Skip to main content
SpringerLink
Log in

Balloon pulmonary angioplasty vs. pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis

  • Published:
Heart Failure Reviews Aims and scope Submit manuscript

Abstract

Although balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) are effective in chronic thromboembolic pulmonary hypertension (CTEPH), the comparison of their efficacy and safety is still unclear. We identified studies through a systematic review of PubMed, Cochrane Library, and Embase and used a random effects meta-analysis model to synthesize estimates of weighted mean differences or combined effect size. In total, 54 studies were included in this meta-analysis. The survival rates at perioperative/in-hospital period, 2 years, and 3 years were 100%, 99%, and 97%, respectively, in BPA group and 93%, 90%, and 88%, respectively, in PEA group. The variation of 6-min walk distance was 141.80 m in BPA and 100.73 m in PEA when the follow-up was 1–6 months. At < 1-month, 1–6-month, and > 12-month follow-up, the changed results of mean pulmonary arterial pressure were − 18.31, − 17.00, and − 12.97 mmHg in BPA group and − 18.93, − 21.21, and − 21.35 mmHg in PEA group. At < 1-month and 1–6-month follow-up, the changed values of pulmonary vascular resistance were − 542.24 and − 599.77 dyne•s•cm−5 in PEA group and − 443.49 and − 280.00 dyne•s•cm−5 in BPA group. In addition, there was more wide variety of complications in PEA group than in BPA group. BPA might have higher survival rate (perioperative/in-hospital period, 2-year and 3-year follow-up) and fewer types of complications compared with PEA. The improvement in exercise capacity (1–6-month follow-up) in the BPA group might be more pronounced than in PEA group. Moreover, PEA might be superior in improvement of hemodynamic parameters (< 1-month, 1–6-month, and > 12-month follow-up).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

Data availability

The data are transparency.

Code availability

This study was using Stata 13.0 (StataCorp, TX) and GraphPad Prism (version 8; GraphPad Software, Inc) for analyzing the data.

References

  1. Dunlap B, Weyer G (2016) Pulmonary hypertension: diagnosis and treatment. Am Fam Physician 94(6):463–469

    PubMed  Google Scholar 

  2. Simonneau G, Montani D, Celermajer DS, Denton CP, Gatzoulis MA, Krowka M, Williams PG, Souza R (2019) Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J 53(1) https://doi.org/10.1183/13993003.01913-2018

  3. Fukuda K, Date H, Doi S, Fukumoto Y, Fukushima N, Hatano M, Ito H, Kuwana M, Matsubara H, Momomura SI, Nishimura M, Ogino H, Satoh T, Shimokawa H, Yamauchi-Takihara K, Tatsumi K, Ishibashi-Ueda H, Yamada N, Yoshida S, Abe K, Ogawa A, Ogo T, Kasai T, Kataoka M, Kawakami T, Kogaki S, Nakamura M, Nakayama T, Nishizaki M, Sugimura K, Tanabe N, Tsujino I, Yao A, Akasaka T, Ando M, Kimura T, Kuriyama T, Nakanishi N, Nakanishi T, Tsutsui H (2019) Guidelines for the treatment of pulmonary hypertension (JCS 2017/JPCPHS 2017). Circulation journal : official journal of the Japanese Circulation Society 83(4):842–945

    Article  Google Scholar 

  4. Matsuda H, Ogino H, Minatoya K, Sasaki H, Nakanishi N, Kyotani S, Kobayashi J, Yagihara T, Kitamura S (2006) Long-term recovery of exercise ability after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Ann Thorac Surg 82(4):1338–1343. https://doi.org/10.1016/j.athoracsur.2006.03.105

    Article  PubMed  Google Scholar 

  5. Li YD, Zhai ZG, Wu YF, Yang YH, Gu S, Liu Y, Su PX, Wang C (2013) Improvement of right ventricular dysfunction after pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension: utility of echocardiography to demonstrate restoration of the right ventricle during 2-year follow-up. Thromb Res 131(5):e196–e201. https://doi.org/10.1016/j.thromres.2013.02.001

    Article  CAS  PubMed  Google Scholar 

  6. Delcroix M, Lang I, Pepke-Zaba J, Jansa P, D’Armini AM, Snijder R, Bresser P, Torbicki A, Mellemkjaer S, Lewczuk J, Simkova I, Barbera JA, de Perrot M, Hoeper MM, Gaine S, Speich R, Gomez-Sanchez MA, Kovacs G, Jais X, Ambroz D, Treacy C, Morsolini M, Jenkins D, Lindner J, Dartevelle P, Mayer E, Simonneau G (2016) Long-term outcome of patients with chronic thromboembolic pulmonary hypertension: results from an International Prospective Registry. Circulation 133(9):859–871. https://doi.org/10.1161/circulationaha.115.016522

    Article  CAS  PubMed  Google Scholar 

  7. Fukuda K, Date H, Doi S, Fukumoto Y, Fukushima N, Hatano M, Ito H, Kuwana M, Matsubara H, Momomura SI, Nishimura M, Ogino H, Satoh T, Shimokawa H, Yamauchi-Takihara K, Tatsumi K, Ishibashi-Ueda H, Yamada N, Yoshida S, Abe K, Ogawa A, Ogo T, Kasai T, Kataoka M, Kawakami T, Kogaki S, Nakamura M, Nakayama T, Nishizaki M, Sugimura K, Tanabe N, Tsujino I, Yao A, Akasaka T, Ando M, Kimura T, Kuriyama T, Nakanishi N, Nakanishi T, Tsutsui H (2019) Guidelines for the Treatment of Pulmonary Hypertension (JCS 2017/JPCPHS 2017). Circ J: official journal of the Japanese Circulation Society 83(4):842–945. https://doi.org/10.1253/circj.CJ-66-0158

    Article  Google Scholar 

  8. Galie N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M (2016) 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37(1):67–119. https://doi.org/10.1093/eurheartj/ehv317

    Article  PubMed  Google Scholar 

  9. de Perrot M, Thenganatt J, McRae K, Moric J, Mercier O, Pierre A, Mak S, Granton J (2015) Pulmonary endarterectomy in severe chronic thromboembolic pulmonary hypertension. J Heart Lung Transplant: the official publication of the International Society for Heart Transplantation 34(3):369–375. https://doi.org/10.1016/j.healun.2014.09.008

    Article  Google Scholar 

  10. Zhang Y, Yu X, Jin Q, Luo Q, Zhao Z, Zhao Q, Yan L, Liu Z (2019) Advances in targeted therapy for chronic thromboembolic pulmonary hypertension. Heart Fail Rev 24(6):949–965. https://doi.org/10.1007/s10741-019-09798-x

    Article  PubMed  Google Scholar 

  11. Chen YJ, Ho CT, Tsai FC, Lin CP, Hsu LA, Wang CL, Lee KT, Ho WJ (2019) Outcomes of pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension at a single center in Taiwan. Acta Cardiologica Sinica 35(2):153–164. https://doi.org/10.6515/acs.201903_35(2).20180904a

    Article  PubMed  PubMed Central  Google Scholar 

  12. Thistlethwaite PA, Madani M, Jamieson SW (2006) Outcomes of pulmonary endarterectomy surgery. Semin Thorac Cardiovasc Surg 18(3):257–264. https://doi.org/10.1053/j.semtcvs.2006.09.008

    Article  PubMed  Google Scholar 

  13. Ogino H, Ando M, Matsuda H, Minatoya K, Sasaki H, Nakanishi N, Kyotani S, Imanaka H, Kitamura S (2006) Japanese single-center experience of surgery for chronic thromboembolic pulmonary hypertension. Ann Thorac Surg 82(2):630–636. https://doi.org/10.1016/j.athoracsur.2006.03.121

    Article  PubMed  Google Scholar 

  14. Yamagata Y, Ikeda S, Nakata T, Yonekura T, Koga S, Muroya T, Koide Y, Kawano H, Maemura K (2018) Balloon pulmonary angioplasty is effective for treating peripheral-type chronic thromboembolic pulmonary hypertension in elderly patients. Geriatrics and Gerontology International 18(5):678–684. https://doi.org/10.1111/ggi.13224

    Article  PubMed  Google Scholar 

  15. Wang W, Wen L, Song Z, Shi W, Wang K, Huang W (2019) Balloon pulmonary angioplasty vs riociguat in patients with inoperable chronic thromboembolic pulmonary hypertension: A systematic review and meta-analysis. Clin Cardiol 42(8):741–752. https://doi.org/10.1002/clc.23212

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tian J, Zhang J, Ge L, Yang K, Song F (2017) The methodological and reporting quality of systematic reviews from China and the USA are similar. J Clin Epidemiol 85:50–58. https://doi.org/10.1016/j.jclinepi.2016.12.004

    Article  PubMed  Google Scholar 

  17. Yao L, Sun R, Chen Y-L, Wang Q, Wei D, Wang X, Yang K (2016) The quality of evidence in Chinese meta-analyses needs to be improved. J Clin Epidemiol 74:73–79. https://doi.org/10.1016/j.jclinepi.2016.01.003

    Article  PubMed  Google Scholar 

  18. Khan MS, Amin E, Memon MM, Yamani N, Siddiqi TJ, Khan SU, Murad MH, Mookadam F, Figueredo VM, Doukky R, Benza RL, Krasuski RA (2019) Meta-analysis of use of balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Int J Cardiol 291:134–139. https://doi.org/10.1016/j.ijcard.2019.02.051

    Article  PubMed  PubMed Central  Google Scholar 

  19. Zoppellaro G, Badawy MR, Squizzato A, Denas G, Tarantini G, Pengo V (2019) Balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension- a systematic review and meta-analysis. &nbsp;Circ J: official journal of the Japanese Circulation Society 83(8):1660–1667. https://doi.org/10.1253/circj.CJ-19-0161

    Article  Google Scholar 

  20. Hsieh WC, Jansa P, Huang WC, Nižnanský M, Omara M, Lindner J (2018) Residual pulmonary hypertension after pulmonary endarterectomy: a meta-analysis. J Thorac Cardiovasc Surg 156(3):1275–1287. https://doi.org/10.1016/j.jtcvs.2018.04.110

    Article  PubMed  Google Scholar 

  21. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ (Clinical research ed) 339:b2700–b2700. https://doi.org/10.1136/bmj.b2700

    Article  Google Scholar 

  22. Ge L, Tian J-H, Li Y-N, Pan J-X, Li G, Wei D, Xing X, Pan B, Chen Y-L, Song F-J, Yang K-H (2018) Association between prospective registration and overall reporting and methodological quality of systematic reviews: a meta-epidemiological study. J Clin Epidemiol 93:45–55. https://doi.org/10.1016/j.jclinepi.2017.10.012

    Article  PubMed  Google Scholar 

  23. Wang X, Chen Y, Yao L, Zhou Q, Wu Q, Estill J, Wang Q, Yang K, Norris SL (2018) Reporting of declarations and conflicts of interest in WHO guidelines can be further improved. J Clin Epidemiol 98:1–8. https://doi.org/10.1016/j.jclinepi.2017.12.021

    Article  CAS  PubMed  Google Scholar 

  24. Pieper D, Buechter RB, Li L, Prediger B, Eikermann M (2015) Systematic review found AMSTAR, but not R(evised)-AMSTAR, to have good measurement properties. J Clin Epidemiol 68(5):574–583. https://doi.org/10.1016/j.jclinepi.2014.12.009

    Article  PubMed  Google Scholar 

  25. Yan P, Yao L, Li H, Zhang M, Xun Y, Li M, Cai H, Lu C, Hu L, Guo T, Liu R, Yang K (2019) The methodological quality of robotic surgical meta-analyses needed to be improved: a cross-sectional study. J Clin Epidemiol 109:20–29. https://doi.org/10.1016/j.jclinepi.2018.12.013

    Article  PubMed  Google Scholar 

  26. Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan A-W, Churchill R, Deeks JJ, Hróbjartsson A, Kirkham J, Jüni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schünemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP (2016) ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ (Clinical research ed) 355:i4919–i4919. https://doi.org/10.1136/bmj.i4919

    Article  Google Scholar 

  27. Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses BMJ (Clinical research ed) 327(7414):557–560. https://doi.org/10.1136/bmj.327.7414.557

    Article  Google Scholar 

  28. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101

    Article  CAS  Google Scholar 

  29. Aoki T, Sugimura K, Tatebe S, Miura M, Yamamoto S, Yaoita N, Suzuki H, Sato H, Kozu K, Konno R, Miyata S, Nochioka K, Satoh K, Shimokawa H (2017) Comprehensive evaluation of the effectiveness and safety of balloon pulmonary angioplasty for inoperable chronic thrombo-embolic pulmonary hypertension: long-term effects and procedure-related complications. Eur Heart J 38(42):3152–3159. https://doi.org/10.1093/eurheartj/ehx530

    Article  PubMed  Google Scholar 

  30. Feinstein JA, Goldhaber SZ, Lock JE, Ferndandes SM, Landzberg MJ (2001) Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation 103(1):10–13. https://doi.org/10.1161/01.cir.103.1.10

    Article  CAS  PubMed  Google Scholar 

  31. Kimura M, Kohno T, Kawakami T, Kataoka M, Hiraide T, Moriyama H, Isobe S, Tsugu T, Itabashi Y, Murata M, Yuasa S, Fukuda K (2019) Shortening hospital stay is feasible and safe in patients with chronic thromboembolic pulmonary hypertension treated with balloon pulmonary angioplasty. Can J Cardiol 35(2):193–198. https://doi.org/10.1016/j.cjca.2018.12.001

    Article  PubMed  Google Scholar 

  32. Mizoguchi H, Ogawa A, Munemasa M, Mikouchi H, Ito H, Matsubara H (2012) Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 5(6):748–755. https://doi.org/10.1161/CIRCINTERVENTIONS.112.971077

  33. Nishiyama T, Takatsuki S, Kawakami T, Katsumata Y, Kimura T, Kataoka M, Tsuruta H, Itabashi Y, Murata M, Yuasa S, Aizawa Y, Fukuda K (2018) Improvement in the electrocardiograms associated with right ventricular hypertrophy after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension. IJC Heart and Vasculature 19:75–82. https://doi.org/10.1016/j.ijcha.2018.05.003

    Article  PubMed  Google Scholar 

  34. Roik M, Wretowski D, Łabyk A, Irzyk K, Lichodziejewska B, Dzikowska-Diduch O, Piotrowska-Kownacka D, Pruszczyk P (2017) Refined balloon pulmonary angioplasty—a therapeutic option in very elderly patients with chronic thromboembolic pulmonary hypertension. J Interv Cardiol 30(3):249–255. https://doi.org/10.1111/joic.12387

    Article  PubMed  Google Scholar 

  35. Sato H, Ota H, Sugimura K, Aoki T, Tatebe S, Miura M, Yamamoto S, Yaoita N, Suzuki H, Satoh K, Takase K, Shimokawa H (2016) Balloon pulmonary angioplasty improves biventricular functions and pulmonary flow in chronic thromboembolic pulmonary hypertension. Circ J 80(6):1470–1477. https://doi.org/10.1253/circj.CJ-15-1187

    Article  PubMed  Google Scholar 

  36. Yokokawa T, Sugimoto K, Nakazato K, Misaka T, Oikawa M, Kobayashi A, Yoshihisa A, Yamaki T, Kunii H, Ishida T, Takeishi Y (2019) Electrocardiographic criteria of right ventricular hypertrophy in patients with chronic thromboembolic pulmonary hypertension after balloon pulmonary angioplasty. Intern Med 58(15):2139–2144. https://doi.org/10.2169/internalmedicine.2320-18

    Article  PubMed  PubMed Central  Google Scholar 

  37. Cannon JE, Su L, Kiely DG, Page K, Toshner M, Swietlik E, Treacy C, Ponnaberanam A, Condliffe R, Sheares K, Taboada D, Dunning J, Tsui S, Ng C, Gopalan D, Screaton N, Elliot C, Gibbs S, Howard L, Corris P, Lordan J, Johnson M, Peacock A, MacKenzie-Ross R, Schreiber B, Coghlan G, Dimopoulos K, Wort SJ, Gaine S, Moledina S, Jenkins DP, Pepke-Zaba J (2016) Dynamic risk stratification of patient long-term outcome after pulmonary endarterectomy: results from the United Kingdom National Cohort. Circulation 133(18):1761–1771. https://doi.org/10.1161/circulationaha.115.019470

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ishida K, Masuda M, Tanabe N, Matsumiya G, Tatsumi K, Nakajima N (2012) Long-term outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. The Journal of thoracic and cardiovascular surgery 144(2):321–326. https://doi.org/10.1016/j.jtcvs.2011.09.004

    Article  PubMed  Google Scholar 

  39. Ishida K, Masuda M, Tanaka H, Imamaki M, Katsumata M, Maruyama T, Miyazaki M (2009) Mid-term results of surgery for chronic thromboembolic pulmonary hypertension. Interact Cardiovasc Thorac Surg 9(4):626–629. https://doi.org/10.1510/icvts.2009.210492

    Article  PubMed  Google Scholar 

  40. Luo WC, Huang SC, Lin YH, Lai HS, Kuo SW, Pan SC, Hsu HH (2015) Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension–a single-center experience in Taiwan. J Formos Med Assoc 114(12):1197–1203. https://doi.org/10.1016/j.jfma.2014.08.009

    Article  PubMed  Google Scholar 

  41. Madani MM, Auger WR, Pretorius V, Sakakibara N, Kerr KM, Kim NH, Fedullo PF, Jamieson SW (2012) Pulmonary endarterectomy: recent changes in a single institution’s experience of more than 2,700 patients. Ann Thorac Surg 94(1):97–103. https://doi.org/10.1016/j.athoracsur.2012.04.004

    Article  PubMed  Google Scholar 

  42. Mayer E, Dahm M, Hake U, Schmid FX, Pitton M, Kupferwasser I, Iversen S, Oelert H (1996) Mid-term results of pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension. Ann Thorac Surg 61(6):1788–1792. https://doi.org/10.1016/0003-4975(96)00169-5

    Article  CAS  PubMed  Google Scholar 

  43. Moser KM, Daily PO, Peterson K, Dembitsky W, Vapnek JM, Shure D, Utley J, Archibald C (1987) Thromboendarterectomy for chronic, major-vessel thromboembolic pulmonary hypertension. Immediate and long-term results in 42 patients. Annals of internal medicine 107(4):560–564. https://doi.org/10.7326/0003-4819-107-4-560

  44. Narayana Iyengar RM, Hegde D, Chattuparambil B, Gupta R, Patil L (2010) Postoperative management of pulmonary endarterectomy and outcome. Annals of cardiac anaesthesia 13(1):22–27. https://doi.org/10.4103/0971-9784.58830

    Article  PubMed  Google Scholar 

  45. Richter MJ, Sommer N, Gall H, Voswinckel R, Seeger W, Mayer E, Wiedenroth CB, Rieth A, Grimminger F, Guth S, Ghofrani HA (2015) Pulmonary hemodynamic response to exercise in chronic thromboembolic pulmonary hypertension before and after pulmonary endarterectomy. Respiration; international review of thoracic diseases 90(1):63–73. https://doi.org/10.1159/000398815

    Article  PubMed  Google Scholar 

  46. Rubens FD, Bourke M, Hynes M, Nicholson D, Kotrec M, Boodhwani M, Ruel M, Dennie CJ, Mesana T (2007) Surgery for chronic thromboembolic pulmonary hypertension-inclusive experience from a national referral center. Ann Thorac Surg 83(3):1075–1081. https://doi.org/10.1016/j.athoracsur.2006.10.007

    Article  PubMed  Google Scholar 

  47. Gu S, Liu Y, Su PX, Zhai ZG, Yang YH, Wang C (2010) Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: preliminary exploration in China. Chin Med J 123(8):979–983

    Google Scholar 

  48. Vistarini N, Morsolini M, Klersy C, Mattiucci G, Grazioli V, Pin M, Ghio S, D’Armini AM (2016) Pulmonary endarterectomy in the elderly: safety, efficacy and risk factors. J Cardiol Cardiovasc Med 17(2):144–151. https://doi.org/10.2459/JCM.0000000000000327

    Article  Google Scholar 

  49. Ando M, Okita Y, Tagusari O, Kitamura S, Nakanishi N, Kyotani S (1999) Surgical treatment for chronic thromboembolic pulmonary hypertension under profound hypothermia and circulatory arrest in 24 patients. J Card Surg 14(5):377–385. https://doi.org/10.1111/j.1540-8191.1999.tb01014.x

    Article  CAS  PubMed  Google Scholar 

  50. Berman M, Hardman G, Sharples L, Pepke-Zaba J, Sheares K, Tsui S, Dunning J, Jenkins DP (2012) Pulmonary endarterectomy: outcomes in patients aged >70. Eur J Cardiothorac Surg: official journal of the European Association for Cardio-thoracic Surgery 41(6):e154-160. https://doi.org/10.1093/ejcts/ezs188

    Article  Google Scholar 

  51. Condliffe R, Kiely DG, Gibbs JS, Corris PA, Peacock AJ, Jenkins DP, Hodgkins D, Goldsmith K, Hughes RJ, Sheares K, Tsui SS, Armstrong IJ, Torpy C, Crackett R, Carlin CM, Das C, Coghlan JG, Pepke-Zaba J (2008) Improved outcomes in medically and surgically treated chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 177(10):1122–1127. https://doi.org/10.1164/rccm.200712-1841OC

    Article  PubMed  Google Scholar 

  52. Corsico AG, D’Armini AM, Cerveri I, Klersy C, Ansaldo E, Niniano R, Gatto E, Monterosso C, Morsolini M, Nicolardi S, Tramontin C, Pozzi E, Vigano M (2008) Long-term outcome after pulmonary endarterectomy. Am J Respir Crit Care Med 178(4):419–424. https://doi.org/10.1164/rccm.200801-101OC

    Article  PubMed  Google Scholar 

  53. D’Armini AM, Zanotti G, Viganò M (2005) Pulmonary endarterectomy: the treatment of choice for chronic thromboembolic pulmonary hypertension. Ital Heart J 6(10):861–868

    PubMed  Google Scholar 

  54. Korsholm K, Andersen A, Mellemkjær S, Nielsen DV, Klaaborg KE, Ilkjær LB, Nielsen-Kudsk JE (2017) Results from more than 20 years of surgical pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension in Denmark. Eur J Cardiothorac Surg 52(4):704–709. https://doi.org/10.1093/ejcts/ezx182

    Article  PubMed  Google Scholar 

  55. Kramm T, Mayer E, Dahm M, Guth S, Menzel T, Pitton M, Oelert H (1999) Long-term results after thromboendarterectomy for chronic pulmonary embolism. Eur J Cardiothorac Surg 15(5):579–584. https://doi.org/10.1016/S1010-7940(99)00076-7

    Article  CAS  PubMed  Google Scholar 

  56. Leung Wai Sang S, Morin JF, Hirsch A (2016) Operative and functional outcome after pulmonary endarterectomy for advanced thromboembolic pulmonary hypertension. J Card Surg 31(1):3–8. https://doi.org/10.1111/jocs.12646

    Article  PubMed  Google Scholar 

  57. Lindner J, Ambrož D, Novotný R, Nižňanský M, Šimková I, Boháčeková M, Pecha O, Jansa P (2015) Pulmonary endarterectomy combined with cardiac surgery: a 7-year retrospective analysis. Cor et Vasa 57(2):e115–e120. https://doi.org/10.1016/j.crvasa.2015.02.009

    Article  Google Scholar 

  58. Lindner J, Jansa P, Kunstyr J, Mayer E, Blaha J, Palecek T, Aschermann M, Grus T, Ambroz D, Tosovsky J, Vitkova I (2006) Implementation of a new programme for the surgical treatment of CTEPH in the Czech Republic-Pulmonary endarterectomy. Thorac Cardiovasc Surg 54(8):528–531. https://doi.org/10.1055/s-2006-924465

    Article  CAS  PubMed  Google Scholar 

  59. Maliyasena VA, Hopkins PM, Thomson BM, Dunning J, Wall DA, Ng BJ, McNeil KD, Mullany D, Kermeen FD (2012) An Australian tertiary referral center experience of the management of chronic thromboembolic pulmonary hypertension. Pulmonary circulation 2(3):359–364. https://doi.org/10.4103/2045-8932.101649

    Article  PubMed  PubMed Central  Google Scholar 

  60. Marston NA, Auger WR, Madani MM, Kimura BJ, Strachan GM, Raisinghani AB, Demaria AN, Blanchard DG (2014) Assessment of left atrial volume before and after pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension. Cardiovascular ultrasound 12(1). https://doi.org/10.1186/1476-7120-12-32

  61. Menzel T, Wagner S, Kramm T, Mohr-Kahaly S, Mayer E, Braeuninger S, Meyer J (2000) Pathophysiology of impaired right and left ventricular function in chronic embolic pulmonary hypertension: changes after pulmonary thromboendarterectomy. Chest 118(4):897–903

    Article  CAS  Google Scholar 

  62. Nierlich P, Hold A, Ristl R (2016) Outcome after surgical treatment of chronic thromboembolic pulmonary hypertension: Dealing with different patient subsets. A single-centre experience. Eur J Cardiothorac Surg 50(5):898–906. https://doi.org/10.1093/ejcts/ezw099

  63. Puis L, Vandezande E, Vercaemst L, Janssens P, Taverniers Y, Foulon M, Demeyere R, Delcroix M, Daenen W (2005) Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension. Perfusion 20(2):101–108. https://doi.org/10.1191/0267659105pf791oa

    Article  PubMed  Google Scholar 

  64. Raza F, Vaidya A, Lachariteroberge AS, Lakhter V, Al-Maluli H, Ahsan I, Boodram P, Dass C, Rogers F, Keane MG, Weaver S, Bashir R, Toyoda Y, Forfia P (2018) Initial clinical and hemodynamic results of a regional pulmonary thromboendarterectomy program. J Cardiovasc Surg 59(3):428–437. https://doi.org/10.23736/S0021-9509.17.10188-6

    Article  Google Scholar 

  65. Sablinskis M, Sablinskis K, Skride A (2019) Pulmonary Endarterectomy in Latvia: A National Experience. Medicina (Kaunas, Lithuania) 55(1). https://doi.org/10.3390/medicina55010018

  66. Saouti N, Morshuis WJ, Heijmen RH, Snijder RJ (2009) Long-term outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: a single institution experience. Eur J Cardiothorac Surg 35(6):947–952. https://doi.org/10.1016/j.ejcts.2009.01.023

    Article  PubMed  Google Scholar 

  67. Sato M, Ando M, Kaneko K, Higuchi Y, Kondo H, Akita K, Ishida M, Takagi Y (2013) Respiratory and hemodynamic changes in patients with chronic thromboembolic pulmonary hypertension 1 year after pulmonary endarterectomy. Ann Vasc Dis 6(3):578–582. https://doi.org/10.3400/avd.oa.13-00056

    Article  PubMed  PubMed Central  Google Scholar 

  68. Tromeur C, Jaïs X, Mercier O, Couturaud F, Montani D, Savale L, Jevnikar M, Weatherald J, Sitbon O, Parent F, Fabre D, Mussot S, Dartevelle P, Humbert M, Simonneau G, Fadel E (2018) Factors predicting outcome after pulmonary endarterectomy. PloS one 13 (6). https://doi.org/10.1371/journal.pone.0198198

  69. Wieteska M, Biederman A, Kurzyna M, Dyk W, Burakowski J, Wawrzyńska L, Szturmowicz M, Fijałkowska A, Szatkowski P, Torbicki A (2016) Outcome of medically versus surgically treated patients with chronic thromboembolic pulmonary hypertension. Clin Appl Thromb Hemost 22(1):92–99. https://doi.org/10.1177/1076029614536604

    Article  PubMed  Google Scholar 

  70. Yanaka K, Nakayama K, Shinke T, Shinkura Y, Taniguchi Y, Kinutani H, Tamada N, Onishi H, Tsuboi Y, Satomi-Kobayashi S, Otake H, Tanaka H, Okita Y, Emoto N, Hirata KI (2018) Sequential hybrid therapy with pulmonary endarterectomy and additional balloon pulmonary angioplasty for chronic thromboembolic pulmonary Hypertension. J Am Heart Assoc 7(13). https://doi.org/10.1161/JAHA.118.008838

  71. Ylldlzeli B, Tas S, Yanartas M, Kaymaz C, Mutlu B, Karakurt S, Altlnay E, Eldem B, Ermerak NO, Batlrel HF, KoçakBekirog̀lu N, Yüksel M, Sunar H, T (2013) Pulmonary endarterectomy for chronic thrombo-embolic pulmonary hypertension: an institutional experience. Eur J Cardiothorac Surg 44(3):e219–e227. https://doi.org/10.1093/ejcts/ezt293

    Article  Google Scholar 

  72. Zoia MC, D’Armini AM, Beccaria M, Corsico A, Fulgoni P, Klersy C, Piovella F, Viganò M, Cerveri I (2002) Mid term effects of pulmonary thromboendarterectomy on clinical and cardiopulmonary function status. Thorax 57(7):608–612. https://doi.org/10.1136/thorax.57.7.608

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Inami T, Kataoka M, Ando M, Fukuda K, Yoshino H, Satoh T (2014) A new era of therapeutic strategies for chronic thromboembolic pulmonary hypertension by two different interventional therapies; pulmonary endarterectomy and percutaneous transluminal pulmonary angioplasty. PLoS ONE 9(4):e94587. https://doi.org/10.1371/journal.pone.0094587

    Article  CAS  Google Scholar 

  74. Taniguchi Y, Miyagawa K, Nakayama K, Kinutani H, Shinke T, Okada K, Okita Y, Hirata KI, Emoto N (2014) Balloon pulmonary angioplasty: an additional treatment option to improve the prognosis of patients with chronic thromboembolic pulmonary hypertension. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 10(4):518–525. https://doi.org/10.4244/EIJV10I4A89

    Article  Google Scholar 

  75. Ogino H, Ando M, Matsuda H, Minatoya K, Sasaki H, Nakanishi N, Kyotani S, Imanaka H, Kitamura S (2006) Japanese single-center experience of surgery for chronic thromboembolic pulmonary hypertension. Ann Cardiothorac Surg 82(2):630–636. https://doi.org/10.1016/j.athoracsur.2006.03.121

    Article  Google Scholar 

  76. Mayer E, Jenkins D, Lindner J, D’Armini A, Kloek J, Meyns B, Ilkjaer LB, Klepetko W, Delcroix M, Lang I, Pepke-Zaba J, Simonneau G, Dartevelle P (2011) Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension: results from an international prospective registry. J Thorac Cardiovasc Surg 141(3):702–709. https://doi.org/10.1016/j.jtcvs.2010.11.024

    Article  PubMed  Google Scholar 

  77. Moriarty JM, Khan SN, Kao SD, Saggar R (2018) Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Cardiovasc Intervent Radiol 41(12):1826–1839. https://doi.org/10.1007/s00270-018-2012-2

    Article  CAS  PubMed  Google Scholar 

  78. Jenkins D, Madani M, Fadel E, D’Armini AM, Mayer E (2017) Pulmonary endarterectomy in the management of chronic thromboembolic pulmonary hypertension. Eur Respir Rev 26 (143). https://doi.org/10.1183/16000617.0111-2016

  79. Minatsuki S, Kiyosue A, Kodera S, Hara T, Saito A, Maki H, Hatano M, Takimoto E, Ando M, Komuro I (2019) Effectiveness of balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension despite having lesion types suitable for surgical treatment. J Cardiol. https://doi.org/10.1016/j.jjcc.2019.07.006

    Article  PubMed  Google Scholar 

  80. Andreassen AK, Ragnarsson A, Gude E, Geiran O, Andersen R (2013) Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Heart (British Cardiac Society) 99(19):1415–1420. https://doi.org/10.1136/heartjnl-2012-303549

    Article  Google Scholar 

  81. Roscoe A, Klein A (2008) Pulmonary endarterectomy. Curr Opin Anaesthesiol 21(1):16–20. https://doi.org/10.1097/ACO.0b013e3282f2bb52

    Article  PubMed  Google Scholar 

  82. Lang I, Meyer BC, Ogo T, Matsubara H, Kurzyna M, Ghofrani HA, Mayer E, Brenot P (2017) Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension. European respiratory review: an official journal of the European Respiratory Society 26 (143). https://doi.org/10.1183/16000617.0119-2016

Download references

Funding

This study was supported by the National Natural Science Foundation of China (grant no. 81860059), the International Cooperation Exchange Project of Gansu Province (grant no. 18YF1WA046) granted to MZ and CAS ‘Light of West China’ Program granted to MZ and YSC.

Author information

Author notes

  1. Liyan Zhang, Yuping Bai, and Peijing Yan contributed equally to this work.

Authors and Affiliations

  1. School of Basic Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, China

    Liyan Zhang, Yuping Bai, Tingting He & Changtian Li

  2. Department of Scientific Research Office, Gansu Provincial Hospital, Lanzhou, 730000, China

    Liyan Zhang, Yuping Bai, Tingting He & Min Zhang

  3. Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610044, Sichuan, China

    Peijing Yan

  4. Department of Pathology, the 940th Hospital of Joint Logistics Support Force of Chinese People´s Liberation Army, 730050, Lanzhou, China

    Liyan Zhang, Yuping Bai, Tingting He, Bin Liu & Zhen Qian

  5. Department of Pathology, Ganzhou People’s Hospital, Ganzhou, 341000, China

    Shanlian Wu

  6. Department of Cardiology, Gansu Provincial Hospital, Lanzhou, 730000, China

    Yunshan Cao

Authors
  1. Liyan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuping Bai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peijing Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tingting He
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bin Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shanlian Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zhen Qian
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Changtian Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yunshan Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Min Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Liyan Zhang, Yuping Bai, and PeijingYan analyzed the patient data and were the major contributors in the preparation of the manuscript. Tingting He and Bin Liu analyzed part of the patient data. Shanlian Wu performed the literature search and extracted the data. Zhen Qian was responsible for the statistical analysis. Changtian Li made substantial contributions to the conception of the study. The first draft of the manuscript was written by Min Zhang and Yunshan Cao and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Yunshan Cao or Min Zhang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, L., Bai, Y., Yan, P. et al. Balloon pulmonary angioplasty vs. pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis. Heart Fail Rev 26, 897–917 (2021). https://doi.org/10.1007/s10741-020-10070-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10741-020-10070-w

Keywords

Search

Navigation