Additional percutaneous transluminal pulmonary angioplasty for residual or recurrent pulmonary hypertension after pulmonary endarterectomy

Nobuhiko Shimura, Masaharu Kataoka, Takumi Inami, Ryoji Yanagisawa, Haruhisa Ishiguro, Takashi Kawakami, Yoshiro Higuchi, Motomi Ando, Keiichi Fukuda, Hideaki Yoshino, Toru Satoh

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Abstract Background Pulmonary endarterectomy (PEA) has been the most effective therapy for chronic thromboembolic pulmonary hypertension (CTEPH). However, residual or recurrent pulmonary hypertension often persists after PEA. Recently, catheter-based angioplasty, called percutaneous transluminal pulmonary angioplasty (PTPA) or balloon pulmonary angioplasty, has been developed as a promising strategy for CTEPH. Therefore, the usefulness of PTPA for residual or recurrent pulmonary hypertension after PEA was investigated. Methods Thirty-nine patients underwent PEA from January 2000, and a total of 423 consecutive PTPA sessions in 110 patients were performed from January 2009 to May 2014. Of them, 9 patients (23.0% of 39 patients undergoing PEA and 8.2% of 110 patients undergoing PTPA) had undergone previous PEA and additional PTPA. Results In these 9 patients, pulmonary vascular resistance (PVR) was 15.6 (7.8-18.9) wood units at baseline, and significantly improved after PEA [5.6 (3.5-6.5) wood units] (p < 0.05). However, PVR gradually deteriorated before PTPA [8.1 (6.1-12.3) wood units] compared to after PEA, suggesting that these 9 patients had residual or recurrent pulmonary hypertension after PEA. PTPA was performed at 4.1 (2.7-7.9) years after PEA. Follow-up catheterization at 1.9 (1.3-3.3) years after PTPA revealed significant improvement of PVR [4.2 (2.8-4.8) wood units] (p < 0.05). Conclusions A hybrid approach combining PEA and additional PTPA may be reasonable for patients with both proximal and very distal lesions not easily approachable by PEA. PTPA could be a promising alternative therapeutic strategy for residual or recurrent pulmonary hypertension after PEA.

Original languageEnglish
Article number19595
Pages (from-to)138-142
Number of pages5
JournalInternational Journal of Cardiology
Volume183
DOIs
Publication statusPublished - 2015 Mar 15

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Endarterectomy
Angioplasty
Pulmonary Hypertension
Lung
Vascular Resistance

Keywords

  • Chronic thromboembolic pulmonary hypertension
  • Percutaneous transluminal pulmonary angioplasty
  • Pulmonary endarterectomy
  • Residual pulmonary hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Additional percutaneous transluminal pulmonary angioplasty for residual or recurrent pulmonary hypertension after pulmonary endarterectomy. / Shimura, Nobuhiko; Kataoka, Masaharu; Inami, Takumi; Yanagisawa, Ryoji; Ishiguro, Haruhisa; Kawakami, Takashi; Higuchi, Yoshiro; Ando, Motomi; Fukuda, Keiichi; Yoshino, Hideaki; Satoh, Toru.

In: International Journal of Cardiology, Vol. 183, 19595, 15.03.2015, p. 138-142.

Research output: Contribution to journalArticle

Shimura, N, Kataoka, M, Inami, T, Yanagisawa, R, Ishiguro, H, Kawakami, T, Higuchi, Y, Ando, M, Fukuda, K, Yoshino, H & Satoh, T 2015, 'Additional percutaneous transluminal pulmonary angioplasty for residual or recurrent pulmonary hypertension after pulmonary endarterectomy', International Journal of Cardiology, vol. 183, 19595, pp. 138-142. https://doi.org/10.1016/j.ijcard.2015.01.034
Shimura, Nobuhiko ; Kataoka, Masaharu ; Inami, Takumi ; Yanagisawa, Ryoji ; Ishiguro, Haruhisa ; Kawakami, Takashi ; Higuchi, Yoshiro ; Ando, Motomi ; Fukuda, Keiichi ; Yoshino, Hideaki ; Satoh, Toru. / Additional percutaneous transluminal pulmonary angioplasty for residual or recurrent pulmonary hypertension after pulmonary endarterectomy. In: International Journal of Cardiology. 2015 ; Vol. 183. pp. 138-142.
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abstract = "Abstract Background Pulmonary endarterectomy (PEA) has been the most effective therapy for chronic thromboembolic pulmonary hypertension (CTEPH). However, residual or recurrent pulmonary hypertension often persists after PEA. Recently, catheter-based angioplasty, called percutaneous transluminal pulmonary angioplasty (PTPA) or balloon pulmonary angioplasty, has been developed as a promising strategy for CTEPH. Therefore, the usefulness of PTPA for residual or recurrent pulmonary hypertension after PEA was investigated. Methods Thirty-nine patients underwent PEA from January 2000, and a total of 423 consecutive PTPA sessions in 110 patients were performed from January 2009 to May 2014. Of them, 9 patients (23.0{\%} of 39 patients undergoing PEA and 8.2{\%} of 110 patients undergoing PTPA) had undergone previous PEA and additional PTPA. Results In these 9 patients, pulmonary vascular resistance (PVR) was 15.6 (7.8-18.9) wood units at baseline, and significantly improved after PEA [5.6 (3.5-6.5) wood units] (p < 0.05). However, PVR gradually deteriorated before PTPA [8.1 (6.1-12.3) wood units] compared to after PEA, suggesting that these 9 patients had residual or recurrent pulmonary hypertension after PEA. PTPA was performed at 4.1 (2.7-7.9) years after PEA. Follow-up catheterization at 1.9 (1.3-3.3) years after PTPA revealed significant improvement of PVR [4.2 (2.8-4.8) wood units] (p < 0.05). Conclusions A hybrid approach combining PEA and additional PTPA may be reasonable for patients with both proximal and very distal lesions not easily approachable by PEA. PTPA could be a promising alternative therapeutic strategy for residual or recurrent pulmonary hypertension after PEA.",
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T1 - Additional percutaneous transluminal pulmonary angioplasty for residual or recurrent pulmonary hypertension after pulmonary endarterectomy

AU - Shimura, Nobuhiko

AU - Kataoka, Masaharu

AU - Inami, Takumi

AU - Yanagisawa, Ryoji

AU - Ishiguro, Haruhisa

AU - Kawakami, Takashi

AU - Higuchi, Yoshiro

AU - Ando, Motomi

AU - Fukuda, Keiichi

AU - Yoshino, Hideaki

AU - Satoh, Toru

PY - 2015/3/15

Y1 - 2015/3/15

N2 - Abstract Background Pulmonary endarterectomy (PEA) has been the most effective therapy for chronic thromboembolic pulmonary hypertension (CTEPH). However, residual or recurrent pulmonary hypertension often persists after PEA. Recently, catheter-based angioplasty, called percutaneous transluminal pulmonary angioplasty (PTPA) or balloon pulmonary angioplasty, has been developed as a promising strategy for CTEPH. Therefore, the usefulness of PTPA for residual or recurrent pulmonary hypertension after PEA was investigated. Methods Thirty-nine patients underwent PEA from January 2000, and a total of 423 consecutive PTPA sessions in 110 patients were performed from January 2009 to May 2014. Of them, 9 patients (23.0% of 39 patients undergoing PEA and 8.2% of 110 patients undergoing PTPA) had undergone previous PEA and additional PTPA. Results In these 9 patients, pulmonary vascular resistance (PVR) was 15.6 (7.8-18.9) wood units at baseline, and significantly improved after PEA [5.6 (3.5-6.5) wood units] (p < 0.05). However, PVR gradually deteriorated before PTPA [8.1 (6.1-12.3) wood units] compared to after PEA, suggesting that these 9 patients had residual or recurrent pulmonary hypertension after PEA. PTPA was performed at 4.1 (2.7-7.9) years after PEA. Follow-up catheterization at 1.9 (1.3-3.3) years after PTPA revealed significant improvement of PVR [4.2 (2.8-4.8) wood units] (p < 0.05). Conclusions A hybrid approach combining PEA and additional PTPA may be reasonable for patients with both proximal and very distal lesions not easily approachable by PEA. PTPA could be a promising alternative therapeutic strategy for residual or recurrent pulmonary hypertension after PEA.

AB - Abstract Background Pulmonary endarterectomy (PEA) has been the most effective therapy for chronic thromboembolic pulmonary hypertension (CTEPH). However, residual or recurrent pulmonary hypertension often persists after PEA. Recently, catheter-based angioplasty, called percutaneous transluminal pulmonary angioplasty (PTPA) or balloon pulmonary angioplasty, has been developed as a promising strategy for CTEPH. Therefore, the usefulness of PTPA for residual or recurrent pulmonary hypertension after PEA was investigated. Methods Thirty-nine patients underwent PEA from January 2000, and a total of 423 consecutive PTPA sessions in 110 patients were performed from January 2009 to May 2014. Of them, 9 patients (23.0% of 39 patients undergoing PEA and 8.2% of 110 patients undergoing PTPA) had undergone previous PEA and additional PTPA. Results In these 9 patients, pulmonary vascular resistance (PVR) was 15.6 (7.8-18.9) wood units at baseline, and significantly improved after PEA [5.6 (3.5-6.5) wood units] (p < 0.05). However, PVR gradually deteriorated before PTPA [8.1 (6.1-12.3) wood units] compared to after PEA, suggesting that these 9 patients had residual or recurrent pulmonary hypertension after PEA. PTPA was performed at 4.1 (2.7-7.9) years after PEA. Follow-up catheterization at 1.9 (1.3-3.3) years after PTPA revealed significant improvement of PVR [4.2 (2.8-4.8) wood units] (p < 0.05). Conclusions A hybrid approach combining PEA and additional PTPA may be reasonable for patients with both proximal and very distal lesions not easily approachable by PEA. PTPA could be a promising alternative therapeutic strategy for residual or recurrent pulmonary hypertension after PEA.

KW - Chronic thromboembolic pulmonary hypertension

KW - Percutaneous transluminal pulmonary angioplasty

KW - Pulmonary endarterectomy

KW - Residual pulmonary hypertension

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