Pulmonary hypertensionIntravenous Epoprostenol in Inoperable Chronic Thromboembolic Pulmonary Hypertension
Section snippets
Patients
Twenty-seven consecutive patients with CTEPH with contraindications to pulmonary thromboendarterectomy or with sustained pulmonary hypertension after surgery, who subsequently received medical treatment with continuous epoprostenol infusion in our hospital from March 1996 to October 2003, were retrospectively evaluated. This study was approved by our local institutional review board. All patients were informed and gave their consent to receive epoprostenol therapy. Ventilation/perfusion lung
Patients’ Characteristics
Twenty-seven consecutive patients with CTEPH were treated with epoprostenol therapy. Among these patients, 23 were not suitable for PTE because of lesions inaccessible by surgery, and 4 presented with persistent, symptomatic and severe pulmonary hypertension about 14 months after PTE. There were 14 women and 13 men, with a mean age of 51 years. Six patients (22.2%) had received previous vasodilator treatments consisting of inhalation (n = 5) or subcutaneous delivery (n = 1) of a prostacyclin
Discussion
Our study shows for the first time the long-term clinical, functional and hemodynamic effects of epoprostenol therapy in patients with PH associated with chronic thromboembolic disease who are not suitable for surgery or with residual PH after thromboendarterectomy. We also found that long-term survival under epoprostenol treatment is associated with baseline distance for the 6MWT.
Previous studies have addressed the need for treatment of inoperable or residual CTEPH. Efficacy of inhaled
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