Aim: To evaluate safety and efficacy of pulmonary artery radiofrequency denervation (PADN) for pulmonary artery (PA) pressure decrease in patients with residual pulmonary hypertension after pulmonary thromboendarterectomy.

Methods: PADN was performed in 14 patients with residual pulmonary hypertension after pulmonary thromboendarterectomy. Indication for PADN was mean PA pressure level >25 mm Hg with absence of proximal PA lesion according to CT scan. For PADN efficacy assessment with V/Q-scanning, echocardiography, right heart catheterization and 6-minute walking distance test were performed. During preoperative evaluation subsegmental PA perfusion defects were revealed in all patients. PADN was performed using of nonfluoroscopic 3-D navigation system with standard catheter for radiofrequency ablation. Swan-Ganz catheter was used for intraoperative hemodynamic measurements. All patients were followed up during 30 days after procedure.

Results: There were no complications or death during the procedure and before discharge. Mean procedure time was 105 [93; 120] min. After PADN the mean PA pressure decrease from 37,3 mm Hg [29; 38] to 24,6 [17; 30] mm Hg (p=0,011) and pulmonary vascular resistance from 672 [387; 566] dyn sec cm^–5 to 386 [155; 449] dyn sec cm^–5 (p=0.017). There were no significant increase of cardiac output and 6-minute walking distance test compared to baseline data (3,4 [3,2; 3,4] l/min vs 3,5 [3,2; 4,0] l/min; p=0,4012 and 427 meters [352; 510] vs 447 m [370; 525]; p=0.1614, respectively). All patients noticed reduction of dyspnea and improving exercise tolerance.

Conclusion: Our initial experience demonstrated that PADN in patients with residual pulmonary hypertension after pulmonary thromboendarterctomy is safe and effective it terms of pulmonary PA decrease. Long-term follow up and further studies are needed to assess the role of PADN in the treatment of these category of patients.