Key result
BPA linked to ~25% reduction in mean pulmonary arterial pressure in persistent PH after PEA.
Why the study?
Persistent pulmonary hypertension after pulmonary endarterectomy confers a worse prognosis, and evidence about the effectiveness and safety of balloon pulmonary angioplasty in this setting is limited.
Does balloon pulmonary angioplasty improve hemodynamics and clinical symptoms in patients with persistent pulmonary hypertension after pulmonary endarterectomy?
Observational (n=14)
No
Does balloon pulmonary angioplasty improve hemodynamics and clinical symptoms in patients with persistent pulmonary hypertension after pulmonary endarterectomy?
Effect estimate: 25.0% decrease (95% CI 14.0-35.5%)
Absolute Event Rate: 38% vs 50.7%
p-value: p=0.01
Balloon pulmonary angioplasty is an effective and safe interventional strategy that significantly improves hemodynamics and functional class in patients with persistent pulmonary hypertension following pulmonary endarterectomy.
BPA was associated with mPAP reduction in persistent PH after PEA; hypothesis-generating and requires RCTs before practice change.
(1) Background: Pulmonary endarterectomy (PEA) is the “gold standard” treatment for operable patients with chronic thromboembolic pulmonary hypertension (CTEPH). Persistent pulmonary hypertension (PH) after PEA confers a worse prognosis. Balloon pulmonary angioplasty (BPA) could represent a useful therapy in this setting, but evidence about its effectiveness and safety in patients with previous PEA is limited. (2) Methods: A total of 14 patients with persistent PH after PEA were treated with BPA in a single PH center. Hemodynamic and clinical effects of BPA and complications of the procedure were retrospectively collected. (3) Results: After BPA, the mean pulmonary arterial pressure fell from 50.7 ± 15.3 mmHg to 38.0 ± 7.9 mmHg (25.0% decrease; 95% confidence interval (CI) 14.0–35.5%; p = 0.01). Pulmonary vascular resistances were reduced from 8.5 ± 3.6 WU to 5.3 ± 2.2 WU (37.6% decrease; 95% CI 18.8–56.5%; p = 0.01). WHO functional class was also improved with BPA. Severe BPA-related complications were infrequent and no periprocedural deaths were observed. (4) Conclusions: BPA is an effective and safe therapy for patients with CTEPH and persistent PH after PEA.
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Melón et al. (2023) conducted an observational in persistent pulmonary hypertension after pulmonary endarterectomy (n=14). Balloon pulmonary angioplasty (BPA) was evaluated on mean pulmonary arterial pressure (25.0% decrease, 95% CI 14.0-35.5%, p=0.01). Balloon pulmonary angioplasty reduced mean pulmonary arterial pressure from 50.7 to 38.0 mmHg (25.0% decrease; 95% CI 14.0-35.5%; p=0.01) in patients with persistent PH after PEA.
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