P2606Refined balloon pulmonary angioplasty - a new therapuetic option in patients over 75 years with chronic thromboembolic pulmonary hypertension

Balloon pulmonary angioplasty (BPA, PTPA) is developing therapy of non-operable CTEPH. The aim of the study was to analyzed clinical and hemodynamic results of sequential BPA/PTPA performed in very elderly patients (in age ≥75 years) disqualified from pulmonary endarterectomy (PEA). Methods: Ten patients (4 M, 6 F) with median age of 81 yrs (75 - 88) with confirmed CTEPH and mPAP >30 mmHg were enrolled to BPA/PTPA program. Overall, 10 pts underwent 39 BPA/PTPA sessions (mean 3.9 sessions per patient, range 1–9), 70 segmental pulmonary arteries were dilated, (mean 6.5 vessels per patient, range 1–14). Results: Pulmonary angioplasties resulted in a significant clinical and hemodynamic improvement in every patient: 6 MWT distance increase from a median of 221 (80–320) to 345 (230–455), plasma NT-proBNP levels decreased (p<0.01). Sequential BPA/PTPA therapy resulted in normalization of mPAP (<25mmHg) in 6 of 10 and a mPAP decrease down to 25–30mmHg in 3 others. In whole group mPAP decreased from 41 (31–53) mmHg to 23 (17–33) mmHg (p<0.01). CTEPH patients were followed for a median of 553 days (range 81 -784). No severe complications occurred during BPA/PTPA therapy and all studied patients are still alive (Table 1).