TCT 88 Innovative Transcatheter Tricuspid Valve Repair System. Initial Outcomes from the First in Human Multi Centre Study.
nos: 89 92 TCT 89 Balloon pulmonary angioplasty for chronic thromboembolic hypertension: report of a two year experience in a surgical center Philippe Brenot, Carlos Garcia Alonso, Benoit Gerardin, Ryad Bourkaib, Xavier Jais, Gerald Simonneau, Elie Fadel Minneapolis Heart Institute Foundation; Hopital Marie Lannelongue, Le Plessis Robinson, France; Hopital Marie Lannelongue; Evecquemont, Evcequemont, France; Hopital Bicetre; Hopital Bicetre; Hopital Marie Lannelongue BACKGROUND Balloon pulmonary angioplasty (BPA) has emerged as a new therapy (beside surgery and medical treatment) for patients suffering of chronic thromboembolic pulmonary hypertension (CTEPH) We describe herein our single center experience in our first 113 patients. METHODS Patients were selected for BPA at weekly multidisciplinary meetings in collaboration with the national reference center for pulmonary hypertension. Patients underwent functional evaluation (NYHA class and 6 minutes walking test) as well as right heart catheterization and pulmonary artery imaging before BPA and systematically 3 months after the last session. BPA was performed via femoral vein under local anesthesia. Balloon diameter ranged from 1.5 to 9 mm. Several sessions were required to reach our goal of mean PAP 30 mmHg. RESULTS From February 2014 to May 2016, 113 patients (64 males, 57% mean age 62 15, underwent BPA. Reasons to perform BPA were: non surgical distal disease in 82, comorbidities in 22, persistent high pulmonary artery pressure (PAP) after surgery in 7 and refusal to surgery in 2. The mean number of sessions was 5.5 (range 1 to 10) After 620 sessions we deplore 29 hemoptysis (4.5% of procedures) none of which was life threatening, 11 pulmonary artery dissections (1.7% 5 of which were treated by stent implantation, and 46 reperfusion pulmonary injuries (7,4% 2 of which required mechanical ventilation. 3 patients died (2.7% 2 because of reperfusion injury and 1 of an infectious complication. Follow up has been completed for the first 79 patients (mean FU of 8 months, range 3 to 20) 3 patients died (1 sudden death, 1 recurrence of pulmonary embolism and 1 road accident) NYHA status improved from 2.91 to 1.77 (p<0.01) Mean PAP improved from 44.5 to 31.2 mmHg (p<0.01) Cardiac output increased from 2.59 L/min/m2 to 2.95 (p<0.01) Pulmonary vascular resistance (PVR) went down from 7.77 UW to 3.92 UW (p<0.01) CONCLUSION Our short term BPA results confirm the usefulness of this technique to improve hemodynamics and more importantly quality of life in well selected patients. Future analysis should help us select responsive patients while diminishing procedure related complications. To our knowledge this series is one of the largest currently available. CATEGORIES STRUCTURAL: Heart Failure TCT 90 Efficacy and safety of sequential hybrid therapy with pulmonary endarterectomy and additional balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension Kenichi Yanaka, Kazuhiko Nakayama, Toshiro Shinke, Hiromasa Otake, Takayoshi Toba, Hachidai Takahashi, Daisuke Terashita, Yuto Shinkura, Koji Kuroda, Kenzo Uzu, Natsuko Tahara, Yoshinori Nagasawa, Yuichiro Nagano, Naoki Tamada, yoshiro tsukiyama, Hiroyuki Yamamoto, Noriaki Emoto, Ken ichi Hirata University of Michigan Health System, Kobe city, Japan; CVPath Institute, Inc; Kobe University Hospital, Kobe, Japan; National Institute of Cardiovascular Diseases, Dhaka, Bangladesh; Himeji Cardiovascular Center, Himeji, Japan; Kobe University, Himeji, Japan; Kobe University Hospital; City Clinic, Kobe, Japan; Kobe University
Journal of the American College of Cardiology