Mid-term follow-up of balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension: An experience in Latin America
| Autor: | Alberto Fuensalida, Pablo Ramirez, Jorge Quitral, José A Martínez, Pablo Sepúlveda, Gonzalo Martínez, Christian Backhouse, René Hameau, Gustavo Charme, Francisco Pacheco |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Hypertension Pulmonary Cardiac index Hemodynamics 030204 cardiovascular system & hematology Pulmonary Artery Balloon 03 medical and health sciences 0302 clinical medicine Internal medicine medicine.artery Angioplasty medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Prospective Studies Lung business.industry General Medicine medicine.disease Pulmonary hypertension medicine.anatomical_structure Latin America Treatment Outcome Pulmonary artery Chronic Disease Vascular resistance Cardiology Female Cardiology and Cardiovascular Medicine business Pulmonary Embolism Angioplasty Balloon Follow-Up Studies |
| Zdroj: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventionsREFERENCES. 97(6) |
| ISSN: | 1522-726X |
| Popis: | Objectives To describe the characteristics of patients who undergo balloon pulmonary angioplasty (BPA) for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) and report the mid-term outcomes. Background BPA has been recently introduced in Latin America. Mid-term results have not been published. Methods Prospective Chilean Registry of inoperable CTEPH patients who underwent BPA. Clinical variables were analyzed at baseline, after each procedure and at follow-up. Hemodynamic variables were recorded before and after the last BPA. Results Between August 2016 and September 2019, 22 patients (17 women), 59 ± 12.7 years, underwent 81 BPA and were followed for as long as 33.1 months (mean 17.3 ± 7.5). Mean pulmonary artery pressure decreased by 17.4% (51.1 ± 12 vs. 42.2 ± 13 mmHg, p = .001), pulmonary vascular resistance by 23.9% (766.7 ± 351 vs. 583 ± 346 dynes/s/cm-5 , p = .001), cardiac index increased by 8% (2.3 ± 0.54 vs. 2.5 ± 0.54 L/min/m2 , p = .012), N-terminal pro-B-type natriuretic peptide decreased by 73.8% (1,685 ± 1,045 vs. 441.8 ± 276 pg/dl, p = .006), and 6-min walk distance improved by 135 m (316.7 ± 94 vs. 451.1 ± 113 m, p = .001). One patient (4.5%) developed lung reperfusion injury and four patients (18.2%) had minor bleeding (hemoptysis), after the procedure. There was no mortality associated with BPA. Conclusions Our results confirm that BPA for inoperable CTEPH is a relatively safe procedure that improves clinical and hemodynamic parameters in the mid-term. This therapy should be considered as an alternative, mainly in places where access to PAH therapy or surgery is restricted. |
| Databáze: | OpenAIRE |
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