Document Detail


Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension.
MedLine Citation:
PMID:  11136677     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although pulmonary thromboendarterectomy is increasingly successful for the definitive treatment of chronic thromboembolic pulmonary hypertension (CTEPH), not all patients have surgically accessible disease. Others are poor surgical candidates because of comorbid illness. Therefore, for selected patients, we defined and implemented an alternative interventional strategy of balloon pulmonary angioplasty (BPA). METHODS AND RESULTS: Eighteen patients (mean age, 51.8 years; range, 14 to 75 years) with CTEPH underwent BPA; they averaged 2.6 procedures (range, 1 to 5) and 6 dilations (range, 1 to 12). Selection of pulmonary artery segments for dilation required (1) complete occlusion, (2) filling defects, or (3) signs of intravascular webs. After an average of 36 months of follow-up (range, 0.5 to 66 months), the average New York Heart Association class improved from 3.3 to 1.8 (P:<0.001), and 6-minute walking distances increased from 209 to 497 yards (P:<0.0001). Pulmonary artery mean pressures decreased from 43.0+/-12.1 to 33. 7+/-10.2 mm Hg (P:=0.007). Eleven patients developed reperfusion pulmonary edema; 3 required mechanical ventilation. CONCLUSIONS: BPA reduces pulmonary artery hypertension in patients with CTEPH and is associated with long-term improvement in New York Heart Association class and 6-minute walking distances. BPA is a promising interventional technique that warrants randomized comparison with medical therapy in CTEPH patients who are not surgical candidates.
Authors:
J A Feinstein; S Z Goldhaber; J E Lock; S M Ferndandes; M J Landzberg
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  103     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-01-09     Completed Date:  2001-01-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  10-3     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiology, Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Angioplasty, Balloon* / adverse effects,  mortality
Chronic Disease
Diuretics / therapeutic use
Follow-Up Studies
Hemodynamics
Humans
Hypertension, Pulmonary / etiology,  surgery*
Middle Aged
Oxygen Inhalation Therapy
Pulmonary Edema / etiology,  therapy
Pulmonary Embolism / complications,  surgery*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Diuretics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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