학술논문

Balloon pulmonary angioplasty outcomes in patients previously treated by pulmonary endarterectomy surgery are inferior to those of inoperable patients
Document Type
article
Source
Pulmonary Circulation, Vol 13, Iss 3, Pp n/a-n/a (2023)
Subject
Balloon pulmonary angioplasty (BPA)
Chronic thromboembolic pulmonary hypertension (CTEPH)
Mean pulmonary artery pressure (mPAP)
Pulmonary endarterectomy (PEA)
Pulmonary vascular resistance (PVR)
Diseases of the circulatory (Cardiovascular) system
RC666-701
Diseases of the respiratory system
RC705-779
Language
English
ISSN
2045-8940
Abstract
Abstract Pulmonary endarterectomy (PEA) may not achieve full clearance of vascular obstructions in patients with more distal chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) may be indicated to treat these residual vascular lesions. We compared whether patients post‐PEA (PP) treated by BPA derived similar benefit to those who had inoperable CTEPH (IC), and assessed predictors of BPA response after surgery. We treated 109 patients with BPA—89 with IC and 20 PP. Serial right heart catheterization performed at baseline (immediately before BPA) and 3 months after completing BPA, compared pulmonary vascular resistance (PVR), mean pulmonary artery pressure (mPAP) as well as change in WHO functional class and 6‐minute walk distance. We also assessed the impact of total thrombus tail length (TTTL) from photographed PEA surgical specimens and PP computed tomography pulmonary angiography (CTPA)‐quantified residual disease burden on BPA response. PP and IC groups did not differ significantly in terms of demographics, baseline hemodynamics or procedural characteristics. However, IC derived greater hemodynamic benefit from BPA: ΔPVR (−27.9 ± 20.2% vs. −13.9 ± 23.9%, p