Pulmonary balloon angioplasty for patients with chronic thromboembolic pulmonary hypertension accompanying with progressed pulmonary hypertension after pulmonary endarterectomy
10.7507/1007-4848.201810032
- VernacularTitle:慢性血栓栓塞性肺动脉高压患者外科术后发生进展性肺动脉高压行序贯式肺动脉球囊扩张治疗结果
- Author:
ZHU Jiade
1
;
JIANG Xin
1
;
DENG Long
1
;
SONG Wu
1
;
HUA Lu
1
;
JING Zhicheng
1
;
LIU Sheng
1
;
SONG Yunhu
1
Author Information
1. Adult Cardiac Surgery Center, Pulmonary Vascular Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, P.R.China
- Publication Type:Journal Article
- Keywords:
Chronic thromboembolic pulmonary hypertension;
pulmonary endarterectomy;
sequential pulmonary balloon angioplasty;
treatment result
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(7):698-703
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe the effect of sequential pulmonary balloon angioplasty for patients with chronic thromboembolic pulmonary hypertension, who was accompanied with progressed pulmonary hypertension after pulmonary endarterectomy surgeries. Methods From 2014 to December 2017, 7 patients were treated with a combination therapy of pulmonary endarterectomy and sequential pulmonary balloon angioplasty. There were 1 male and 6 females at age of 58 (43–59) years. A follow-up period of more than 1 year was accomplished. The result of right sided heart catheterization and ultrasonic cardiogram between and after the pulmonary endarterectomy or balloon angioplasty was collected. Results Seven patients were treated with a combination of pulmonary endarterectomy and sequential pulmonary balloon angioplasty, which included 1 patient of single pulmonary balloon angioplasty and 6 patients of multiple pulmonary balloon angioplasties. The balloon dilation times was 2 (2–6), and the number of segments during each single balloon dilatation was 3–5, compared with the first clinical results before the first balloon dilation, systolic pulmonary artery pressure [53 (47–75) mm Hg vs. 45 (40–54) mm Hg, P=0.042), mean pulmonaryartery pressure [38 (29–47) mm Hg vs. 29 (25–39) mm Hg, P=0.043], N terminal-B type natriuretic peptide [1 872 (1 598–2 898) pg/ml vs. 164 (72–334) pg/ml, P=0.018] improved significantly after the last balloon angioplasty. Heart function classification (NYHA) of all the 7 patients were recovered to Ⅰ-Ⅱclasses (P<0.05). Conclusion Sequential pulmonary balloon angioplasty after pulmonary endarterectomy can further reduce the patient's right heart after load, improve the heart function for patients with progressed pulmonary hypertension after pulmonary endarterectomy surgeries.
