Balloon pulmonary angioplasty for patients with inoperable chronic thromboembolic pulmonary hypertension


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Abstract

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.

About the authors

N M Danilov

National Medical Research Center for Cardiology of the Ministry of Health of Russian Federation

к.м.н., с.н.с. отд. гипертонии ФГБУ «НМИЦ кардиологии»; ORCID: 0000-0001-9853-9087 Moscow, Russia

Yu G Matchin

National Medical Research Center for Cardiology of the Ministry of Health of Russian Federation

д.м.н., руководитель лаб. рентгенэндоваскулярных методов диагностики и лечения в амбулаторных условиях ФГБУ «НМИЦ кардиологии» Moscow, Russia

A M Chernyavsky

E.N. Meshalkin National Medical Research Center of the Ministry of Health of Russian Federation

д.м.н. руководитель центра хирургии аорты и коронарных артерий ФГБУ «НМИЦ им. академика Е.Н. Мешалкина» Novosibirsk, Russia

A G Edemsky

E.N. Meshalkin National Medical Research Center of the Ministry of Health of Russian Federation

сердечно-сосудистый хирург центра хирургии аорты и коронарных артерий ФГБУ «НМИЦ им. академика Е.Н. Мешалкина» Novosibirsk, Russia

D S Grankin

E.N. Meshalkin National Medical Research Center of the Ministry of Health of Russian Federation

к.м.н., специалист по рентгенэндоваскулярным методам диагностики и лечения ФГБУ «НМИЦ им. академика Е.Н. Мешалкина» Novosibirsk, Russia

O V Sagaydak

National Medical Research Center for Cardiology of the Ministry of Health of Russian Federation

Email: olesyasagaydak@gmail.com
м.н., н.с. отд. гипертонии ФГБУ «НМИЦ кардиологии»; тел.: +7(903)687-12-39; ORCID: 0000-0002-2534-8463 Moscow, Russia

I E Chazova

National Medical Research Center for Cardiology of the Ministry of Health of Russian Federation

д.м.н., академик РАН, руководитель отд. гипертонии ФГБУ «НМИЦ кардиологии»; ORCID: 0000-0002-9822-4357 Moscow, Russia

S A Boytsov

National Medical Research Center for Cardiology of the Ministry of Health of Russian Federation

д.м.н., проф., член-корр. РАН, директор ФГБУ «НМИЦ кардиологии» Moscow, Russia

A M Karaskov

E.N. Meshalkin National Medical Research Center of the Ministry of Health of Russian Federation

д.м.н., академик РАН, директор ФГБУ «НМИЦ им. академика Е.Н. Мешалкина» Novosibirsk, Russia

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