Preview

Systemic Hypertension

Advanced search

Long-term outcomes after percutaneous transluminal pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

https://doi.org/10.26442/2075082X.2019.4.190609

Abstract

Introduction. Chronic thromboembolic pulmonary hypertension is a precapillary form of pulmonary hypertension that develops due to thrombotic mass obstruction of the pulmonary arteries. Balloon pulmonary angioplasty (BPA) is a new, alternative treatment method for inoperable chronic thromboembolic pulmonary hypertension (CTEPH), which demonstrated good hemodynamic and clinical effects. In this article we studied the long-term outcomes results after BPA. Material and methods. The study included 22 patients with inoperable CTEPH who were treated by BPA 6 (5; 8) interventions per patient. The results of the procedure were evaluated 2 months and 18 (12; 18) months after the last BPA. Results. A significant decrease in all important hemodynamic parameters was noted. There no difference between the date immediately after the operation and the long term period. However, the division of patients into groups with and without disease progression allow us to identify factors affecting the effectiveness of BPA (weight, the number of BPA procedures per patient, the total number of treated segmental arteries, the presence of coronary heart disease and chronic obstructive pulmonary disease, not the appointment of a concomitant pathogenetic pulmonary arterial hypertension (PAH) therapy. Conclusion. BPA is an effective method of treating patients with inoperable CTEPH, which demonstrates a good, sustainable long-term result. Patients with classical type 4 pulmonary hypertension receiving PAH-specific therapy are best responders to BPA.

About the Authors

M. B. Karabasheva
Myasnikov Institute of Clinical Cardiology, National Medical Research Center for Cardiology
Russian Federation


N. M. Danilov
D. Sci. (Med.)
Russian Federation


O. V. Sagaidak
Myasnikov Institute of Clinical Cardiology, National Medical Research Center for Cardiology
Russian Federation


Y. G. Matchin
D. Sci. (Med.)
Russian Federation


I. E. Chazova
Myasnikov Institute of Clinical Cardiology, National Medical Research Center for Cardiology
Russian Federation


References

1. Чазова И.Е., Мартынюк Т.В. Клинические рекомендации по диагностике и лечению хронической тромбоэмболической легочной гипертензии. Терапевтический архив. 2016; 10: 63-72.

2. Delcroix M, Vonk Noordegraaf A, Fadel E et al. Vascular and right ventricular remodelling in chronic thromboembolic pulmonary hypertension. Eur Respir J 2013; 41: 224-32.

3. D’Armini A.M, Morsolini M, Mattiucci G et al. Pulmonary endarterectomy for distal chronic thromboembolic pulmonary hypertension. J Thorac Cardiovasc Surg 2014; 148: 1005-11.

4. Madani M.M, Auger W.R, Pretorius V et al. Pulmonary endarterectomy: Recent changes in a single institution’s experience of more than 2.700 patients. Ann Thorac Surg 2012; 94: 97-103.

5. Pepke-Zaba J, Delcroix M, Lang I et al. Chronic thromboembolic pulmonary hypertension (CTEPH): Results from an international prospective registry. Circulation 2011; 124: 1973-81.

6. Mizoguchi H, Ogawa A, Munemasa M et al. Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2012; 5: 748-55.

7. Sugimura K, Fukumoto Y, Satoh K et al. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 2012; 76: 485-8.

8. Kataoka M, Inami T, Hayashida K et al. Percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hyper- tension. Circ Cardiovasc Interv 2012; 5: 756-62.

9. Рекомендации ESC/ERS по диагностике и лечению легочной гипертензии 2015 г. Рос. кардиол. журн. 2016; 5 (133): 5-64. DOI: org/10.15829/1560-4071-2016-5-5-64

10. Sugimura K, Fukumoto Y, Satoh K et al. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long - term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 2012; 76: 485-8.


Review

For citations:


Karabasheva M.B., Danilov N.M., Sagaidak O.V., Matchin Y.G., Chazova I.E. Long-term outcomes after percutaneous transluminal pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Systemic Hypertension. 2019;16(4):27-32. (In Russ.) https://doi.org/10.26442/2075082X.2019.4.190609

Views: 155


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2075-082X (Print)
ISSN 2542-2189 (Online)