PMID- 33381946
OWN - NLM
STAT- MEDLINE
DCOM- 20210112
LR  - 20210112
IS  - 1565-1088 (Print)
VI  - 22
IP  - 12
DP  - 2020 Dec
TI  - Balloon Pulmonary Angioplasty for Inoperable Chronic Thromboembolic Pulmonary 
      Hypertension: First Experience at the Israeli National CTEPH Referral Center.
PG  - 752-756
AB  - BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, 
      distinct pulmonary vascular disease caused by chronic obstruction of major 
      pulmonary arteries, which can be cured by pulmonary endarterectomy. However, many 
      CTEPH patients are not surgical candidates. Balloon pulmonary angioplasty (BPA) 
      is an emerging technique used to treat inoperable CTEPH. OBJECTIVES: To describe 
      the first Israeli experience with BPA for inoperable CTEPH. METHODS: In 2017 we 
      established a BPA program at our institution. We reviewed the outcomes to date of 
      BPA in our center. RESULTS: Forty-seven BPA procedures were performed in five 
      patients with inoperable CTEPH (4-17 procedures/patient). Mean pulmonary artery 
      pressure improved in all patients (median decrease 17 mmHg, range 10-26 mmHg). 
      Pulmonary vascular resistance also improved (median decrease 11 Woods Units/m2, 
      range 8-16 Woods Units/m2). Cardiac output increased in 4 of 5 patients and 
      decreased in one. Functional capacity improved from New York Heart Association 
      (NYHA) III to II in four patients; one patient was NYHA II at baseline without 
      change after BPA. Six-minute walking distance improved by a median of 97 meters. 
      (range 21-197 meters). Hemodynamic and functional improvements were sustained at 
      follow-up 5-11 months after the last BPA procedure. BPA enabled 2 of 3 patients 
      treated with parenteral prostanoids to be switched to oral therapy. There were no 
      major complications. CONCLUSIONS: We successfully established BPA as a treatment 
      for inoperable CTEPH in our center. BPA resulted in hemodynamic and clinical 
      improvements that were sustained over time.
FAU - Segel, Michael J
AU  - Segel MJ
AD  - Pulmonary Institute, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, 
      Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Israel.
FAU - Somech, Dafna
AU  - Somech D
AD  - Pulmonary Institute, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, 
      Israel.
FAU - Lang, Irene M
AU  - Lang IM
AD  - Depatment of Medicine II - Cardiology, Medical University of Vienna, Vienna, 
      Austria.
FAU - Segev, Amit
AU  - Segev A
AD  - Department of Interventional Cardiology, Leviev Heart Center, Sheba Medical 
      Center, Tel Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Israel.
LA  - eng
PT  - Journal Article
PL  - Israel
TA  - Isr Med Assoc J
JT  - The Israel Medical Association journal : IMAJ
JID - 100930740
SB  - IM
MH  - Adult
MH  - *Angioplasty, Balloon/methods
MH  - Female
MH  - Hemodynamics
MH  - Humans
MH  - Hypertension, Pulmonary/etiology/*therapy
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Artery
MH  - Pulmonary Embolism/complications/*therapy
MH  - Retrospective Studies
EDAT- 2021/01/01 06:00
MHDA- 2021/01/13 06:00
CRDT- 2020/12/31 05:29
PHST- 2020/12/31 05:29 [entrez]
PHST- 2021/01/01 06:00 [pubmed]
PHST- 2021/01/13 06:00 [medline]
PST - ppublish
SO  - Isr Med Assoc J. 2020 Dec;22(12):752-756.