Author + information
Patient initials or identifier number
Relevant clinical history and physical exam
A 39 years old woman with hx of hereditaryspherocytosis with anemia and hyperbilirubinemia s/p splenectomy. She complained of exertional shortness of breath recently. The physical examination showed engorged carotid vein with leg edema.
Relevant test results prior to catheterization
The echocardiogram showed D-shape of LV. The V/Q scan and CTA of pulmonary artery confirmed the diagnosis of chronicthromboembolic pulmonary hypertension (CTEPH).
Relevant catheterization findings
The OCT showed Colander-Like lesion within pulmonary artery, and OCT-guided balloon dilatation to pulmonary artery was smooth.
The JR guiding catheter was engaged to right A8 pulmonary artery, and soft SION wire passed through the pulmonary artery. Under the OCT guide, we could see Colander-Like lesion. A 3.5/20 balloon dilatation was done to open the stenotic pulmonary artery smoothly. After procedure the mean pulmonary artery pressure (mPAP) decreased from 64 mmHg to 53 mmHg. There was no complication, and patient was sent to CCU for one night monitor. The procedure was smooth, and she was discharged two days later. The mPAP decreased to 43 mmHg one month later.
This is the first case in Taiwan. We used the OCT-guided balloon dilatation to treat CTEPH, and dilated the stenotic vessel smoothly. The mPAP lowered obviously without complication, and relieved patient's discomfort.