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Master Thesis

L'angioplastie pulmonaire dans la prise en charge de l'HTAP post-embolique. Expérience du 3e centre français

Abstract : Introduction: The treatment of choice for post-embolic PAH is pulmonary thromboendarterectomy surgery. However, one in two patients is ineligible to surgical treatment. The purpose of this study is to describe our first local experience with pulmonary angioplasty.
Methods: The patients benefited from several sessions of pulmonary angioplasty. Clinical, biological and hemodynamic data were collected before and after the last intervention. Complications were reported during the procedures and follow-up.
Results: 71 pulmonary angioplasty procedures have been performed in 16 patients. On a median follow-up of 97 days, pulmonary revascularization was associated with improvement in symptoms of dyspnea with a decrease in NYHA functional status (p = 0.01) and a 35-meter increase in 6 minutes walk test (p = 0.006). The biological evaluation found a significant decrease in BNP levels. Echocardiographic data show an improvement in right ventricular parameters. The hemodynamic assessment found a significant decrease in systolic and mean pulmonary arterial pressures of 19 mmHg and 9 mmHg respectively. During follow-up, we found a significant decrease in pulmonary vascular resistances by 35%. 7 complications occurred out of a total of 71 procedures (9.8%). Four non-severe haemoptysis during the procedure and 2 reperfusion edema after the procedure. No deaths or serious complications occurred during the procedures or during the follow-up period.
Conclusion: We demonstrate the feasibility of implementing the pulmonary angioplasty technique in the management of post-embolic PAH ineligible for surgery with results in terms of efficacy and safety similar to those described in the literature.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02380867
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Tuesday, November 26, 2019 - 2:09:12 PM
Last modification on : Wednesday, October 14, 2020 - 4:23:00 AM

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Mohamed Labbaoui. L'angioplastie pulmonaire dans la prise en charge de l'HTAP post-embolique. Expérience du 3e centre français. Médecine humaine et pathologie. 2019. ⟨dumas-02380867⟩

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