Elsevier

Heart & Lung

Volume 41, Issue 6, November–December 2012, Pages 599-605
Heart & Lung

Care of Patients with Pulmonary Artery Hypertension
Subcutaneous implantation of a new intravenous pump system for prostacyclin treatment in patients with pulmonary arterial hypertension

https://doi.org/10.1016/j.hrtlng.2012.07.001Get rights and content

Abstract

Background

Intravenous prostacyclin treatment is a well recognized option in patients suffering from pulmonary arterial hypertension (PAH), and remains the gold standard of treatment. However, intravenous prostacyclin treatment involves several limitations, because the available battery-driven pump systems carry the risk of line infections, catheter-related embolisms, thrombosis, and delivery system malfunctions.

Case Report

We report for the first time, to the best of our knowledge, on the safe transition procedure from subcutaneous to intravenous treprostinil in a 74-year-old woman suffering from severe PAH (New York Heart Association functional class III), using a new implantable, gas-driven, intravenous pump device (LenusPro, Tricumed/OMT, Frittlingen, Germany).

Conclusions

This implantable pump system may overcome the well-known limitations and risks of commonly used delivery systems, and thus may provide a new option for continuous intravenous prostacyclin treatment in patients with PAH.

Section snippets

Case Report

We report on a 74-year-old woman suffering from idiopathic PAH (New York Heart Association functional class III). The first diagnosis was rendered in 2001 at the University Specialized Center for Pulmonary Hypertension at Innsbruck Medical University (Innsbruck, Austria). Since then, the patient has been controlled regularly, and her therapy was adopted according to a goal-oriented strategy.5, 8, 10 Her most recent right heart catheter revealed hemodynamics of mean pulmonary artery pressure at

Discussion

The use of prostanoid constitutes a cornerstone in the treatment of PAH.5, 6 To their advantage, prostanoids can be applied by an oral, inhalational, subcutaneous, or intravenous route. However, their main disadvantage involves the short half-life of all available prostacyclin analogues, which results in continuous parenteral delivery. Currently, 4 prostacyclin analogues are licensed for the treatment of PAH: epoprostenol, treprostinil, and iloprost in the United States and some European

Acknowledgments

The work of C.M.K. was supported by the Verein für Tumorforschung—Pneumologie.

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Cited by (0)

The authors received no funding from the pump distributor OMT (Frittlingen, Germany) or the treprostinil supplier AOP Orphan Pharmaceuticals (Vienna, Austria) for this article.

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