Blade Balloon Atrial Septostomy in Patients With Severe Primary Pulmonary Hypertension

Kerstein, Diane; Levy, Paul S.; Hsu, Daphne T.; Hordof, Allan J.; Gersony, Welton M.; Barst, Robyn J.

doi:10.1161/01.cir.91.7.2028

Cited by 236 publications

(161 citation statements)

References 14 publications

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“…Our study series provides the longest follow-up of patients with AS in the setting of PAH and, as in other study series [5,7,27], AS significantly improved long-term survival in these patients. AS improved haemodynamic parameters that correlate with survival (cardiac index and right ventricular filling pressures) and 6MWT, another surrogate of survival in PAH, and this may explain the impact of the procedure on shortterm survival.…”

Section: Effect Of As On Long-term Survivalsupporting

confidence: 74%

“…In most reported series [5,[7][8][9][10][11], AS has been performed only after the failure of different PAH-specific pharmacological interventions. In the present study, patients with concomitant pharmacological treatment had AS performed before pharmacological treatment was initiated.…”

Section: Discussionmentioning

confidence: 99%

“…Little information exists regarding the long-term impact of AS on the survival of PAH patients [5][6][7]. In most of the reported series [5,[7][8][9][10][11], the procedure was performed after all available medical therapy failed, late in the course of the disease, when the risk of procedural death is increased and the impact of the intervention on long-term survival is minimised.…”

mentioning

confidence: 99%

“…In most of the reported series [5,[7][8][9][10][11], the procedure was performed after all available medical therapy failed, late in the course of the disease, when the risk of procedural death is increased and the impact of the intervention on long-term survival is minimised. We describe the effect of AS on the survival of a group of patients with PAH in whom the procedure was performed either as an isolated treatment intervention or prior to the use of PAH-specific pharmacological therapy.…”

mentioning

confidence: 99%

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Effect of atrial septostomy on the survival of patients with severe pulmonary arterial hypertension

Sandoval¹,

Gaspar²,

Peña³

et al. 2011

Eur Respir J

122

100

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Atrial septostomy (AS) is a palliative treatment for right ventricular failure from severe pulmonary arterial hypertension (PAH). We sought to investigate the effect of AS, alone or combined with PAH-specific pharmacotherapy, on the survival of patients with PAH.We performed a retrospective analysis of the functional and haemodynamic changes in patients with PAH following AS, and long-term survival characteristics for the whole group and separately for the subgroup who received post-procedural pharmacotherapy. 50 procedures performed in 34 patients (mean¡SD age 35¡10 yrs) resulted in haemodynamic and symptomatic improvement in most of the patients. Only one (2%) procedure-related death occurred. Due to spontaneous closure of the defect, AS was repeated in 10 patients. In 21 patients, AS was the only form of treatment, while 11 received additional pharmacotherapy after AS. During follow-up (58.5¡38 months), 21 patients died; median survival of the group was 60 months (95% CI 43-77 months). Median survival for patients on pharmacotherapy additional to AS was 83 months (95% CI 57-109 months), which was better than that for patients with AS alone (53 months, 95% CI 39-67 months) (log-rank 6.52; p50.010).In selected patients with PAH, AS is a safe and effective intervention that exerts a beneficial impact on long-term survival. Survival appears to be improved when AS is combined with PAHspecific pharmacotherapy.

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Section: Effect Of As On Long-term Survivalsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Effect of atrial septostomy on the survival of patients with severe pulmonary arterial hypertension

Sandoval¹,

Gaspar²,

Peña³

et al. 2011

Eur Respir J

122

100

View full text Add to dashboard Cite

show abstract

“…A study in children with iPAH has demonstrated a significant long-lasting benefit with clinical, haemodynamic and survival advantage following blade-balloon atrial septostomy. 102 In adults, a large series is reported by Sandoval and colleagues from Mexico. 103 The atrial septum is first punctured percutaneously.…”

Section: Balloon Atrial Septostomymentioning

confidence: 99%

Pulmonary hypertension—“state of the art” management in 2012

Saxena

2012

Indian Heart Journal

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A B S T R A C TPulmonary artery hypertension (PAH) is a pathological condition of small pulmonary arteries, characterised by vascular proliferation and remodelling. The pulmonary artery pressure and pulmonary vascular resistance progressively rise, leading to right heart failure and death. Pulmonary artery hypertension may be secondary to various conditions, or it may be idiopathic where no underlying cause is identifiable. Earlier, only symptomatic treatment was available for such patients which did not change the natural history of the disease. However, over the years, improvement in understanding the pathogenesis has resulted in the development of targeted approaches to the treatment of PAH. Survival advantage has also been shown with some of the pharmacologic agents. This review article discusses the current management strategy for PAH with special emphasis on an idiopathic variety, in an Indian context.

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Palliation of systemic sclerosis-associated pulmonary hypertension by atrial septostomy

Allcock

O’Sullivan

Corris

2001

Arthritis & Rheumatism

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Blade Balloon Atrial Septostomy in Patients With Severe Primary Pulmonary Hypertension

Abstract: Blade balloon atrial septostomy resulted in clinical and hemodynamic improvement and improved survival in selected patients with severe primary pulmonary hypertension.

Cited by 236 publications

References 14 publications

Effect of atrial septostomy on the survival of patients with severe pulmonary arterial hypertension

Effect of atrial septostomy on the survival of patients with severe pulmonary arterial hypertension

Pulmonary hypertension—“state of the art” management in 2012

Palliation of systemic sclerosis-associated pulmonary hypertension by atrial septostomy

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