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Balloon Pulmonary Angioplasty in Technically Operable and Technically Inoperable Chronic Thromboembolic Pulmonary Hypertension
| Content Provider | MDPI |
|---|---|
| Author | Sylwia, Sławek-Szmyt Piotr, Kędzierski Dariusz, Zieliński Darocha, Szymon Araszkiewicz, Aleksander Kurzyna, Marcin Banaszkiewicz, Marta Jankiewicz, Stanisław Dobosiewicz, Anna Janus, Magdalena Grymuza, Maciej Pietrasik, Arkadiusz Mularek-Kubzdela, Tatiana Pietura, Radosław Biederman, Andrzej Lesiak, Maciej Torbicki, Adam |
| Copyright Year | 2021 |
| Description | Background: In this study, we aimed to assess the efficacy and safety of balloon pulmonary angioplasty (BPA) in patients with technically inoperable distal-type chronic thromboembolic pulmonary hypertension (d-CTEPH) and technically operable proximal-type disease (p-CTEPH) by analyzing the results of BPA treatment in two collaborating CTEPH referral centers. Methods and results: We assessed hemodynamic results, functional efficacy, complication and survival rate after BPA treatment in 70 CTEPH patients (median age 64 years; (interquartile range (IQR): 52–73 years)), of whom 16 (median age 73 years; (QR 62–82 years)) were in the p-CTEPH subgroup. Altogether, 377 BPA procedures were performed, resulting in significant (p < 0.001) improvement in mean pulmonary artery pressure (mPAP 48.6 ± 10 vs. 31.3 ± 8.6 mmHg), pulmonary vascular resistance (694 ± 296 vs. 333 ± 162 dynes*s*cm−5), six-minute walk test (365 ± 142 vs. 433 ± 120 metres) and N-terminal pro B-type natriuretic peptide (1307 (510–3294) vs. 206 (83–531) pg/mL). The rate of improvement did not differ between the sub-groups. Lung injury episodes and severe hemoptysis were similarly infrequent in d-CTEPH and p-CTEPH (6.4% vs. 5%; p = 0.55 and 1.0% vs. 2.5; p = 0.24, respectively). There was no significant difference between the sub-groups regarding survival (p = 0.53 by log-rank test). Conclusion: BPA may be beneficial in patients with p-CTEPH who cannot undergo pulmonary endarterectomy (PEA). Larger long-term studies are needed to better define the efficacy, safety, and optimal BPA procedural standards in this population. |
| Starting Page | 1038 |
| e-ISSN | 20770383 |
| DOI | 10.3390/jcm10051038 |
| Journal | Journal of clinical medicine |
| Issue Number | 5 |
| Volume Number | 10 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2021-03-03 |
| Access Restriction | Open |
| Subject Keyword | Journal of clinical medicine Journal of Clinical Medicine Peripheral Vascular Disease Respiratory System Balloon Pulmonary Angioplasty Chronic Thromboembolic Pulmonary Hypertension Pulmonary Endarterectomy Proximal-type Cteph Distal-type Cteph |
| Content Type | Text |
| Resource Type | Article |
