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2021, Number 4

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Rev Cubana Cardiol Cir Cardiovasc 2021; 27 (4)

Atrial septostomy in patients with pulmonary arterial hypertension and predictors of high risk trans procedure. Report of five procedures

Echarte-Martínez JC, Hechavarría-Pouymiró S, Alfonso-Rodríguez E, Echarte-Morales JC, Naranjo-Dominguez A, González DLR

Language: Spanish
References: 9
Page: 1-5
PDF size: 329.48 Kb.


ABSTRACT

Pulmonary arterial hypertension is incurable, it limits functional capacity. Without treatment, life expectancy is short. Specific drug therapy improves quality and life expectancy. We only have Sildenafil. The atrial septostomy, constitutes the last step to face it. (carries risk of complications and lethality).Objectives: To demonstrate that atrial septostomy can be an alternative in the treatment of pulmonary arterial hypertension. Method: Prior informed consent of patients and relatives, atrial septostomy was performed following the technique of Sandoval et al. We presented results of 5 procedures in patiens in WHO functional class IV, (four with recurrent syncope). Post procedure they all passed to class II, with syncope disappearance. Previously to atrial septostomy, 4 of them had right atrial mean pressure greater than 20 mm Hg. Some of them, with elements of right ventricular failure (pericardial Effusion and Ascites). Post intervention right atrial pressure dropped and signs of venous hypertension. Systemic cardiac output increased, related to the right to left shunt created by atrial septostomy, and systemic vascular resistance and total pulmonary vascular resistance decreased. 2 minor complications trans procedure. No Mortality (Peri procedure- follow-up) Conclusion: atrial septostomy is a feasible procedure in patients with pulmonary arterial hypertension, improves their quality of life.


REFERENCES

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