PMC7528185_01
A 12-lead resting electrocardiogram (A) and chest X-ray (B) on admission.
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A chest X-ray showed a markedly enlarged cardiac and pulmonary artery silhouette (Fig. 1).
Pulmonary perfusion scintigraphy on admission (A) and at 6 months after a final balloon pulmonary angioplasty (BPA) session (B).
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PH (88 mmHg) as estimated by the tricuspid systolic pressure gradient, significant right atrial and ventricular dilation, and oppression of the left ventricle by the right ventricle. Pulmonary perfusion scintigraphy showed a severe segmental perfusion defect whereas we could not find the contrast defect suggesting the thrombus in the contrast enhanced computed tomography (Fig. 2, Fig. 3).
Pulmonary angiography (PAG) of the right lower lobe on admission (A) and PAG at 6 months of follow-up after the final BPA session (B). Intravascular ultrasounds image at right A9 (red arrow in (A)). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Pulmonary angiography showed typical findings consistent with CTEPH (Fig. 4). A1,3,5,6,8,10 in first session, left 1,2,3,6,8,9 in second session, right A1,8,9,10 in third session, left A1,3,4, 8,9,10 in forth session), which were successfully done without any complications. Any unusual lesion findings including intravascular ultrasounds images were not observed (Fig. 4).