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Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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1/2024
vol. 20
 
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abstract:
Original paper

Refined balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension – reference center experience

Andrzej Łabyk
1
,
Marcin Krakowian
1
,
Łukasz Mysiorski
1
,
Barbara Lichodziejewska
1
,
Olga Dzikowska-Diduch
1
,
Aisha Ou-Pokrzewińska
1
,
Dariusz Zieliński
2
,
Marek Gołębiowski
3
,
Piotr Pruszczyk
1
,
Marek Roik
1

  1. Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
  2. Department of Cardiac Surgery, Medicover Hospital, Warsaw, Poland
  3. 1st Department of Radiology, Medical University of Warsaw, Infant Jesus Teaching Hospital Warsaw, Warsaw, Poland
Adv Interv Cardiol 2024; 20, 1 (75): 84–88
DOI: https://doi.org/10.5114/aic.2024.136411
Online publish date: 2024/03/15
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Introduction:
Chronic thromboembolic pulmonary hypertension (CTEPH), characterized by thromboembolic changes affecting the pulmonary bed, leads to ventricular function deterioration and premature death. The introduction of balloon pulmonary angioplasty (BPA) has significantly improved the prognosis of CTEPH patients.

Aim:
The authors of this article decided to summarize the experience of the BPA program, conducted between 2014 and 2022, at the reference center.

Material and methods:
Among 111 CTEPH patients, 55 were included in the analysis. A total of 226 sessions were performed, with a significant percentage of intravascular imaging and pressure catheter use.

Results:
Mean pulmonary pressure decreased significantly from 42 (22–66) to 26.5 mm Hg (11–54) (p < 0.05). Pulmonary vascular resistance and natriuretic peptide concentration decreased from 6.67 (1.66–14) to 3.295 Wood units (1.09–11.11), respectively, and from 1934 (60–16963) to 296 (21–9901) ng/ml (p < 0.05). There was also an improvement in the functional class (WHO) from 2.85 ±0.61 to 2.15 ±0.62 and an increase in the 6-minute walking distance from 300 ±131 to 367 ±154 m (p < 0.05). There were no in-hospital deaths or within 30 days of the procedure. Arterial damage occurred during nine sessions (n = 9/226, 4%), while 0.9% (n = 2/226) were complicated by acute right ventricular failure. Post-reperfusion pulmonary edema (RPE 0 – none) was observed in almost 90% of the sessions, grade 1 to 3 RPE occurred in 10.2%, and grade 4 RPE was not noted.

Conclusions:
BPA programs conducted in experienced centers are a safe and effective treatment option for inoperable CTEPH patients.

keywords:

percutaneous, chronic thromboembolic pulmonary hypertension, balloon pulmonary angioplasty
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