Percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension

Masaharu Kataoka, Takumi Inami, Kentaro Hayashida, Nobuhiko Shimura, Haruhisa Ishiguro, Takayuki Abe, Yuichi Tamura, Motomi Ando, Keiichi Fukuda, Hideaki Yoshino, Toru Satoh

Research output: Contribution to journalArticle

204 Citations (Scopus)

Abstract

Background-Chronic thromboembolic pulmonary hypertension leads to pulmonary hypertension and right-sided heart failure. The purpose of this study was to investigate the efficacy of percutaneous transluminal pulmonary angioplasty (PTPA) for the treatment of chronic thromboembolic pulmonary hypertension. Methods and Results-Twenty-nine patients with chronic thromboembolic pulmonary hypertension underwent PTPA. One patient had a wiring perforation as a complication of PTPA and died 2 days after the procedure. In the remaining 28 patients, PTPA did not produce immediate hemodynamic improvement at the time of the procedure. However, after follow-up (6.0 ± 6.9 months), New York Heart Association functional classifications and levels of plasma B-type natriuretic peptide significantly improved (both P<0.01). Hemodynamic parameters also significantly improved (mean pulmonary arterial pressure, 45.3 ± 9.8 versus 31.8 ± 10.0 mm Hg; cardiac output, 3.6 ± 1.2 versus 4.6 ± 1.7 L/min, baseline versus follow-up, respectively; both P<0.01). Twenty-seven of 51 procedures in total (53%), and 19 of 28 first procedures (68%), had reperfusion pulmonary edema as the chief complication. Patients with severe clinical signs and/or severe hemodynamics at baseline had a high risk of reperfusion pulmonary edema. Conclusions-PTPA improved subjective symptoms and objective variables, including pulmonary hemodynamics. PTPA may be a promising therapeutic strategy for the treatment of chronic thromboembolic pulmonary hypertension.

Original languageEnglish
Pages (from-to)756-762
Number of pages7
JournalCirculation: Cardiovascular Interventions
Volume5
Issue number6
DOIs
Publication statusPublished - 2012 Dec 1

Keywords

  • Chronic thromboembolic pulmonary hypertension
  • Hypertension
  • Percutaneous transluminal pulmonary angioplasty
  • Pulmonary
  • Reperfusion pulmonary edema

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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