Takano Ryo, Ueda Jin, Seike Yoshimasa, Kotoku Akiyuki, Horinouchi Hiroki, Inoue Yosuke, Fukuda Tetsuya, Matsuda Hitoshi, Ogo Takeshi
Division of Pulmonary Circulation, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Osaka Japan.
Department of Cardiovascular Surgery National Cerebral and Cardiovascular Center Osaka Japan.
Pulm Circ. 2025 Aug 29;15(3):e70155. doi: 10.1002/pul2.70155. eCollection 2025 Jul.
Pulmonary endarterectomy (PEA) is the gold standard treatment for chronic thromboembolic pulmonary hypertension (CTEPH). While balloon pulmonary angioplasty (BPA) is an emerging treatment for distal CTEPH, a standard therapeutic strategy for CTEPH with unilateral central lesions has yet to be established. Herein, we describe the successful treatment of a patient with CTEPH who underwent BPA for left distal lesions, followed by PEA for unilateral right central lesions, without serious complications. BPA before PEA may reduce perioperative complications by improving hemodynamics and contribute to a better clinical course by shortening deep hypothermic circulatory arrest time through reduction of the PEA treatment area. Depending on the anatomical characteristics of the lesions, this combination therapy should be discussed by a multidisciplinary CTEPH team.
肺动脉内膜剥脱术（PEA）是慢性血栓栓塞性肺动脉高压（CTEPH）的金标准治疗方法。虽然球囊肺动脉血管成形术（BPA）是治疗远端CTEPH的一种新兴方法，但针对单侧中心性病变的CTEPH的标准治疗策略尚未确立。在此，我们描述了一例CTEPH患者的成功治疗过程，该患者先接受BPA治疗左远端病变，随后接受PEA治疗单侧右中心性病变，且未出现严重并发症。PEA前进行BPA可能通过改善血流动力学减少围手术期并发症，并通过减少PEA治疗面积缩短深低温循环停搏时间，从而有助于获得更好的临床病程。根据病变的解剖特征，这种联合治疗应由多学科CTEPH团队进行讨论。
