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Thorac Cardiovasc Surg
DOI: 10.1055/s-0043-1772770
Original Thoracic

Patient-Reported Long-Term Outcome of Balloon Pulmonary Angioplasty for Inoperable CTEPH

Christoph B. Wiedenroth
1   Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany
,
Kristin Steinhaus
2   University of Göttingen, Department of Cardiology and Pneumology, Göttingen, Germany
,
Andreas Rolf
3   Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
,
Andreas Breithecker
4   Kerckhoff Heart and Thorax Center, Department of Radiology, Bad Nauheim, Germany
5   Gesundheitszentrum Wetterau, Department of Radiology, Bad Nauheim, Germany
,
Miriam S. D. Adameit
1   Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany
,
Steffen D. Kriechbaum
3   Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
6   German Center for Cardiovascular Research (DZHK), partner site RheinMain, Bad Nauheim, Germany
,
Moritz Haas
3   Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
,
Fritz Roller
7   University of Giessen, Department of Radiology, Giessen, Germany
,
Christian W. Hamm
3   Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
6   German Center for Cardiovascular Research (DZHK), partner site RheinMain, Bad Nauheim, Germany
8   University of Giessen, Department of Internal Medicine I, Division of Cardiology, Giessen, Germany
,
H.-Ardeschir Ghofrani
9   Kerckhoff Heart and Thorax Center, Department of Pulmonology, Bad Nauheim, Germany
10   Universities of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL)
11   Department of Medicine, Imperial College London, UK
,
Eckhard Mayer
1   Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany
,
Stefan Guth    *
1   Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, Bad Nauheim, Germany
,
Christoph Liebetrau   *
3   Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
6   German Center for Cardiovascular Research (DZHK), partner site RheinMain, Bad Nauheim, Germany
12   Cardioangiologisches Centrum Bethanien, Frankfurt am Main, Germany
› Author Affiliations Funding Funded by the Deutsche Forschungsgemeinschaft (DFG) and the Collaborative Research Center (CRC) 1213, central project CP01.
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Abstract

Background Balloon pulmonary angioplasty (BPA) is a promising interventional treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Evidence in favor of BPA is growing, but long-term data remain scarce. The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is validated for the assessment of patients with pulmonary hypertension within three domains: symptoms, activity, and quality of life (QoL). The aim of the present study was to evaluate the long-term effects of BPA on these domains in patients with inoperable CTEPH.

Methods Between March 2014 and August 2019, technically inoperable patients with target lesions for BPA were included in this prospective, observational study. CAMPHOR scores were compared between baseline (before the first BPA) and 6 months after the last intervention and also for scores assessed at annual follow-ups.

Results A total of 152 patients had completed a full series of BPA interventions and a 28 (interquartile range [IQR]: 26–32) week follow-up. Further follow-up assessments including the CAMPHOR score were performed 96 (IQR: 70–117) weeks, 178 (IQR: 156–200) weeks, and 250 (IQR: 237–275) weeks after the last intervention. From baseline to the last follow-up, CAMPHOR scores for symptoms, activity, and QoL improved from 9 (IQR: 6–14) to 3 (IQR: 0–9) (p < 0.001), 8 (IQR: 5–12) to 4 (IQR: 2–8) (p < 0.001), and 5 (IQR: 2–9) to 1 (IQR: 0–5) (p < 0.001).

Conclusion BPA leads to long-lasting, significant improvement of symptoms, physical capacity, and QoL in inoperable CTEPH patients.

Keywords

chronic thromboembolic pulmonary hypertension - balloon pulmonary angioplasty - long-term outcome - CAMPHOR

Data Availability Statement

The data underlying this article will be shared on reasonable request to the corresponding author.


Authors' Contribution

Study conception and design: C.B.W., H.A.G., E.M., S.G., C.L.. Data analysis: C.B.W., A.R., K.S., S.G., C.L.. All authors have drafted and revised the manuscript and approved the version to be published. All authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


* These authors contributed equally as last authors.




Publication History

Received: 06 May 2023

Accepted: 18 July 2023

Article published online:
29 August 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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