Endovascular treatment of chronic thromboembolic pulmonary hypertension: transluminal balloon angioplasty of pulmonary artery

Authors: Rakhmonov K. Kh., Diasamidze K.E., Sagymbaev B.A.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

UDC: 616.131-008.341.1-089.819.5
DOI: https://doi.org/10.24022/1810-0694-2023-24-4-303-316

Cite as: Rakhmonov K.Kh., Diasamidze K.E., Sagymbaev B.A. Endovascular treatment of chronic thromboembolic pulmonary hypertension: transluminal balloon angioplasty of pulmonary artery. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2023; 24 (4): 303–16 (in Russ.). DOI: 10.24022/1810-0694-2023-24-4-303-316

Received / Accepted: 24.05.2023 / 26.07.2023

Keywords: chronic thromboembolic pulmonary hypertension balloon pulmonary angioplasty right ventricular heart failure residual/recurrent pulmonary hypertension reperfusion pulmonary edema

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Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) results from recurrence or incomplete resolution of a pulmonary embolism. CTEPH is much more common than is commonly believed. If left untreated, it can lead to right ventricular failure and death. It is critical that all patients with pulmonary hypertension (PH) be screened for CTEPH, as this form of PH is potentially treatable. Pulmonary endarterectomy (PEA) is the operation of choice for the treatment of CTEPH. Different levels of thromboembolic lesions cause different complexity of performing PEA. Higher levels are considered hard cases. Even in technically operable patients, the risk-benefit ratio of PEA should be considered due to the high operative risk. Patients who are not indicated for PEA are candidates for balloon pulmonary angioplasty (BPA) Ballon pulmonary angioplasty in CTEPH is indicated: for patients who are recognized as inoperable due to concomitant diseases; with residual or recurrent PH after PEA; as well as with surgically inaccessible lesions of the LA branches; after ineffective medical treatment; patients who were denied open surgery; patients who do not have contraindications for performing BPA.

This review is devoted to the clinical history of the disease, endovascular treatment of the CTEPH, balloon pulmonary angioplasty performed either alone or in combination with PEA.

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About the authors

Komoliddin Kh. Rakhmonov, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
Kakhaber E. Diasamidze, Dr. Med. Sci., Leading Researcher; ORCID
Baizak A. Sagymbaev, Physician for X-ray Endovascular Diagnostics and Treatment; ORCID

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Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

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