Balloon Pulmonary Angioplasty — Nebraska Medicine

A team led by interventional cardiologist Karen Deffenbacher, MD, PhD performs a balloon pulmonary angioplasty on Kim Miller.

After starting chemo about four years ago, Kim Miller noticed she was short of breath. That's when she discovered she had chronic thromboembolic pulmonary hypertension or CTEPH.

"They found a blood clot on one of my scans, so I went for a CT scan," says Miller, who is the manager of Blood and Marrow Transplantation and the CAR T Program. "It turns out I had a lot of clots in both of my lungs. Once I started blood thinners, my breathing was better, but I still got abnormally short of breath with exertion."

After several more tests, it was discovered that some of the clots didn’t resolve and left residual scar tissue. That causes pulmonary hypertension. Miller took some medication and improved even more, but still had issues breathing when she exercised.

That's when it was decided Miller would benefit from a balloon pulmonary angioplasty — a minimally invasive procedure that opens up the blocked pulmonary arteries and allows perfusion to those areas. Prior to Miller's procedure, we referred patients to the Mayo Clinic in Rochester, Minnesota, University of California - San Diego or Temple University in Philadelphia, Pennsylvania.

On March 17, interventional cardiologist Karen Deffenbacher, MD, PhD, performed the first balloon pulmonary angioplasty in Nebraska on Miller. Patients often need an additional procedure to remove remaining clots — Dr. Deffenbacher performed a follow-up procedure on April 7.

"It's really gratifying to be able to offer this to our patients when they previously had to travel," says Dr. Deffenbacher. "We've had a fair number of patients in the past who would have benefited from this procedure, now they can stay right here in Nebraska."

"Performing the first balloon pulmonary angioplasty in the state again demonstrates our dedication to offering the highest levels of care," says Michael Moulton, MD, cardiothoracic surgeon. "This will make things much easier for our patients in the long run."

"It is exciting to have Dr. Deffenbacher bring these skills to Nebraska Medicine," says Dan Anderson, MD, PhD, cardiologist. "The ability for us to perform pulmonary angioplasty here is very much needed in the region. This allows us to effectively treat and manage our patients with CTEPH where historically many patients would go untreated."

Miller appreciates the improved perfusion as she and her husband prepare for a long hiking trek.

"With improved perfusion, I get improved oxygenation, which will help improve my activity tolerance," says Miller. "Plus, it could eliminate my CTEPH and possibly help me get off one of the medications. My husband and I are hiking the West Highland Way in September – the trail is 96 miles, and we’re hiking it over seven days. So I’ll be really grateful to have my full lung function back for that trip!"