Systematic Review: Does Balloon Pulmonary Angioplasty (BPA) Improve Right Ventricular Function in CTEPH Patients? Evalua
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(2020) 22:54
Coronary Artery Disease (D Feldman and V Voudris, Section Editors)
Systematic Review: Does Balloon Pulmonary Angioplasty (BPA) Improve Right Ventricular Function in CTEPH Patients? Evaluation Based on Imaging Findings V. Papadopoulou, MD, Msc1,* P. Karyofyllis1 D. Tsiapras2 E. Demerouti2 I. Kosmas1 V. Voudris1 Address *,1 Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Sygrou Ave 356, Kallithea, 17674, Athens, Greece Email: [email protected] 2 Noninvasive Cardiology Diagnostic Unit, Onassis Cardiac Surgery Centre, Athens, Greece
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Coronary Artery Disease Keywords Chronic thromboembolic pulmonary hypertension I Balloon pulmonary angioplasty I Right ventricular function
Abstract Purpose of review Chronic thromboembolic pulmonary hypertension (CTEPH) is a lifethreatening disease with many complications, such as right heart failure. Therefore, a direct and efficient therapy is imperative. This review aims to determine the effectiveness of balloon pulmonary angioplasty (BPA) on right ventricular (RV) function among CTEPH patients, using imaging methods. Recent findings From April 2019 to August 2019, PubMed database was searched for randomized control trials and cohort studies conducted until August 2019, evaluating the impact of BPA on RV function as assessed by non-invasive modalities. Data were extracted, and validity
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was assessed by 2 reviewers and graded using the Cochrane Collaboration tool for assessing a risk of bias. A total of 204 articles were screened for relevance. Only 14 articles were deemed eligible for this review, 4 studies being prospective and 10 retrospective trials. Totally 395 patients with CTEPH who underwent BPA enrolled. The findings indicated improvement in hemodynamic parameters and RV function. Summary BPA is an effective and appropriate therapy for non-operable CTEPH patients leading to significant improvements in RV function. Two-dimensional and 3D echocardiography and cardiac magnetic resonance imaging (CMRI) are reliable non-invasive imaging methods for RV function assessment after BPA.
Introduction Chronic thromboembolic pulmonary hypertension (CTEPH) is a life-threatening disease characterized by the presence of organized thrombi in the pulmonary circulation and especially by thrombotic occlusion or narrowing of the pulmonary arteries. The thrombotic lesions in CTEPH lead to pulmonary hypertension, right-sided heart failure (RHF), and death [1]. The early diagnosis of CTEPH, as well as the appropriate treatment, is imperative in order to avoid the devastating results of the disease. Pulmonary endarterectomy (PEA) is a surgical treatment for CTEPH since it removes the thrombotic material and is considered the treatment of choice; however, this method is characterized by some limitations. For instance, PEA cannot be applied in patients with distal-type CTEPH or pa
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