Balloon pulmonary angioplasty for the treatment of residual or recurrent pulmonary hypertension after pulmonary endarterectomy.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
01 Mar 2019
Historique:
received: 08 06 2018
revised: 17 09 2018
accepted: 22 10 2018
pubmed: 10 11 2018
medline: 23 11 2019
entrez: 10 11 2018
Statut: ppublish

Résumé

Pulmonary endarterectomy (PEA) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). However, persistent pulmonary hypertension continues in 5-35% of patients after PEA. Recently, balloon pulmonary angioplasty (BPA) showed promise as a strategy for patients with non-operable CTEPH. Therefore, we investigated the usefulness of BPA for residual pulmonary hypertension after PEA. Fifteen patients with residual pulmonary hypertension after PEA received 71 BPA sessions (4.7 ± 1.4 sessions/patient). The mean time between the PEA and the first BPA session was 28.1 ± 25.8 months. All patients underwent a comprehensive diagnostic work-up, including right heart catheterization, functional and laboratory tests, before, and 6-4 weeks after the BPA sessions. After BPA, the mean pulmonary arterial pressure decreased from 44.7 ± 6.4 to 30.8 ± 7.5 mm Hg (31% decline; p < 0.001). Pulmonary vascular resistance decreased from 551.9 ± 185.2 to 343.8 ± 123.8 dyn∗s/cm BPA could be a promising therapeutic strategy for persistent pulmonary hypertension after PEA in patients with CTEPH.

Sections du résumé

BACKGROUND BACKGROUND
Pulmonary endarterectomy (PEA) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). However, persistent pulmonary hypertension continues in 5-35% of patients after PEA. Recently, balloon pulmonary angioplasty (BPA) showed promise as a strategy for patients with non-operable CTEPH. Therefore, we investigated the usefulness of BPA for residual pulmonary hypertension after PEA.
METHODS METHODS
Fifteen patients with residual pulmonary hypertension after PEA received 71 BPA sessions (4.7 ± 1.4 sessions/patient). The mean time between the PEA and the first BPA session was 28.1 ± 25.8 months. All patients underwent a comprehensive diagnostic work-up, including right heart catheterization, functional and laboratory tests, before, and 6-4 weeks after the BPA sessions.
RESULTS RESULTS
After BPA, the mean pulmonary arterial pressure decreased from 44.7 ± 6.4 to 30.8 ± 7.5 mm Hg (31% decline; p < 0.001). Pulmonary vascular resistance decreased from 551.9 ± 185.2 to 343.8 ± 123.8 dyn∗s/cm
CONCLUSIONS CONCLUSIONS
BPA could be a promising therapeutic strategy for persistent pulmonary hypertension after PEA in patients with CTEPH.

Identifiants

pubmed: 30409735
pii: S0167-5273(18)33706-9
doi: 10.1016/j.ijcard.2018.10.066
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

232-237

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2018 Elsevier B.V. All rights reserved.

Auteurs

Aleksander Araszkiewicz (A)

Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland. Electronic address: aleksander.araszkiewicz@skpp.edu.pl.

Szymon Darocha (S)

Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Centre Otwock, Medical Centre for Postgraduate Education, Otwock, Poland.

Arkadiusz Pietrasik (A)

Department and Faculty of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Radosław Pietura (R)

Department of Radiography, Medical University of Lublin, Lublin, Poland.

Stanisław Jankiewicz (S)

Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland.

Marta Banaszkiewicz (M)

Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Centre Otwock, Medical Centre for Postgraduate Education, Otwock, Poland.

Sylwia Sławek-Szmyt (S)

Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland.

Andrzej Biederman (A)

Department of Cardiac Surgery, Medicover Hospital, Warsaw, Poland.

Tatiana Mularek-Kubzdela (T)

Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland.

Maciej Lesiak (M)

Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland.

Adam Torbicki (A)

Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Centre Otwock, Medical Centre for Postgraduate Education, Otwock, Poland.

Marcin Kurzyna (M)

Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Centre Otwock, Medical Centre for Postgraduate Education, Otwock, Poland.

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