Balloon Pulmonary Angioplasty in Patients with Chronic Thromboembolic Pulmonary Hypertension: Impact on Clinical and Hemodynamic Parameters, Quality of Life and Risk Profile

Balloon pulmonary angioplasty (BPA) is a novel treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are not eligible for pulmonary endarterectomy (PEA) or suffer from persistent pulmonary hypertension after PEA. The aim of this study was to evaluate the real-l...

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Published in:Journal of clinical medicine 2020-11, Vol.9 (11), p.3608
Main Authors: Jansa, Pavel, Heller, Samuel, Svoboda, Michal, Pad’our, Michal, Ambrož, David, Dytrych, Vladimír, Širanec, Michal, Kovárník, Tomáš, Felšőci, Marián, Hutyra, Martin, Linhart, Aleš, Lindner, Jaroslav, Aschermann, Michael
Format: Article
Language:English
Subjects:
Angioplasty
Anticoagulants
Cardiac catheterization
Catheters
Clinical medicine
Data collection
Drug therapy
Heart rate
Hemodynamics
Hospitals
Intubation
Medical prognosis
Patients
Pulmonary arteries
Pulmonary embolisms
Pulmonary hypertension
Quality of life
Thromboembolism
Veins & arteries
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Summary:Balloon pulmonary angioplasty (BPA) is a novel treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are not eligible for pulmonary endarterectomy (PEA) or suffer from persistent pulmonary hypertension after PEA. The aim of this study was to evaluate the real-life efficacy and safety of BPA in a consecutive group of patients who were diagnosed and treated in the national referral center for CTEPH in the Czech Republic. Here we report data from 160 BPA procedures performed in 64 patients. Efficacy analysis was performed in the subgroup of 25 patients who completed BPA series. Significant improvements were observed in New York Heart Association functional class (4% to 79% in I/II, p < 0.001), 6 min walking test distance (+54.3 m, p < 0.001), risk profile (15.8% to 68.5% with presence of 2/3 low risk criteria, p < 0.001), pulmonary artery mean pressure (−18%, p < 0.001), pulmonary vascular resistance (−32%, p < 0.001), stroke volume (+17%, p = 0.011) and quality of life (+37% in assessment of overall health status by a patient, p < 0.001). We observed 1 fatal periprocedural complication (1.6% of all 64 patients) and 19 BPA-related non-fatal complications (11.9% of all 160 interventions) that predominantly included hemoptysis (10.0% of all sessions). Overall survival at 12 months was 94.6%.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm9113608