| Revista: | Revista médica de Chile |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000429275 |
| ISSN: | 0034-9887 |
| Autors: | Sepúlveda, Pablo1 Ortega, Juan1 Armijo, German1 Torres, José1 Ramírez, Pablo1 Backhouse, Christian1 Vargas, César1 López, Leonel1 González, Felipe1 Puentes, Angel1 Donoso, Hernán1 Bellet, Augusto1 Godoy, Diego1 Araya, Mario1 Andrade, Carmen Luz2 Molina, Juan Pablo3 Nazzal, Carolina4 |
| Institucions: | 1Hospital San Juan de Dios, Unidad de Cardiología, Santiago de Chile. Chile 2Universidad de Chile, Facultad de Medicina, Santiago de Chile. Chile 3Hospital San Juan de Dios, Centro Diagnóstico y Terapéutico, Santiago de Chile. Chile 4Universidad de Chile, Escuela de Salud Pública, Santiago de Chile. Chile |
| Any: | 2019 |
| Període: | Abr |
| Volum: | 147 |
| Número: | 4 |
| Paginació: | 426-436 |
| País: | Chile |
| Idioma: | Español |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | Balloon pulmonary angioplasty (BPA) is a therapeutic alternative for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Aim: To report the initial experience with the “refined BPA technique” with the use of intravascular images. Patients and Methods: Between June 2015 and June 2016 we selected fourteen patients with CTEPH who were considered candidates for BPA. Lesions targeted for treatment were further analyzed using intravascular imaging with optical frequency domain imaging (OFDI). We report the immediate hemodynamic results and four weeks of follow-up of the first eight patients of this series. Results: We performed 16 BPA in eight patients aged 61 ± 14 years (88% women). Mean pulmonary artery pressure (PAPm) was 48.6 ± 5.8 mmHg. Success was achieved in seven patients (88%). A mean of 2.3 segments per patient were intervened in 11 sessions (1.6 sessions/ patient). Only one patient developed lung reperfusion injury. No mortality was associated with the procedure. After the last BPA session, PAPm decreased to 37.4 ± 8.6 mmHg (p=0.02). Pulmonary vascular resistance (RVP) decreased from 858,6 ± 377,0 at baseline to 516,6 ± 323,3 Dynes/sec/cm−5 (p<0.01) and the cardiac index increased from 2.4±0.6 at baseline to 2.8±0.3 L/min/m2 (p=0.01). At 4 weeks after the last BPA, WHO functional class improved from 3.3±0.5 to 2.5±0.5 (p<0,01) and six minutes walking distance from 331±92 to 451±149 m (p=0.01). Conclusions: BPA guided by OFDI for the treatment of inoperable CTEPH patients is a safe alternative with excellent immediate hemodynamic and clinical results |
| Disciplines | Medicina |
| Paraules clau: | Sistema cardiovascular, Cirugía, Hipertensión pulmonar, Enfermedad tromboembólica crónica, Angioplastia, Hemodinámica |
| Keyword: | Cardiovascular system, Surgery, Pulmonary hypertension, Chronic thromboembolic disease, Angioplasty, Hemodynamics |
| Text complet: | Texto completo (Ver HTML) |
