Atrial sepstostomy
Medical > Therapy > Operative treatments
Atrial septostomy
It is known that in patients with pulmonary hypertension right heart function correlates best with survival. Patients with pulmonary hypertension in whom the foramen ovale is patent or an atrial septal defect is present have been reported to live longer than those without an interatrial communication. This is explained by the decompression of the hypertensive ventricle through the interatrial communication. The cardiac output is maintained by paying the price of cyanosis. This lead several groups to create, in patients with severe pulmonary hypertension, a communication between the atria to decompress the right ventricle. This can be performed in the catheterization laboratory (percutaneous procedure) and is called an atrial septostomy. The acute hemodynamic effects of this procedure are an increase in cardiac output, a decrease in right atrial pressure, an improvement in right heart function but a decrease in systemic oxygen saturation. This procedure clearly does not treat the underlying disease and has to be considered as a palliative procedure, for example as a bridge to lung transplantation in selected patients. This procedure is not without risks and should be performed by experienced physicians; the procedure should not be performed on critically ill patients as a salvage procedure. Guidelines have been published in 1998 after the World Symposium of Primary Pulmonary Hypertension: www.who.int/en
References:
Barst RJ. Role of atrial septostomy in the treatment of pulmonary vascualr disease. Thorax 2000;55:95-96.
Kerstein D, Levy PS, Hsu DT, Hordorf AJ, Gersony WM, Barst RJ. Blade balloon atrial septostomy in patients with severe primary pulmonary hypertension. Circulation 1995; 91:2028-2035.
Rich S, Dodin E, McLaughlin VV. Usefulness of atrial septostomy as a treatment for primary pulmonary hypertension and guidelines for its application. Am J Cardiol 1997;80:369-371
Sandoval J, Gasper J, Pulido T, bautista E, Matrinez-Guerra ML, Zeballos M, Palomar A, Gomez. Graded balloon dilation atrial septostomy in severe pulmonary hypertension. A therapeutic alternative for patients nonresponsive to vasodilator treatment. J Am Coll Cardiol 1998;32:297-304.
Back to > Medical > Therapy > Operative treatments
Atrial septostomy
It is known that in patients with pulmonary hypertension right heart function correlates best with survival. Patients with pulmonary hypertension in whom the foramen ovale is patent or an atrial septal defect is present have been reported to live longer than those without an interatrial communication. This is explained by the decompression of the hypertensive ventricle through the interatrial communication. The cardiac output is maintained by paying the price of cyanosis. This lead several groups to create, in patients with severe pulmonary hypertension, a communication between the atria to decompress the right ventricle. This can be performed in the catheterization laboratory (percutaneous procedure) and is called an atrial septostomy. The acute hemodynamic effects of this procedure are an increase in cardiac output, a decrease in right atrial pressure, an improvement in right heart function but a decrease in systemic oxygen saturation. This procedure clearly does not treat the underlying disease and has to be considered as a palliative procedure, for example as a bridge to lung transplantation in selected patients. This procedure is not without risks and should be performed by experienced physicians; the procedure should not be performed on critically ill patients as a salvage procedure. Guidelines have been published in 1998 after the World Symposium of Primary Pulmonary Hypertension: www.who.int/en
References:
Barst RJ. Role of atrial septostomy in the treatment of pulmonary vascualr disease. Thorax 2000;55:95-96.
Kerstein D, Levy PS, Hsu DT, Hordorf AJ, Gersony WM, Barst RJ. Blade balloon atrial septostomy in patients with severe primary pulmonary hypertension. Circulation 1995; 91:2028-2035.
Rich S, Dodin E, McLaughlin VV. Usefulness of atrial septostomy as a treatment for primary pulmonary hypertension and guidelines for its application. Am J Cardiol 1997;80:369-371
Sandoval J, Gasper J, Pulido T, bautista E, Matrinez-Guerra ML, Zeballos M, Palomar A, Gomez. Graded balloon dilation atrial septostomy in severe pulmonary hypertension. A therapeutic alternative for patients nonresponsive to vasodilator treatment. J Am Coll Cardiol 1998;32:297-304.
Back to > Medical > Therapy > Operative treatments
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SSPH Research Prize 2012
Deadline for submission: April 30, 2012
Further information
Symposium "pulmonal-arterielle Hypertension im Kindesalter"
Donnerstag, 10. Mai 2012, 16.00-18.00, Bern
Further information:
5th International Congress of the Swiss Society of Pulmonary Hypertension (SSPH)
28.-29. September 2012, Thun, Congress Hotel Seepark Thun
Informationen: www.imk.ch/sgph2012
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