TITLE:
Combined Balloon Pulmonary Angioplasty and Pulmonary Endarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension
AUTHORS:
Sergey V. Gorbachevsky, Karen V. Petrosyan, Komoliddin Kh. Rakhmonov, Baizak A. Sagymbaev, Tatyana B. Averina, Kakhaber Z. Diasamidze, Elena Z. Golukhova
KEYWORDS:
Chronic Thromboembolic Pulmonary Hypertension, Pulmonary Thromboendarterectomy, Balloon Pulmonary Angioplasty, Staged Approach, Residual/Recurrent Pulmonary Hypertension
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.16 No.2,
February
6,
2026
ABSTRACT: Introduction. The combination of pulmonary thromboendarterectomy (PEA) and balloon pulmonary angioplasty (BPA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) is increasingly performing for the treatment. Objective: To present our experience of step-by-step surgical treatment of patients with CTEPH and severe pulmonary hypertension (PH). Methods: Retrospective analysis of two-stage treatment 27 patients from January 2019 to March 2024 was conducted. BPA as the first stage of treatment was performed to improve hemodynamic data and reduce surgical risk. After 3 - 4 months, the same patients underwent PEA. Results: The median age at diagnosis was 47 (IQR 15 - 78) years, 51.9% males and 48.1% females. Due to New York Heart Association (NYHA), 1 (3.7%) patient belonged to class II, 19 (70.4%) to class III and 7 (25.9%) to class IV. After BPA the mean pulmonary artery pressure (mPAP, mmHg) and pulmonary vascular resistance (PVR, dynes*s*cm5) significantly decreased (66.2 ± 9.5 vs 53.7 ± 9.5, P *s*cm5) also significantly decreased (51.3 ± 5.5 vs 27.6 ± 4.5, P Conclusion: A staged approach may be an effective surgical tactic in patients with CTEPH and severe PH. However, it is necessary to identify criteria for patient selection, and procedural efficacy.