Effectiveness and Safety of Balloon Pulmonary Angioplasty for the Treatment of Patients with Persistent Pulmonary Hypertension after Pulmonary Endarterectomy

• Published in: Journal of clinical medicine Vol. 12; no. 3; p. 905
• Main Authors: Maneiro Melon, Nicolas M, Velazquez Martin, Maite, Huertas Nieto, Sergio, Albarran Gonzalez-Trevilla, Agustin, Sarnago Cebada, Fernando, Cruz Utrilla, Alejandro, Hinojosa Camargo, Williams, Aguilar Colindres, Ricardo, Melendo Viu, Maria, Lopez Gude, Maria Jesus, Morales Ruiz, Rafael, Perez Nuñez, Marta, Arribas Ynsaurriaga, Fernando, Escribano Subias, Pilar
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 23.01.2023; MDPI
• Subjects: Angioplasty; Cardiology; Edema; Hemodynamics; Hemoptysis; Medical imaging; Mortality; Multidisciplinary teams; Normal distribution; Patients; Pulmonary hypertension; Statistical analysis; Surgery; Tomography; Variables; United States > US; chronic thromboembolic pulmonary hypertension; balloon pulmonary angioplasty; pulmonary endarterectomy; pulmonary hypertension
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12030905

(1) Background: Pulmonary endarterectomy (PEA) is the "gold standard" treatment for operable patients with chronic thromboembolic pulmonary hypertension (CTEPH). Persistent pulmonary hypertension (PH) after PEA confers a worse prognosis. Balloon pulmonary angioplasty (BPA) could represent a useful therapy in this setting, but evidence about its effectiveness and safety in patients with previous PEA is limited. (2) Methods: A total of 14 patients with persistent PH after PEA were treated with BPA in a single PH center. Hemodynamic and clinical effects of BPA and complications of the procedure were retrospectively collected. (3) Results: After BPA, the mean pulmonary arterial pressure fell from 50.7 ± 15.3 mmHg to 38.0 ± 7.9 mmHg (25.0% decrease; 95% confidence interval (CI) 14.0-35.5%; = 0.01). Pulmonary vascular resistances were reduced from 8.5 ± 3.6 WU to 5.3 ± 2.2 WU (37.6% decrease; 95% CI 18.8-56.5%; = 0.01). WHO functional class was also improved with BPA. Severe BPA-related complications were infrequent and no periprocedural deaths were observed. (4) Conclusions: BPA is an effective and safe therapy for patients with CTEPH and persistent PH after PEA.