Background
Patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) are
often treated with pulmonary arterial hypertension-specific drugs. However, most of
these patients remain symptomatic, despite medical treatment. Balloon pulmonary angioplasty
(BPA) is an emerging therapeutic intervention for patients with inoperable CTEPH.
This study aimed to report the initial experience of BPA in a tertiary referral centre
for CTEPH.
Methods
A total of 26 consecutive patients, who underwent 91 BPA sessions, were included in
the study. All patients underwent a detailed examination, including 6-minute walking
distance (6MWD), and right heart catheterisation at baseline and 3 months after the
last BPA session.
Results
The mean age of the patients was 51±17 years. Fifteen (15) patients had inoperable
CTEPH and 11 patients had residual or recurrent CTEPH post pulmonary endarterectomy
(PEA). Functional class improved in 17 of 26 (65%) patients. The 6MWD increased from
a mean 315±129 to 411±140 m (p<0.001), and NT pro-BNP reduced from a median 456 to
189 pg/mL (p=0.001). The number of patients who required supplemental oxygen decreased
from 11 (42.3%) to five (19%) (p=0.031) after BPA treatment. The mean pulmonary artery
pressure decreased from a mean 47.5±13.4 to 38±10.9 mmHg (p<0.001), the pulmonary
vascular resistance decreased from a mean 9.3±4.7 to 5.8±2.8 Wood units (p<0.001),
and the cardiac index increased from a mean 2.4±0.7 to 2.9±0.6 L/min/m2 (p=0.008).
Conclusions
Balloon pulmonary angioplasty improved haemodynamics, 6MWD, and functional class,
and reduced the requirement for supplemental oxygen, with an acceptable risk-benefit
ratio in patients with inoperable CTEPH and with residual/recurrent CTEPH.
Keywords
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Article info
Publication history
Published online: November 24, 2021
Accepted:
October 16,
2021
Received in revised form:
May 31,
2021
Received:
August 26,
2020
Identification
Copyright
© 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
