TY - JOUR
T1 - Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension results of a multicenter registry
AU - Ogawa, Aiko
AU - Satoh, Toru
AU - Fukuda, Tetsuya
AU - Sugimura, Koichiro
AU - Fukumoto, Yoshihiro
AU - Emoto, Noriaki
AU - Yamada, Norikazu
AU - Yao, Atsushi
AU - Ando, Motomi
AU - Ogino, Hitoshi
AU - Tanabe, Nobuhiro
AU - Tsujino, Ichizo
AU - Hanaoka, Masayuki
AU - Minatoya, Kenji
AU - Ito, Hiroshi
AU - Matsubara, Hiromi
N1 - Funding Information:
Dr Ogawa received lecture fees from Actelion Pharmaceuticals Japan, Ltd; GlaxoSmithKline KK; Nippon Shinyaku Co, Ltd; and Pfizer Japan, Inc. Dr Sugimura received lecture fees from Bayer Yakuhin, Ltd; GlaxoSmithKline KK; Kaneka Medix Corporation; Nippon Shinyaku Co, Ltd; and Pfizer Japan, Inc. Dr Fukumoto received research grants from Actelion Pharmaceuticals Japan, Ltd;
Funding Information:
This study was partly supported by the Japanese Circulation Society.
Funding Information:
Bayer Yakuhin, Ltd; Mochida Pharmaceutical Co, Ltd; Nippon Shinyaku Co, Ltd; and Pfizer Japan, Inc, and lecture fees from Bayer Yakuhin, Ltd; Mochida Pharmaceutical Co, Ltd; Nippon Shinyaku Co, Ltd; and Pfizer Japan, Inc. Dr Emoto received lecture fees and research grants from Actelion Pharmaceuticals Japan, Ltd; Bayer Yakuhin, Ltd; GlaxoSmithKline KK; Nippon Shinyaku Co, Ltd; and Pfizer Japan, Inc. Dr Yamada received lecture fees from Actelion Pharmaceuticals Japan, Ltd; Bayer Yakuhin, Ltd; Nippon Shinyaku Co, Ltd; and Pfizer Japan, Inc. Dr Yao received lecture fees from Actelion Pharmaceuticals Japan, Ltd; Nippon Shinyaku Co, Ltd; Bayer Yakuhin, Ltd; and Mochida Pharmaceutical Co, Ltd. Dr Tanabe received lecture fees from Actelion Pharmaceuticals Japan, Ltd; Bayer Yakuhin, Ltd; Nippon Shinyaku Co, Ltd; and Pfizer Japan, Inc; received a scholarship fund from Nippon Shinyaku Co, Ltd; and belonged to endowed department from Actelion Pharmaceuticals Japan, Ltd. Dr Tsujino received lecture fees from Actelion Pharmaceuticals Japan, Ltd; Bayer Yakuhin, Ltd; Nippon Shinyaku Co, Ltd; and Pfizer Japan, Inc. Dr Matsubara received lecture fees from Actelion Pharmaceuticals Japan, Ltd; AOP Orphan Pharmaceuticals AG; Bayer Yakuhin, Ltd; GlaxoSmithKline KK; Kaneka Medix Corporation; Nippon Shinyaku Co, Ltd; and Pfizer Japan, Inc. The other authors report no conflicts.
Publisher Copyright:
© 2017 American Heart Association, Inc.
PY - 2017
Y1 - 2017
N2 - Background-Balloon pulmonary angioplasty (BPA) is an alternative therapy for patients with chronic thromboembolic pulmonary hypertension who are ineligible for pulmonary endarterectomy-the standard therapy. Currently, most reported results of BPA are from relatively small cohorts treated at single centers. The present study evaluated the safety and efficacy of BPA for chronic thromboembolic pulmonary hypertension based on a multicenter registry. Methods and Results-A total of 308 patients (62 men and 246 women; mean age, 61 years) underwent 1408 procedures at 7 institutions in Japan. Data were retrospectively reviewed to evaluate clinical outcome and complications. Hemodynamics were significantly improved in 249 patients in whom BPA was terminated, most often because of improvement in mean pulmonary arterial pressure or symptomatic improvement after 1154 procedures. In 196 patients who underwent followup right heart catheterization, improvement of hemodynamic parameters was maintained. Mean pulmonary arterial pressure decreased from 43.2±11.0 to 24.3±6.4 mm Hg after final BPA and 22.5±5.4 mm Hg at follow-up, with significant reduction of concomitant use of pulmonary hypertension-targeted therapy and oxygen supplementation. Complications occurred in 511 (36.3%), including pulmonary injury (17.8%), hemoptysis (14.0%), and pulmonary artery perforation (2.9%). Twelve patients (3.9%) died during follow-up, including 8 patients who died within 30 days after BPA. The leading causes of death were right heart failure, multiorgan failure, and sepsis. Overall survival was 96.8% (95% confidence interval, 93.7%-98.4%) at 1 and 2 years and 94.5% (95% confidence interval, 89.3%-97.3%) at 3 years, respectively, after the initial BPA procedure for all 308 patients. Conclusions-This multicenter registry suggested improved hemodynamic results after BPA. Complication rates were high, but overall survival was comparable with pulmonary endarterectomy. BPA may be an important therapeutic option in patients with chronic thromboembolic pulmonary hypertension.
AB - Background-Balloon pulmonary angioplasty (BPA) is an alternative therapy for patients with chronic thromboembolic pulmonary hypertension who are ineligible for pulmonary endarterectomy-the standard therapy. Currently, most reported results of BPA are from relatively small cohorts treated at single centers. The present study evaluated the safety and efficacy of BPA for chronic thromboembolic pulmonary hypertension based on a multicenter registry. Methods and Results-A total of 308 patients (62 men and 246 women; mean age, 61 years) underwent 1408 procedures at 7 institutions in Japan. Data were retrospectively reviewed to evaluate clinical outcome and complications. Hemodynamics were significantly improved in 249 patients in whom BPA was terminated, most often because of improvement in mean pulmonary arterial pressure or symptomatic improvement after 1154 procedures. In 196 patients who underwent followup right heart catheterization, improvement of hemodynamic parameters was maintained. Mean pulmonary arterial pressure decreased from 43.2±11.0 to 24.3±6.4 mm Hg after final BPA and 22.5±5.4 mm Hg at follow-up, with significant reduction of concomitant use of pulmonary hypertension-targeted therapy and oxygen supplementation. Complications occurred in 511 (36.3%), including pulmonary injury (17.8%), hemoptysis (14.0%), and pulmonary artery perforation (2.9%). Twelve patients (3.9%) died during follow-up, including 8 patients who died within 30 days after BPA. The leading causes of death were right heart failure, multiorgan failure, and sepsis. Overall survival was 96.8% (95% confidence interval, 93.7%-98.4%) at 1 and 2 years and 94.5% (95% confidence interval, 89.3%-97.3%) at 3 years, respectively, after the initial BPA procedure for all 308 patients. Conclusions-This multicenter registry suggested improved hemodynamic results after BPA. Complication rates were high, but overall survival was comparable with pulmonary endarterectomy. BPA may be an important therapeutic option in patients with chronic thromboembolic pulmonary hypertension.
KW - Angioplasty
KW - Hypertension
KW - Lung injury
KW - Pulmonary
KW - Survival
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U2 - 10.1161/CIRCOUTCOMES.117.004029
DO - 10.1161/CIRCOUTCOMES.117.004029
M3 - Article
C2 - 29101270
AN - SCOPUS:85042465746
VL - 10
JO - Circulation: Cardiovascular Quality and Outcomes
JF - Circulation: Cardiovascular Quality and Outcomes
SN - 1941-7713
IS - 11
M1 - e004029
ER -