scholarly journals Safety and efficacy of balloon pulmonary angioplasty in a Portuguese pulmonary hypertension expert center: A step in the right direction

2021 ◽  
Author(s):  
Graça Castro
Keyword(s):  
Pulmonary Hypertension ◽  
Safety And Efficacy ◽  
Balloon Pulmonary Angioplasty ◽  
Expert Center ◽  
The Right

scholarly journals Balloon pulmonary angioplasty for patients with inoperable chronic thromboembolic pulmonary hypertension

2019 ◽  
Vol 91 (4) ◽  
pp. 43-47
Author(s):  
N M Danilov ◽  
Yu G Matchin ◽  
A M Chernyavsky ◽  
A G Edemsky ◽  
D S Grankin ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Functional Class ◽  
Reverse Remodeling ◽  
Systolic Pulmonary Artery Pressure ◽  
Right Heart ◽  
Balloon Pulmonary Angioplasty ◽  
Thromboembolic Pulmonary Hypertension ◽  
The Right

Aim. To evaluate the effectiveness of balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Materials and methods. Forty patients with inoperable CTEPH were enrolled in this study. The indications were determined by multidisciplinary team. The average age of patients was 53.5 [43; 63] years. In 65% of cases patients had functional class III (according to WHO); the distance in the 6-minute walk test (6MWD) was 327 [280; 400] m; catheterization of the right heart revealed systolic pulmonary artery pressure (SPAP) 82 [64; 100] mm Hg, mean pulmonary artery (mPAP) 48.5 [38; 56] mm Hg, pulmonary vascular resistance (PVR) 784 [525; 1257] dyn·s/cm-5. Each patient underwent 6 BPA. Results and discussion. The effectiveness of BPA was assessed 2 months after the last session. According to the data of right heart catheterization SPAP decreased by 27.3%, mPAP by 26%, PVR by 34.5% from baseline. After all series of BPA echocardiography and magnetic resonance imaging demonstrated reverse remodeling of the right heart. Also significant decrease in the level of BNP by 62%, increasing in 6MWD distance by 39% and improvement of the functional class up to I in 60% cases and up to II in 40% cases were noted. Conclusion. The results of the present study demonstrated a high efficacy of BPA allowing to normalize hemodynamic and clinical parameters, increasing the physical activity. Balloon pulmonary angioplasty is a new highly effective, safe method for treating patients with inoperable CTEPH.

scholarly journals Balloon pulmonary angioplasty protocol in a Portuguese pulmonary hypertension expert center

2021 ◽  
Author(s):  
Rita Calé ◽  
Filipa Ferreira ◽  
Ana Rita Pereira ◽  
Carla Saraiva ◽  
Ana Santos ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Balloon Pulmonary Angioplasty ◽  
Expert Center

scholarly journals Balloon pulmonary angioplasty protocol in a Portuguese pulmonary hypertension expert center

2021 ◽  
Vol 40 (9) ◽  
pp. 653-665
Author(s):  
Rita Calé ◽  
Filipa Ferreira ◽  
Ana Rita Pereira ◽  
Carla Saraiva ◽  
Ana Santos ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Balloon Pulmonary Angioplasty ◽  
Expert Center

scholarly journals Safety and efficacy of balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension in the Netherlands

2019 ◽  
Vol 28 (2) ◽  
pp. 81-88 ◽  
Author(s):  
M. C. J. van Thor ◽  
R. J. Lely ◽  
N. J. Braams ◽  
L. ten Klooster ◽  
M. A. M. Beijk ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
The Netherlands ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Stroke Volume Index ◽  
Functional Class ◽  
Right Atrial ◽  
Volume Index ◽  
Safety And Efficacy ◽  
Balloon Pulmonary Angioplasty ◽  
Thromboembolic Pulmonary Hypertension

Abstract Background Balloon pulmonary angioplasty (BPA) is an emerging treatment in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic disease (CTED). We describe the first safety and efficacy results of BPA in the Netherlands. Methods We selected all consecutive patients with inoperable CTEPH and CTED accepted for BPA treatment who had a six-month follow-up in the St. Antonius Hospital in Nieuwegein and the Amsterdam University Medical Center (UMC) in Amsterdam. Functional class (FC), N‑terminal pro-brain natriuretic peptide (NT-proBNP), 6‑minute walking test distance (6MWD) and right-sided heart catheterisation were performed at baseline and six months after last BPA. Complications for each BPA procedure were noted. Results A hundred and seventy-two BPA procedures were performed in 38 patients (61% female, mean age 65 ± 15 years). Significant improvements six months after BPA treatment were observed for functional class (63% FC I/II to 90% FC I/II, p = 0.014), mean pulmonary artery pressure (−8.9 mm Hg, p = 0.0001), pulmonary vascular resistance (−2.8 Woods Units (WU), p = 0.0001), right atrial pressure (−2.0 mm Hg, p = 0.006), stroke volume index (+5.7 ml/m2, p = 0.009) and 6MWD (+48m, p = 0.007). Non-severe complications occurred in 20 (12%) procedures. Conclusions BPA performed in a CTEPH expert centre is an effective and safe treatment in patients with inoperable CTEPH.

scholarly journals French experience of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

2019 ◽  
Vol 53 (5) ◽  
pp. 1802095 ◽  
Author(s):  
Philippe Brenot ◽  
Xavier Jaïs ◽  
Yu Taniguchi ◽  
Carlos Garcia Alonso ◽  
Benoit Gerardin ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Injury ◽  
Initial Period ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Heart Association ◽  
Functional Class ◽  
Recent Period ◽  
Safety And Efficacy ◽  
Balloon Pulmonary Angioplasty ◽  
Thromboembolic Pulmonary Hypertension

AimsTo evaluate safety and efficacy of balloon pulmonary angioplasty (BPA) in a large cohort of patients with chronic thromboembolic pulmonary hypertension (CTEPH).MethodsFrom 2014 to 2017, 184 inoperable CTEPH patients underwent 1006 BPA sessions. Safety and efficacy during the first 21 months (initial period) were compared with those of the last 21 months (recent period). A total of 154 patients had a full evaluation after a median duration of 6.1 months.ResultsOverall, there was a significant improvement in New York Heart Association functional class, 6-min walk distance (mean change +45 m), and a significant decrease in mean pulmonary artery pressure (PAP) and in pulmonary vascular resistance (PVR) by 26% and 43%, respectively. The percentage decreases of mean PAP and PVR were 22% and 37% in the initial period versus 30% and 49% in the recent period, respectively (p<0.05). The main complications included lung injury, which occurred in 9.1% of 1006 sessions (13.3% in the initial period versus 5.9% in the recent period; p<0.001). Per-patient multivariate analysis revealed that baseline mean PAP and the period during which BPA procedure was performed (recent versus initial period) were the strongest factors related to the occurrence of lung injury. 3-year survival was 95.1%.ConclusionThis study confirms that a refined BPA strategy improves short-term symptoms, exercise capacity and haemodynamics in inoperable CTEPH patients with an acceptable risk–benefit ratio. Safety and efficacy improve over time, underscoring the unavoidable learning curve for this procedure.

scholarly journals Balloon Pulmonary Angioplasty with Stent Implantation as a Treatment of Proximal Chronic Thromboembolic Pulmonary Hypertension

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 363
Author(s):  
Szymon Darocha ◽  
Radosław Pietura ◽  
Marta Banaszkiewicz ◽  
Arkadiusz Pietrasik ◽  
Łukasz Kownacki ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Balloon Angioplasty ◽  
Lower Lobe ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Elastic Recoil ◽  
Balloon Catheters ◽  
Balloon Pulmonary Angioplasty ◽  
Thromboembolic Pulmonary Hypertension ◽  
The Right ◽  
Second Procedure

We present a case of a 67-year-old female with proximal chronic thromboembolic pulmonary hypertension (CTEPH), disqualified from pulmonary endarterectomy due to multiple comorbidities and high risk-to-benefit ratio as assessed by multidisciplinary CTEPH team. She was referred for balloon pulmonary angioplasty (BPA) and underwent three sessions with balloon catheters up to 8 mm diameter. During the second procedure, the elastic recoil phenomenon was observed in the treated post-thrombotic lesion of the right lower lobe artery, which made the balloon angioplasty ineffective. It was decided to implant a self-expanding stent for the prevention of restenosis. The procedure resulted in significant improvement of regional perfusion, as confirmed by control angiography. We feel that it contributed to the significant improvement of hemodynamic parameters and exercise capacity, as assessed three months after the last BPA procedure. In conclusion, pulmonary artery stenting may be an option in proximal CTEPH when elastic recoil phenomenon makes balloon angioplasty of a large vessel ineffective.

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