Clinical efficacy and safety of sequential balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension
10.20039/j.cnki.1007-3949.2025.05.006
- VernacularTitle:分次逐级经皮腔内球囊肺动脉瓣成形术在治疗慢性血栓栓塞性肺动脉高压患者中的临床疗效及安全性
- Author:
Weifeng ZHENG
1
;
Hao WANG
1
;
Caifeng FAN
1
;
Guohua XUE
1
Author Information
1. 郑州大学附属洛阳中心医院心内科,河南省洛阳市 471000
- Publication Type:Journal Article
- Keywords:
balloon pulmonary angioplasty;
chronic thromboembolic pulmonary hypertension;
clinical efficacy;
safety
- From:
Chinese Journal of Arteriosclerosis
2025;33(5):412-418
- CountryChina
- Language:Chinese
-
Abstract:
Aim To explore the clinical efficacy of sequential balloon pulmonary angioplasty(BPA)in the treat-ment of patients with chronic thromboembolic pulmonary hypertension(CTEPH),and analyze the safety during the periop-erative period.Methods 30 patients with CTEPH who underwent BPA treatment at Luoyang Central Hospital affiliated to Zhengzhou University from August 2018 to February 2024 were selected,30 patients with CTEPH who chose drug treatment were set as controls,the patients'gender,age,body mass index,comorbidities,plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)levels,application of pulmonary hypertension targeted drugs,6-minute walking dis-tance(6-MWD),WHO cardiac function classification and cardiac ultrasound pulmonary arterial pressure related data were collected.Right heart catheterization was performed to obtain pulmonary hemodynamic parameters in the BPA group.Changes in WHO cardiac function classification,6-MWD,NT-proBNP,pulmonary vascular hemodynamic parameters and cardiac ultrasound pulmonary artery pressure data before BPA,after the final BPA and at 6-month follow-up were com-pared,as well as differences between the two groups.The occurrence and management results of surgical complications such as pulmonary artery injury,contrast nephropathy and reperfusion pulmonary edema were recorded.Results Compared with before BPA,after the last BPA,cardiac output(CO),cardiac index(CI),and mixed venous oxygen satu-ration(SvO2)increased,mean pulmonary artery pressure(mPAP)and pulmonary vascular resistance(PVR)decreased(all P＜0.05),and 6-MWD,NT-proBNP,right ventricular diameter,right atrial up-down diameter,right atrial left-right diameter,left ventricular diastolic end diameter,and tricuspid regurgitation velocity all improved(all P＜0.05).Com-pared with the control group,the surgical group showed an increase in 6-MWD,a decrease in NT-proBNP levels,a de-crease in right ventricular diameter,right atrial up-down diameter and right atrial left-right diameter,an increase in left ventricular end diastolic diameter,a decrease in tricuspid regurgitation velocity and a significant improvement in WHO car-diac function classification(all P＜0.05).Among 30 BPA patients,2 patients experienced hemoptysis during surgery,1 patient developed reperfusion pulmonary edema after surgery,and 1 patient developed contrast nephropathy.After treat-ment,all patients improved and were discharged.Conclusion Sequential BPA has good clinical efficacy and safety in the treatment of CTEPH patients,and is an effective technique for treating CTEPH,which is worth promoting in clinical practice.
