Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany.
Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany.
J Heart Lung Transplant. 2022 Aug;41(8):1086-1094. doi: 10.1016/j.healun.2022.05.002. Epub 2022 May 20.
Balloon pulmonary angioplasty (BPA) is an emerging interventional treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) that targets subsegmental branches of the pulmonary artery. As the reported complication rates are high, the aim of the present study was to evaluate the effects of certain complications on the outcome after treatment.
From March 2014 to December 2019, a total of 235 patients with inoperable CTEPH underwent BPA. Of these patients, 140 were included who completed a follow-up examination 6 months after the last intervention; another 2 patients deceased due to complications of BPA.
A high baseline pulmonary vascular resistance (PVR) >6.6 WU correlated with a higher rate of complications (mostly pulmonary artery perforations). Wire perforation during BPA did not correlate with worse outcome in terms of PVR reduction. The complication rate per intervention decreased from 21% to 14% during the 5 year period of the study.
Complications are frequently observed in BPA, but the mortality rate is very low in expert centers. Importantly, the occurrence of complications does not portend a worse outcome.
球囊肺动脉成形术（BPA）是一种新兴的介入治疗方法，适用于无法手术的慢性血栓栓塞性肺动脉高压（CTEPH），针对的是肺动脉的亚段分支。由于报告的并发症发生率较高，本研究旨在评估治疗后某些并发症对结果的影响。
2014 年 3 月至 2019 年 12 月，共有 235 例无法手术的 CTEPH 患者接受了 BPA 治疗。其中 140 例患者完成了最后一次介入治疗后 6 个月的随访检查；另有 2 例患者因 BPA 并发症死亡。
基线肺血管阻力（PVR）>6.6 WU 较高与较高的并发症发生率（主要是肺动脉穿孔）相关。BPA 过程中的导丝穿孔与 PVR 降低的预后恶化无关。在研究的 5 年期间，每次介入的并发症发生率从 21%降至 14%。
BPA 中经常观察到并发症，但在专家中心死亡率非常低。重要的是，并发症的发生并不预示着预后更差。
