Balloon Angioplasty of the Peripheral Thrombosis of the Pulmonary Artery in Treatment of Chronic Thromboembolic Pulmonary Hypertension

Issa A. Jeblawi , Manolis G. Pursanov, Sergey V. Gorbachevskiy, Andrey V. Sobolev, Gulamjan M. Dadabayev, Kamollidin H. Rakhmonov, Vladimir V. Losev

A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – A

Abstract

Objective: to determine effectiveness and possibilities of percutaneous balloon angioplasty (PBA) of the peripheral pulmonary artery (PA) stenosis in patients with chronic thromboembolic pulmonary hypertension (CTEPH).

Materials and methods: PBA of 44 PA segments were performed in 25 patients at the age from 30 to 80 years old (median 52,8+9,7 years) with CTEPH during the period from June 2015 to December 2017. Signs of severe heart failure were registered in 17 patients, decrease of oxygen saturation of the arterial blood. Patient’s deviation according to NYHA functional class (FC): in II - 4, in III – 18 and in IV – 3 patients. In 12 patients, lesions were localized in the left lung, in 10 – in the right lung and in 3 – both lungs. One segment PBA was performed in 14 patients, 2 segments- in 6, 3 segments – in 5 and in 1 patients – 4 segments in one session.

Results.There was 1 lethal case (4%) due to PA perforation, and in 3 patents (12%) – we registered development of reperfusion syndrome, which was treated conservatively. After PBA a systolic pressure gradient on the PA stenosis was decreased in median from 26,7+12,5 to 9,6+4,2 mm.Hg. (p<0,05). Decrease of systolic pressure in PA was registered immediately after PBA (71,5+33,7 до 60+26,9 (p<0,01) mm.Hg) as well as increase of oxygen saturation of the arterial blood (from 91,7+3,4% to 93,8+1,9% (p>0,01)). Long-term follow up results were studied in 12 patients (median 7,7+4,0 month after PBA). Patient’s deviation according to NYHA FC in Long-term follow up: II – 6, III – 5 and IV – 1 patient.

Conclusion: PBA of distal lesions of the PA in patients with CTEPH is effective and relatively safe method of treatment, which helps achieve improvement in patients quality of life.