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Continuous intravenous epoprostenol for chronic thromboembolic pulmonary hypertension.

Publication ,  Journal Article
Bresser, P; Fedullo, PF; Auger, WR; Channick, RN; Robbins, IM; Kerr, KM; Jamieson, SW; Rubin, LJ
Published in: Eur Respir J
April 2004

Pathophysiological findings in chronic thromboembolic pulmonary hypertension (CTEPH) have suggested that a secondary small vessel arteriopathy may contribute to the haemodynamic impairment observed in these patients. It was hypothesised that this element of the elevated vascular resistance may be responsive to continuous intravenous epoprostenol therapy. Retrospectively, the clinical and haemodynamic responses to continuous intravenous epoprostenol were evaluated in nine CTEPH patients who subsequently underwent pulmonary thromboendarterectomy (PTE). Cardiopulmonary haemodynamics were determined prior to the initiation of epoprostenol, while on epoprostenol, prior to PTE, and after PTE. Six patients, treated for 2-26 months prior to PTE, experienced either clinical stability or improvement that was associated with a mean reduction in pulmonary vascular resistance (PVR) of 28% (median 33%, range 0-46%). Three patients, treated for 3-9 months, experienced clinical deterioration during epoprostenol administration, with a significant increase in PVR in two patients. Subsequent PTE resulted in a highly significant improvement of cardiac index, mean pulmonary artery pressure and total pulmonary resistance. To conclude, selected patients with chronic thromboembolic pulmonary hypertension may benefit clinically and haemodynamically from continuous intravenous epoprostenol treatment prior to pulmonary thromboendarterectomy. Factors predictive of a beneficial response, and whether this intervention influences either morbidity or mortality associated with pulmonary thromboendarterectomy, remain to be established.

Duke Scholars

Published In

Eur Respir J

DOI

ISSN

0903-1936

Publication Date

April 2004

Volume

23

Issue

4

Start / End Page

595 / 600

Location

England

Related Subject Headings

  • Vascular Resistance
  • Treatment Outcome
  • Statistics, Nonparametric
  • Retrospective Studies
  • Respiratory System
  • Pulmonary Embolism
  • Pulmonary Artery
  • Platelet Aggregation Inhibitors
  • Middle Aged
  • Male
 

Citation

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Chicago
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Bresser, P., Fedullo, P. F., Auger, W. R., Channick, R. N., Robbins, I. M., Kerr, K. M., … Rubin, L. J. (2004). Continuous intravenous epoprostenol for chronic thromboembolic pulmonary hypertension. Eur Respir J, 23(4), 595–600. https://doi.org/10.1183/09031936.04.00020004
Bresser, P., P. F. Fedullo, W. R. Auger, R. N. Channick, I. M. Robbins, K. M. Kerr, S. W. Jamieson, and L. J. Rubin. “Continuous intravenous epoprostenol for chronic thromboembolic pulmonary hypertension.Eur Respir J 23, no. 4 (April 2004): 595–600. https://doi.org/10.1183/09031936.04.00020004.
Bresser P, Fedullo PF, Auger WR, Channick RN, Robbins IM, Kerr KM, et al. Continuous intravenous epoprostenol for chronic thromboembolic pulmonary hypertension. Eur Respir J. 2004 Apr;23(4):595–600.
Bresser, P., et al. “Continuous intravenous epoprostenol for chronic thromboembolic pulmonary hypertension.Eur Respir J, vol. 23, no. 4, Apr. 2004, pp. 595–600. Pubmed, doi:10.1183/09031936.04.00020004.
Bresser P, Fedullo PF, Auger WR, Channick RN, Robbins IM, Kerr KM, Jamieson SW, Rubin LJ. Continuous intravenous epoprostenol for chronic thromboembolic pulmonary hypertension. Eur Respir J. 2004 Apr;23(4):595–600.
Journal cover image

Published In

Eur Respir J

DOI

ISSN

0903-1936

Publication Date

April 2004

Volume

23

Issue

4

Start / End Page

595 / 600

Location

England

Related Subject Headings

  • Vascular Resistance
  • Treatment Outcome
  • Statistics, Nonparametric
  • Retrospective Studies
  • Respiratory System
  • Pulmonary Embolism
  • Pulmonary Artery
  • Platelet Aggregation Inhibitors
  • Middle Aged
  • Male