Author + information
- Arun Kanmanthareddy1,
- alok saurav2,
- Hemantha Koduri3,
- JItendra Pandya4,
- Abhilash Akinapelli5,
- Aiman Smer6,
- Muhammad Azzouz7,
- Michael White8,
- Anjali Vaidya9 and
- Scott Lilly10
- 1Creighton University School of Medicine, Omaha, Nebraska, United States
- 2Creighton University Medical Center, Omaha, Nebraska, United States
- 3Creighton University School of Medicine, Omaha, Nebraska, United States
- 4Creighton University School of Medicine
- 5German Heart Center Munich
- 6Omaha, Nebraska, United States
- 7Creighton University, Omaha, Nebraska, United States
- 8Creighton University, Omaha, Nebraska, United States
- 9Temple University Hospital
- 10univ penn, philadelphia, Pennsylvania, United States
Balloon pulmonary angioplasty (BPA) is an alternative to patients with chronic thromboembolic pulmonary hypertension (CTEPH) who have contraindications to undergo pulmonary endarterectomy.
We performed electronic search of PubMed, Google Scholar, EBSCO databases to identify studies evaluating the efficacy of BPA for the treatment of CTEPH. Pre-procedure and follow up hemodynamic data and 6-minute walk distance (6MWD) were extracted from the included studies. Weighted mean difference (WMD) with 95% confidence intervals were calculated using random or fixed effects model based on heterogeneity. All statistical analyses were performed using STATA 13.0 software.
A total of 10 studies with 268 patients were included in this study. The 6MWD increased by 83 meters (95% CI 59 – 108) after BPA. The mean pulmonary artery pressure (WMD 15.6, 95% CI 12.7 – 18.5 mm Hg), pulmonary capillary wedge pressure (WMD 1.2, 95% CI 0.5 – 1.9 mm Hg), pulmonary vascular resistance (WMD 295, 95% CI 75 – 515 dynes/cm/sec5), right atrial pressure (WMD 2.3, 95% CI 1.3 – 3.3 mm Hg) and BNP (WMD 158, 95% CI 123 – 194 pg/ml) decreased following BPA. The cardiac output (WMD 0.75, 95% CI 0.42 – 1.8 l/min) and cardiac index (WMD 0.53, 95% CI 0.22 – 0.84 l/min/m2) improved significantly after the BPA procedure.
BPA in the treatment of inoperable CTEPH appears to favorably improve functional capacity and is also associated with improvement in cardiopulmonary hemodynamic parameters. Our study results are limited by the small study population and lack of control subjects.
CORONARY: Angioplasty Overview and Outcomes