Currently, the standard treatment for proximal thromboses lesions responsible for post-embolic pulmonary hypertension, is the surgical thromboendarterectomy. When the ravages are judged too distal or the patient is judged inoperable for a curative surgical gesture, there is no evidence of any therapeutic option, exept for K anti-vitamins for recurrent embolism. Prognosis is then pejorative with a 60% mortality at 5 years. This study propose an alternative treatment for these patients in therapeutic "dead end". This is about applying arterial thrombosis technique to the pulmonary circulation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
33
UniversityHospitalGrenoble
La Tronche, France
Percutaneous angioplasty
International Normalized Ratio wil be measure and need to be between 2 and 3.
Time frame: About 90 minutes
Balloon angioplasty
Same mode than valscular or coronal angioplasty.
Time frame: About 90 minutes
Right heart catheterization
Right auricular pressure auriculaire droite moyenne ou POD (mmHg) * Blood pressure : systolic, diastolic, and average(mmHg) * pression artérielle pulmonaire d'occlusion (PAPO) moyenne (mmHg)
Time frame: Few minutes
Echocardiography
Right ventricular heart function with evaluation of : \- The maximum pressure gradient (mmHg)
Time frame: Few minutes
Walking test
Start heart rate (T0) and at the end (T6) of the test (bpm)
Time frame: 6 minutes
Functional respiratory investigations
* Forced expiratory volume (FEV) ml/kg * Forced vital capacity (FVC) ml/kg * Total lung capacity ml/kg * Alveolar capillarytransfer of Carbon monoxide (CO) ml/kg * Transfer coefficient of CO (KCO) ml/kg All volumes in ml/kg
Time frame: About an hour
Pulmonary tomography or pulmonary angiography
tomography (CT) or angiography
Time frame: About 30 minutes
Heart rate
Heart rate (bpm) during right heart catheterization.
Time frame: Few minutes
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Cardiac output (L/min)
Cardiac output (L/min) during right heart catheterization.
Time frame: Few minutes
Venous oxygen saturation (%)
Venous oxygen saturation (%) during right heart catheterization.
Time frame: Few minutes
Echocardiography
Right ventricular heart function with evaluation of : Surface area of the right ventricle (cm²)
Time frame: Few minutes
Echocardiography
Right ventricular heart function with evaluation of : Cardiac output (L/min) and cardiac index (L/min/m²)
Time frame: Few minutes
Walking test
Patient self evaluation of the dyspnea on a Borg scale from 0 (not breathless) to 10 (serious breathless)
Time frame: 6 minutes
Walking test
Arterial blood saturation in oxygen measured by an oxymeter dat the beginning (T0) and at the end of the test (T6) (SO2)
Time frame: 6 minutes