital Rikshospitalet;4. Faculty of Medicine, University of Oslo, Oslo, Norway;1. Department of Thoracic Surgery;2. Department of Cardiology, Kerckhoff Heart and Lung Center, DZHK (German Centre for Cardiovascular Research), partner site, Bad Nauheim, Germany;3. Department of Diagnostic and Interventional Radiology, Justus-Liebig University Giessen, Giessen, Germany;4. Department of Anaesthesiology;5. Intensive Care Unit, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany;6. Division of Cardiology, Department of Internal Medicine I, Justus-Liebig University Giessen, Giessen, Germany

Abstract:	PurposeTo evaluate the safety and efficacy of balloon pulmonary angioplasty (BPA) for nonoperable chronic thromboembolic pulmonary hypertension (CTEPH) patients during the initial experience of a single center.MethodsA total of 18 CTEPH patients (5 with residual pulmonary hypertension after pulmonary endarterectomy) were treated with BPA during the period 2014–2018 and were retrospectively reviewed. Mean age was 61 ± 19 years; 55% were female; mean pulmonary artery pressure was 44 ± 12 mmHg; cardiac output was 4.3 ± 1.0 l/min; and pulmonary vascular resistance was 8.4 ± 3.6 WU. Patients were evaluated by New York Heart Association functional class, 6-minute walk distance, N-terminal pro b-type natriuretic peptide, echocardiography, right heart catheterization, and before and after completions of BPA.ResultsA total of 91 procedures were performed, with a median number of 4 BPA sessions per patient (range, 2–8). There were no deaths or major complications requiring extracorporeal support or (non)invasive ventilation. The most common complication was self-limiting hemoptysis (3%). According to Society of Interventional Radiology classification, 4 mild, 4 moderate, and 1 severe adverse events were noted. Invasive hemodynamics significantly improved, with a cardiac index increase of 15% (P = .0333), decrease of mean pulmonary artery pressure of 30% (P = .0013), and decrease of pulmonary vascular resistance of 45% (P = .0048). Stroke volume index (P = .0171) and pulmonary arterial compliance (P = .0004) were also significantly enhanced.ConclusionsBPA significantly improves cardiopulmonary hemodynamics with an acceptable safety profile. Further studies assessing the long-term efficacy of BPA are required.

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