Abstract 17125: Impact of Balloon Pulmonary Angioplasty for the Treatment of Chronic Thromboembolic Pulmonary Hypertension
Background: The most powerful conventional therapeutic strategy for chronic thromboembolic pulmonary hypertension (CTEPH) is invasive surgical pulmonary endarterectomy (PEA). Recently, balloon pulmonary angioplasty (BPA) has been demonstrated to be effective for the treatment of CTEPH and has been developed as a new alternative therapeutic strategy. The aim of this study was to investigate the efficacy of BPA for the treatment of CTEPH.
Methods and Results: Forty-six patients with CTEPH underwent a total of 83 BPA. Excluding one patient who had severe right heart failure and could not be saved with BPA, remaining 45 patients (age; 62 ± 11 years) were analyzed (the mortality rate associated with BPA in this study; 2.2%). After follow-up periods (average 158 days), New York Heart Association functional classifications, six-minute walk distance, and levels of plasma B-type natriuretic peptide significantly improved (all P<0.01). Hemodynamic parameters also significantly improved (mean pulmonary arterial pressure, 43.9 ± 10.6 vs. 30.9 ± 9.4 mmHg; pulmonary vascular resistance, 10.7 ± 5.3 vs. 5.9 ± 3.2 Wood units; cardiac output, 3.8 ± 1.1 vs. 4.4 ± 1.5 L/min, baseline vs. follow-up, respectively; all P<0.01). Of a total 82 procedures, 42 procedures (51%) resulted in reperfusion pulmonary edema. One patient needed artificial ventilation and 5 patients needed biphasic positive-airway-pressure. Patients with more severe clinical signs and/or more severe hemodynamics at baseline had a high risk of reperfusion pulmonary edema.
Conclusions: BPA markedly improved all the hemodynamic parameters and the exercise capacity. BPA is emerging as a promising therapeutic strategy for CTEPH.
- © 2012 by American Heart Association, Inc.