Balloon dilation atrial septostomy for advanced pulmonary hypertension in patients on prostanoid therapy

Kühn, Bärbel; Javed, Usman; Armstrong, Ehrin J.; Singh, Gagan D.; Smith, Thomas W.; Whitcomb, Charles; Allen, Roblee P.; Rogers, Jason H.

doi:10.1002/ccd.25751

Cited by 19 publications

(11 citation statements)

References 29 publications

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“…Contraindications to AS include end-stage disease with right atrial pressure >20 mm Hg and O2 saturation <85% on room air [ 1 ]. Multiple authors reported high peri-procedural mortality in this category of patients [ 5 , 7 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, this technique cannot be considered to be a well-established procedure because of controversial results and relatively small clinical experience. Experience with stent fenestratration of the atrial septum is very limited and does not exceed 15 interventions at one particular institution [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ] ( Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Atrioseptostomy with Stenting in Patients with Pulmonary Arterial Hypertension from a Large Single-Institution Cohort

et al. 2020

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The aim of this study was to analyze results of stenting atrioseptostomy in patients with pulmonary arterial hypertension and a different level of risk for one-year mortality that is not well described. Patients that underwent atrioseptostomy with stenting were retrospectively divided in two groups: “intermediate” (n = 55) or “high” risk (n = 13), according to the 2015 ESC/ESR guideline. Results of atrioseptostomy were assessed during hospital period and at follow-up. Patients from “intermediate” risk group demonstrated lower mortality rate (10/55, vs. 6/13) during the course of the study period, as well as higher freedom from lung transplantation or Potts shunt. At discharge, patients of both groups presented improvement in functional class and mobility. Patients from “intermediate” risk group showed longer 6-min walking distance, and lower levels of brain natriuretic peptide. At the latest follow-up, stable position and full patency of stents with right-to-left or bidirectional shunt at atrial level and absence of syncope was confirmed in patients of both groups. Patients from the “intermediate” risk group demonstrated higher functional class, better performance of walking test, and lower levels of brain natriuretic peptide. Stenting atrioseptostomy reliably secured interatrial communication and improved clinical condition in patients with idiopathic pulmonary arterial hypertension. Mid-term results were better in “intermediate” risk group.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes of Atrioseptostomy with Stenting in Patients with Pulmonary Arterial Hypertension from a Large Single-Institution Cohort

et al. 2020

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“…21 Technical expertise and experience with the procedure also contribute to mortality, as reflected by lower mortality reported in recent series. 22,23,29 The hemodynamic effects of an atrial septostomy depend highly on the baseline RAP. Table 1 shows how a higher baseline RAP will result in a more pronounced hemodynamic effect, particularly when RAP is Ͼ20 mm Hg (ie, severe RVF).…”

Section: Methodsmentioning

confidence: 99%

Balloon Dilation Atrial Septostomy and Potts Anastomosis for Severe Pulmonary Arterial Hypertension: Why, When, and How

Sandoval

Pulido

Sandoval

et al. 2016

Advances in Pulmonary Hypertension

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Despite advances in pharmacologic treatment, pulmonary arterial hypertension (PAH) remains a fatal disease. In recent years, surgical/interventional approaches including balloon dilation atrial septostomy and Potts anastomosis have been applied to improve the hemodynamic variables associated with right ventricular failure in the setting of PAH. These interventions may improve quality of life and prolong survival in this population. In this review, we will discuss the role of these 2 therapeutic alternatives in the management of PAH.

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“…Ballon atrial septostomy is a known method used as a bridge to lung transplantation (LuTX) in patients with severe PAH and right ventricular failure with elevated right atrial pressure, however it may also be used as a palliative treatment for patients disqualified from LuTX to prolong their lives [4,5]. In the described case, such a reduction of right atrial pressure and sympathetic overactivity by the means of BAS [6] not only fulfilled the abovementioned role, but also showed another benefit -a relief from atrial tachycardia, which improved the patient's short-term prognosis [2,3].…”

Section: Balloon Atrial Septostomy In Pulmonarymentioning

confidence: 99%

Balloon atrial septostomy in pulmonary arterial hypertension: A beneficial effect on the control of rhythm abnormalities

2016

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Balloon dilation atrial septostomy for advanced pulmonary hypertension in patients on prostanoid therapy

Abstract: BDAS may be an alternate therapy for select PH patients who have symptomatic progression despite prostanoid therapy. Survival is comparable to prior reports of BDAS in the pre-prostanoid era.

Cited by 19 publications

References 29 publications

Outcomes of Atrioseptostomy with Stenting in Patients with Pulmonary Arterial Hypertension from a Large Single-Institution Cohort

Outcomes of Atrioseptostomy with Stenting in Patients with Pulmonary Arterial Hypertension from a Large Single-Institution Cohort

Balloon Dilation Atrial Septostomy and Potts Anastomosis for Severe Pulmonary Arterial Hypertension: Why, When, and How

Balloon atrial septostomy in pulmonary arterial hypertension: A beneficial effect on the control of rhythm abnormalities

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