title: Low complication rates with totally implantable access port use in epoprostenol treatment of pulmonary hypertension.
abstract: BACKGROUND
  Among patients with advanced pulmonary arterial hypertension (PAH) who are receiving epoprostenol treatment, complications due to the delivery system are known to be a cause of serious morbidity and mortality. In this study, we aimed to outline the complications associated with the use of a totally implantable access port (TIAP) and their consequences in continuous intravenous epoprostenol treatment.
  
  
  METHODS
  One hundred eleven pulmonary hypertension (PH) patients treated with epoprostenol through a totally implantable access port (TIAP) between May 1998 and July 2006 at three Dutch PH referral centers were retrospectively studied.
  
  
  RESULTS
  During a mean follow-up period of 946 +/- 719 days, TIAP-related complications included local port site infections, bloodstream infections, port site skin perforations and incorrect port placement, with incidence rates of 0.11, 0.15, 0.06 and 0.04 per patient-year, respectively. Fatal, serious, moderate and minor consequences of these complications had incidence rates of 0.01, 0.50, 0.09 and 0.01 per patient-year, respectively. The median complication-free survival was 371 days. Staphylococcus aureus was the dominant infectious agent. The median TIAP life duration was 677 days. Female patients showed significantly longer first TIAP survival (p = 0.004).
  
  
  CONCLUSIONS
  The use of a TIAP showed long-lasting port survival and relatively low complication rates. Our data suggest that the TIAP is well suited for continuous intravenous epoprostenol delivery in patients with pulmonary hypertension.
authors.affiliation: Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Dickinson
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Schölvinck
authors.forename: Anco
authors.initials: A
authors.lastname: Boonstra
authors.forename: Anton
authors.initials: A
authors.lastname: Vonk-Noordegraaf
authors.forename: Repke J
authors.initials: RJ
authors.lastname: Snijder
authors.forename: Rolf M F
authors.initials: RM
authors.lastname: Berger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D011464:Epoprostenol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D011464:Epoprostenol