Outcomes of Chronic Thromboembolic Pulmonary Hypertension After Balloon Pulmonary Angioplasty and Pulmonary Endarterectomy (JACC Asia August 2024)-Article:Outcomes of Chronic Thromboembolic Pulmonary Hypertension After Balloon Pulmonary Angioplasty and Pulmonary Endarterectomy

Article:Outcomes of Chronic Thromboembolic Pulmonary Hypertension After Balloon Pulmonary Angioplasty and Pulmonary Endarterectomy

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A study compared outcomes of chronic thromboembolic pulmonary hypertension (CTEPH) patients undergoing balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) in Japan using data from a registry of 1,270 patients. The study revealed that older patients more commonly underwent BPA and showed comparable outcomes in terms of morbidity and mortality to PEA. BPA resulted in greater improvements in renal function and decreased incidence of symptomatic venous thromboembolism compared to PEA. Both strategies improved functional class, exercise tolerance, pulmonary hemodynamics, and lab test results. Kaplan-Meier estimates indicated lower incidence of morbidity and mortality events in the PEA group over 5 years. Propensity score-matched analysis showed similar outcomes between BPA and PEA in treatment-naive patients. The study concluded that BPA is a viable option for CTEPH treatment, particularly in older patients, with benefits for renal function and comparable efficacy to PEA. Recommendations for future research included the need for randomized controlled trials to further compare BPA and PEA strategies in CTEPH patients. The research highlighted the potential advantages of BPA, such as improved renal function, and the importance of expert administration of BPA, suggesting it as an effective treatment for CTEPH patients, especially in restoring exercise tolerance.

Keywords

CTEPH

balloon pulmonary angioplasty

pulmonary endarterectomy

BPA

PEA

renal function

morbidity

mortality

exercise tolerance

Kaplan-Meier