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A 37-year-old man with chronic thromboembolic pulmonary hypertension was admitted to our hospital. Hemodynamics revealed right atrial pressure (RAP) of 21 mmHg, pulmonary artery pressure (PAP) of 60 mmHg, and pulmonary vascular resistance (PVR) of 9.1 WU. Right ventricular systolic pressure (RVSP) was 122 mmHg. Inhaled nitric oxide (NO) was added to his treatment with heparin (7,000 units/day), and transthoracic echocardiography (TTE) revealed an ejection fraction (EF) of 39.0%, dilatation of all the cardiac chambers, and increased right ventricular systolic pressure. Balloon pulmonary angioplasty (BPA) of the right pulmonary artery (PA) via right femoral artery was performed. Inhaled NO decreased PAP from 60 mmHg to 32 mmHg after BPA. EF improved from 39.0% to 50.5%, and PVR decreased from 9.1 WU to 5.4 WU. Right ventricular end-diastolic pressure (RVEDP) decreased from 39 mmHg to 18 mmHg. The PAP reduced to 30 mmHg by maximum dilatation, and BPA of the main trunk of the PA was completed. This case demonstrated that BPA for pulmonary hypertension was effective. Inhaled NO may be useful for preventing pulmonary hypertension from BPA for chronic thromboembolic pulmonary hypertension.Q:
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