Interventional and surgical therapeutic strategies for pulmonary arterial hypertension: Beyond palliative treatments

• Published in: Journal of cardiology Vol. 66; no. 4; pp. 304 - 314
• Main Authors: Sandoval, Julio, MD, Gomez-Arroyo, Jose, MD, PhD, Gaspar, Jorge, MD, Pulido-Zamudio, Tomas, MD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.10.2015
• Subjects: Anastomosis, Surgical - methods; Aorta, Thoracic - surgery; Atrial septostomy; Atrial Septum - surgery; Cardiovascular; Humans; Hypertension, Pulmonary - therapy; Palliative Care; Palliative treatment; Pulmonary arterial hypertension; Pulmonary Artery - physiopathology; Pulmonary Artery - surgery; Pulmonary artery pressure; Quality of Life; Atrial septostomy; Pulmonary arterial hypertension; Palliative treatment; Pulmonary artery pressure
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2015.02.001

Abstract Despite significant advances in pharmacological treatments, pulmonary arterial hypertension remains an incurable disease with an unreasonably high morbidity and mortality. Although specific pharmacotherapies have shifted the survival curves of patients and improved exercise endurance as well as quality of life, it is also true that these pharmacological interventions are not always accessible (particularly in developing countries) and, perhaps most importantly, not all patients respond similarly to these drugs. Furthermore, many patients will continue to deteriorate and will eventually require an additional, non-pharmacological, intervention. In this review we analyze the role of atrial septostomy and Potts anastomosis in the management of patients with pulmonary arterial hypertension, we summarize the current worldwide clinical experience (case reports and case series), and discuss why these interventional/surgical strategies might have a therapeutic role beyond that of a “bridge” to transplantation.