• Masaharu Kataoka, Takumi Inami, Kentaro Hayashida, Nobuhiko Shimura, Haruhisa Ishiguro, Takayuki Abe, Yuichi Tamura, Motomi Ando, Keiichi Fukuda, Hideaki Yoshino, and Toru Satoh.
• Division of Cardiology, Department of Medicine, Kyorin University School of Medicine, Keio University School of Medicine, Tokyo, Japan.
• Circ Cardiovasc Interv. 2012 Dec 1;5(6):756-62.

BackgroundChronic thromboembolic pulmonary hypertension leads to pulmonary hypertension and right-sided heart failure. The purpose of this study was to investigate the efficacy of percutaneous transluminal pulmonary angioplasty (PTPA) for the treatment of chronic thromboembolic pulmonary hypertension.Methods And ResultsTwenty-nine patients with chronic thromboembolic pulmonary hypertension underwent PTPA. One patient had a wiring perforation as a complication of PTPA and died 2 days after the procedure. In the remaining 28 patients, PTPA did not produce immediate hemodynamic improvement at the time of the procedure. However, after follow-up (6.0 ± 6.9 months), New York Heart Association functional classifications and levels of plasma B-type natriuretic peptide significantly improved (both P<0.01). Hemodynamic parameters also significantly improved (mean pulmonary arterial pressure, 45.3 ± 9.8 versus 31.8 ± 10.0 mm Hg; cardiac output, 3.6 ± 1.2 versus 4.6 ± 1.7 L/min, baseline versus follow-up, respectively; both P<0.01). Twenty-seven of 51 procedures in total (53%), and 19 of 28 first procedures (68%), had reperfusion pulmonary edema as the chief complication. Patients with severe clinical signs and/or severe hemodynamics at baseline had a high risk of reperfusion pulmonary edema.ConclusionsPTPA improved subjective symptoms and objective variables, including pulmonary hemodynamics. PTPA may be a promising therapeutic strategy for the treatment of chronic thromboembolic pulmonary hypertension.Clinical Trial RegistrationURL: http://www.umin.ac.jp. Unique identifier: UMIN000001572.

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