RT Journal Article
SR Electronic
T1 French experience of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1802095
DO 10.1183/13993003.02095-2018
VO 53
IS 5
A1 Philippe Brenot
A1 Xavier Jaïs
A1 Yu Taniguchi
A1 Carlos Garcia Alonso
A1 Benoit Gerardin
A1 Sacha Mussot
A1 Olaf Mercier
A1 Dominique Fabre
A1 Florence Parent
A1 Mitja Jevnikar
A1 David Montani
A1 Laurent Savale
A1 Olivier Sitbon
A1 Elie Fadel
A1 Marc Humbert
A1 Gérald Simonneau
YR 2019
UL http://erj.ersjournals.com/content/53/5/1802095.abstract
AB Aims To evaluate safety and efficacy of balloon pulmonary angioplasty (BPA) in a large cohort of patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods From 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.Results Overall, 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%.Conclusion This 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.Refined balloon pulmonary angioplasty improves short-term symptoms, oxygenation, exercise capacity and haemodynamics in inoperable CTEPH patients with an acceptable risk–benefit ratio http://bit.ly/2UjaHhb