Balloon pulmonary angioplasty was considered safe and effective even in patients considered “oldest-old” (≥80 years) with chronic thromboembolic pulmonary hypertension (CTEPH), according to research presented at the 68th Annual Scientific Session and Expo of the American College of Cardiology held March 16 to 18 in New Orleans, Louisiana.

Researchers from the Toho University Oshahi Medical Center in Tokyo, Japan, conducted a study to explore the use of balloon pulmonary angioplasty in elderly patients with CTEPH.

A total of 45 patients were divided into 2 groups by age: an older group (n=8) of patients who were ≥80 years of age and a younger group (n=37) of patients who were <80 years of age.

Changes in hemodynamic parameters and 6-minute walking distance were used as measures of effectiveness. Adverse events were noted throughout the 180 balloon pulmonary angioplasty sessions.

Both groups experienced improvements in hemodynamic parameters. Patients in the older group had a significant change in mean pulmonary artery pressure (32.1±10.3 mm Hg vs 23.0±8.4 mm Hg; P <.0001). The younger group also had a significant change in mean pulmonary artery pressure (35.6±10.3 vs 23.2±5.6 mm Hg; P <.0001).

However, the change in 6-minute walking distance was not significant in the older group (253.0 ±99.7 m vs 295.3±94.8 m; P =.13) but was significant in the younger patients (299.3±143.6 m vs 419.1±155.2 m; P <.0001).

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In addition, there was no significant difference in adverse events between the groups (3/30 sessions in the older group: 10%; 16/150 sessions in the younger group: 10.7%). The majority of adverse events were occurrences of minor hemosputum.

The researchers concluded that balloon pulmonary angioplasty is effective and safe even in the oldest of patients with CTEPH. They added that “[t]he improvement of exercise tolerance might be affected by preoperative exercise function and orthopedic factors.”

Reference

Ikeda N, Kubota S, Okazaki T, et al. The effectiveness and safety of balloon pulmonary angioplasty for oldest old patients with chronic thromboembolic pulmonary hypertension. Presented at: the 68th Annual Scientific Session and Expo of the American College of Cardiology; March 16-18, 2019; New Orleans, LA. Abstract 482.