Aleksander Araszkiewicz1, Szymon Darocha2, Arkadiusz Pietrasik3, Radosław Pietura4, Stanisław Jankiewicz5, Marta Banaszkiewicz2, Sylwia Sławek-Szmyt5, Andrzej Biederman6, Tatiana Mularek-Kubzdela5, Maciej Lesiak5, Adam Torbicki2, Marcin Kurzyna2. 1. Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland. Electronic address: aleksander.araszkiewicz@skpp.edu.pl. 2. Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Centre Otwock, Medical Centre for Postgraduate Education, Otwock, Poland. 3. Department and Faculty of Cardiology, Medical University of Warsaw, Warsaw, Poland. 4. Department of Radiography, Medical University of Lublin, Lublin, Poland. 5. Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland. 6. Department of Cardiac Surgery, Medicover Hospital, Warsaw, Poland.
Abstract
BACKGROUND: Pulmonary endarterectomy (PEA) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). However, persistent pulmonary hypertension continues in 5-35% of patients after PEA. Recently, balloon pulmonary angioplasty (BPA) showed promise as a strategy for patients with non-operable CTEPH. Therefore, we investigated the usefulness of BPA for residual pulmonary hypertension after PEA. METHODS: Fifteen patients with residual pulmonary hypertension after PEA received 71 BPA sessions (4.7 ± 1.4 sessions/patient). The mean time between the PEA and the first BPA session was 28.1 ± 25.8 months. All patients underwent a comprehensive diagnostic work-up, including right heart catheterization, functional and laboratory tests, before, and 6-4 weeks after the BPA sessions. RESULTS: After BPA, the mean pulmonary arterial pressure decreased from 44.7 ± 6.4 to 30.8 ± 7.5 mm Hg (31% decline; p < 0.001). Pulmonary vascular resistance decreased from 551.9 ± 185.2 to 343.8 ± 123.8 dyn∗s/cm-5 (38% decline; p < 0.001). The 6-min walking distance increased from 383 ± 104 to 476 ± 107 m (mean change +93 m; p < 0.001). In two sessions (2.8%), serious periprocedural complications occurred. During a mean follow-up of 18 ± 14.3 months, one patient died two months after the last BPA session. Fourteen patients survived. CONCLUSIONS: BPA could be a promising therapeutic strategy for persistent pulmonary hypertension after PEA in patients with CTEPH.
BACKGROUND: Pulmonary endarterectomy (PEA) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). However, persistent pulmonary hypertension continues in 5-35% of patients after PEA. Recently, balloon pulmonary angioplasty (BPA) showed promise as a strategy for patients with non-operable CTEPH. Therefore, we investigated the usefulness of BPA for residual pulmonary hypertension after PEA. METHODS: Fifteen patients with residual pulmonary hypertension after PEA received 71 BPA sessions (4.7 ± 1.4 sessions/patient). The mean time between the PEA and the first BPA session was 28.1 ± 25.8 months. All patients underwent a comprehensive diagnostic work-up, including right heart catheterization, functional and laboratory tests, before, and 6-4 weeks after the BPA sessions. RESULTS: After BPA, the mean pulmonary arterial pressure decreased from 44.7 ± 6.4 to 30.8 ± 7.5 mm Hg (31% decline; p < 0.001). Pulmonary vascular resistance decreased from 551.9 ± 185.2 to 343.8 ± 123.8 dyn∗s/cm-5 (38% decline; p < 0.001). The 6-min walking distance increased from 383 ± 104 to 476 ± 107 m (mean change +93 m; p < 0.001). In two sessions (2.8%), serious periprocedural complications occurred. During a mean follow-up of 18 ± 14.3 months, one patient died two months after the last BPA session. Fourteen patients survived. CONCLUSIONS:BPA could be a promising therapeutic strategy for persistent pulmonary hypertension after PEA in patients with CTEPH.
Authors: Sylwia Sławek-Szmyt; Aleksander Araszkiewicz; Stanisław Jankiewicz; Marek Grygier; Tatiana Mularek-Kubzdela; Maciej Lesiak Journal: J Clin Med Date: 2022-05-12 Impact factor: 4.964
Authors: Anna Siennicka; Szymon Darocha; Marta Banaszkiewicz; Piotr Kędzierski; Anna Dobosiewicz; Piotr Błaszczak; Małgorzata Peregud-Pogorzelska; Jarosław Damian Kasprzak; Michał Tomaszewski; Ewa Mroczek; Bożena Zięba; Danuta Karasek; Katarzyna Ptaszyńska-Kopczyńska; Katarzyna Mizia-Stec; Tatiana Mularek-Kubzdela; Anna Doboszyńska; Ewa Lewicka; Marcin Ruchała; Maciej Lewandowski; Sylwia Łukasik; Łukasz Chrzanowski; Dariusz Zieliński; Adam Torbicki; Marcin Kurzyna Journal: Ther Adv Respir Dis Date: 2019 Jan-Dec Impact factor: 4.031
Authors: Marta Banaszkiewicz; Arkadiusz Pietrasik; Michał Florczyk; Piotr Kędzierski; Michał Piłka; Rafał Mańczak; Janusz Kochman; Grzegorz Opolski; Adam Torbicki; Marcin Kurzyna; Szymon Darocha Journal: Diagnostics (Basel) Date: 2021-01-16
Authors: Michał Piłka; Szymon Darocha; Marta Banaszkiewicz; Maria Wieteska-Miłek; Małgorzata Mańczak; Rafał Mańczak; Piotr Kędzierski; Michał Florczyk; Anna Dobosiewicz; Adam Torbicki; Marcin Kurzyna Journal: Ann Noninvasive Electrocardiol Date: 2020-04-26 Impact factor: 1.468
Authors: Szymon Darocha; Aleksander Araszkiewicz; Marcin Kurzyna; Marta Banaszkiewicz; Stanisław Jankiewicz; Anna Dobosiewicz; Sylwia Sławek-Szmyt; Magdalena Janus; Maciej Grymuza; Arkadiusz Pietrasik; Tatiana Mularek-Kubzdela; Piotr Kędzierski; Radosław Pietura; Dariusz Zieliński; Andrzej Biederman; Maciej Lesiak; Adam Torbicki Journal: J Clin Med Date: 2021-03-03 Impact factor: 4.241