학술논문
The Initial Experience of Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension in Latvia.
Document Type
Academic Journal
Author
Krigere A; Department of Rare Diseases, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia.; Kalejs VR; Department of Rare Diseases, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia.; Kaulins R; Department of Internal Diseases, Riga Stradins University, 1007 Riga, Latvia.; Rudzitis A; Department of Rare Diseases, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia.; Department of Internal Diseases, Riga Stradins University, 1007 Riga, Latvia.; Bondare L; Department of Rare Diseases, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia.; Sablinskis M; Department of Rare Diseases, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia.; Lejnieks A; Department of Internal Diseases, Riga Stradins University, 1007 Riga, Latvia.; Department of Internal Diseases, Riga East Clinical University Hospital, 1038 Riga, Latvia.; Kigitovica D; Department of Rare Diseases, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia.; Department of Internal Diseases, Riga Stradins University, 1007 Riga, Latvia.; Kurzyna M; Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Center of Postgraduate Medical Education, ERN-LUNG Member, 05-400 Otwock, Poland.; Skride A; Department of Rare Diseases, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia.; Department of Internal Diseases, Riga Stradins University, 1007 Riga, Latvia.
Source
Publisher: MDPI Country of Publication: Switzerland NLM ID: 9425208 Publication Model: Electronic Cited Medium: Internet ISSN: 1648-9144 (Electronic) Linking ISSN: 1010660X NLM ISO Abbreviation: Medicina (Kaunas) Subsets: MEDLINE
Subject
Language
English
Abstract
Background : Treatment options for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or persistent pulmonary hypertension after pulmonary endarterectomy (PEA) include targeted medical therapy and balloon pulmonary angioplasty (BPA). BPA is an emerging treatment modality that has been reported to improve functional capacity, pulmonary hemodynamics, and right ventricular function. Reports from expert centers are promising, but more data are needed to make the results more generalizable. Materials and Methods : We conducted a prospective analysis of nine consecutive CTEPH patients who underwent balloon pulmonary angioplasty (BPA) sessions at Pauls Stradins Clinical University Hospital in Riga, Latvia between 1 April 2022 and 1 July 2023. We assessed World Health Organization (WHO) functional class, 6 min walk distance (6MWD), blood oxygen saturation (SpO 2 ), brain natriuretic peptide (BNP) level at baseline and 3 months after the first BPA session. For two patients on whom repeated BPA sessions were performed, we additionally assessed cardiac output (CO), pulmonary vascular resistance (PVR), and mean pulmonary artery pressure (mPAP). Results : A total of 12 BPA procedures for nine patients were performed; repeated BPA sessions were performed for two patients. Our results show a reduction in BNP levels and improvement in WHO functional class, 6MWD, and SpO 2 after the first BPA session. Improvement in 6MWD was statistically significant. Additionally, an improvement in pulmonary hemodynamic parameters was observed. Conclusions : Our data show that BPA is an effective interventional treatment modality, improving both the pulmonary hemodynamics and functional status. Moreover, BPA is safe and excellently tolerated.