Multicenter registry of surgical and catheter interventions for chronic thromboembolic pulmonary hypertension

2017 Fiscal Year Final Research Report

• Project/Area Number: 26462118
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular surgery
• Research Institution: Tokyo Medical University
• Principal Investigator: OGINO HITOSHI 東京医科大学, 医学部, 主任教授 (60393237)
• Co-Investigator(Kenkyū-buntansha): 湊谷 謙司 京都大学, 医学研究科, 教授 (20393241) ; 安藤 太三 藤田保健衛生大学, 医学部, 教授 (70340247) ; 中西 宣文 国立研究開発法人国立循環器病研究センター, 病院, 部長 (80164234) ; 高木 靖 藤田保健衛生大学, 医学部, 教授 (80324432) ; 大郷 剛 国立研究開発法人国立循環器病研究センター, 研究所, 特任部長 (80617077) ; 佐々木 啓明 国立研究開発法人国立循環器病研究センター, 病院, 医長 (50393236)
• Research Collaborator: ANDO MOTOMI 藤田保健衛生大学, 医学部, 教授 (70340247)
• Project Period (FY): 2014-04-01 – 2018-03-31
• Keywords: 慢性肺動脈血栓塞栓症 / 肺高血圧症 / 慢性血栓塞栓性肺高血圧症 / 肺動脈内膜摘除術 / 経皮的バルーン肺動脈拡張術

Outline of Final Research Achievements

Pulmonary endarterectomy (PEA) has been the first-line treatment for chronic thromboembolic pulmonary hypertension (CTEPH) with severe pulmonary hypertension (PH). On the other hand, less-invasive balloon pulmonary angioplasty (BPA) has recently been indicated for cases with surgically inaccessible distal CTEPH lesions or residual PH after PEA. In this study, 1) The outcome of PEA is investigated through the PEA registry in the PEA leading centers. 2) The PEA outcome is compared with that of BPA to establish a more adequate CTEPH treatment algorism. Between 2014 and 2017, 163 patients having mainly proximal type of CTEPH underwent PEA. The outcome was favorable with the hospital mortality of 2.5% and significant PH improvement. Regarding BPA, 231 patients received it with no mortalities and remarkable PH reduction. We conclude that appropriate treatment selection between PEA and BPA, depending on CTEPH lesion site and surgical risk adjustment, is mandatory for favorable outcome.

Free Research Field

心臓血管外科