Abstract 16839: Impact of Interventional Therapies for Chronic Thromboembolic Pulmonary Hypertension: Comparison of Clinical Outcomes of Pulmonary Endarterectomy vs. Percutaneous Transluminal Pulmonary Angioplasty
Background: This study was conducted to investigate the latest survival of chronic thromboembolic pulmonary hypertension (CTEPH) with recently-available interventional therapies such as pulmonary endarterectomy (PEA) and percutaneous transluminal pulmonary angioplasty (PTPA), recently-developed catheter-based less-invasive therapy, and to compare the clinical outcomes of the two interventional strategies based on collaborative multi-institution data.
Methods and Results: One hundred thirty-six consecutive patients with CTEPH were enrolled. Twenty-nine were treated only with medical therapy (Drug-group), and the other 107 underwent interventional therapies (Interventions-group) (39 underwent PEA [PEA-group] and 68 PTPA [PTPA-group]). Although baseline hemodynamic parameters in the Interventions-group were significantly more severe than those in the Drug-group, the prognosis after the diagnosis was much better in the Interventions-group than in the Drug-group (98% vs. 64% at 5-year survival, p < 0.01), suggesting the effectiveness of the interventional therapies. Hemodynamic improvement after each interventional therapy was almost comparable (46% vs. 40% decrease in mean pulmonary arterial pressure and 56% vs. 58% decrease in pulmonary vascular resistance during the mean follow-up period of 74.7 ± 32.3 vs. 17.4 ± 9.3 months, PEA-group vs. PTPA-group, respectively). The 2-year survival rate (97.4% vs. 98.5%), the 2-year occurrence of heart failure (2.6% vs. 2.9%), and the 2-year re-vascularization rate (2.8% vs. 2.9%) were not statistically different between in the PEA-group and the PTPA-group, respectively.
Conclusions: Interventional therapies were more beneficial than medical therapy in prognosis of patients with CTEPH, and the clinical outcomes of PTPA and PEA were comparable.
- © 2013 by American Heart Association, Inc.