Complications of balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension: Impact on the outcome.


Journal

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
ISSN: 1557-3117
Titre abrégé: J Heart Lung Transplant
Pays: United States
ID NLM: 9102703

Informations de publication

Date de publication:
08 2022
Historique:
received: 25 10 2021
revised: 02 05 2022
accepted: 11 05 2022
pubmed: 12 6 2022
medline: 28 7 2022
entrez: 11 6 2022
Statut: ppublish

Résumé

Balloon pulmonary angioplasty (BPA) is an emerging interventional treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) that targets subsegmental branches of the pulmonary artery. As the reported complication rates are high, the aim of the present study was to evaluate the effects of certain complications on the outcome after treatment. From March 2014 to December 2019, a total of 235 patients with inoperable CTEPH underwent BPA. Of these patients, 140 were included who completed a follow-up examination 6 months after the last intervention; another 2 patients deceased due to complications of BPA. A high baseline pulmonary vascular resistance (PVR) >6.6 WU correlated with a higher rate of complications (mostly pulmonary artery perforations). Wire perforation during BPA did not correlate with worse outcome in terms of PVR reduction. The complication rate per intervention decreased from 21% to 14% during the 5 year period of the study. Complications are frequently observed in BPA, but the mortality rate is very low in expert centers. Importantly, the occurrence of complications does not portend a worse outcome.

Sections du résumé

BACKGROUND
Balloon pulmonary angioplasty (BPA) is an emerging interventional treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) that targets subsegmental branches of the pulmonary artery. As the reported complication rates are high, the aim of the present study was to evaluate the effects of certain complications on the outcome after treatment.
METHODS
From March 2014 to December 2019, a total of 235 patients with inoperable CTEPH underwent BPA. Of these patients, 140 were included who completed a follow-up examination 6 months after the last intervention; another 2 patients deceased due to complications of BPA.
RESULTS
A high baseline pulmonary vascular resistance (PVR) >6.6 WU correlated with a higher rate of complications (mostly pulmonary artery perforations). Wire perforation during BPA did not correlate with worse outcome in terms of PVR reduction. The complication rate per intervention decreased from 21% to 14% during the 5 year period of the study.
CONCLUSIONS
Complications are frequently observed in BPA, but the mortality rate is very low in expert centers. Importantly, the occurrence of complications does not portend a worse outcome.

Identifiants

pubmed: 35690560
pii: S1053-2498(22)01944-1
doi: 10.1016/j.healun.2022.05.002
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1086-1094

Informations de copyright

Copyright © 2022 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Auteurs

Christoph B Wiedenroth (CB)

Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany. Electronic address: c.wiedenroth@kerckhoff-klinik.de.

Henrike Deissner (H)

Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany.

Miriam S D Adameit (MSD)

Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany.

Steffen D Kriechbaum (SD)

Kerckhoff Heart and Thorax Center, Department of Cardiology, German Center for Cardiovascular Research (DZHK), Frankfurt am Main, Germany.

H-Ardeschir Ghofrani (HA)

Kerckhoff Heart and Thorax Center, Department of Pulmonology, Bad Nauheim, Germany; Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Germany; Department of Medicine, Imperial College London, UK.

Andreas Breithecker (A)

Gesundheitszentrum Wetterau, Department of Radiology, Bad Nauheim, Germany.

Moritz Haas (M)

Kerckhoff Heart and Thorax Center, Department of Cardiology, German Center for Cardiovascular Research (DZHK), Frankfurt am Main, Germany.

Fritz Roller (F)

University of Giessen, Department of Radiology, Giessen, Germany.

Andreas Rolf (A)

Kerckhoff Heart and Thorax Center, Department of Cardiology, German Center for Cardiovascular Research (DZHK), Frankfurt am Main, Germany; University of Giessen, Department of Internal Medicine I, Division of Cardiology, Giessen, Germany.

Christian W Hamm (CW)

Kerckhoff Heart and Thorax Center, Department of Cardiology, German Center for Cardiovascular Research (DZHK), Frankfurt am Main, Germany; University of Giessen, Department of Internal Medicine I, Division of Cardiology, Giessen, Germany.

Eckhard Mayer (E)

Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany.

Stefan Guth (S)

Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany.

Christoph Liebetrau (C)

Kerckhoff Heart and Thorax Center, Department of Cardiology, German Center for Cardiovascular Research (DZHK), Frankfurt am Main, Germany; University of Giessen, Department of Internal Medicine I, Division of Cardiology, Giessen, Germany; Cardioangiologisches Centrum Bethanien, Frankfurt am Main, Germany.

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