[Palliative interatrial septostomy in severe pulmonary hypertension].
Three patients with severe pulmonary hypertension underwent palliative atrial septostomy by dilating the interatrial septum with valvuloplasty catheter-balloons. In two cases successful dilation improved cardiac index and symptoms of cardiac failure (13 and 11 months follow-up). One patient died immediately post-septotomy due to severe hypoxemia. Severe pulmonary hypertension with low cardiac output and high right ventricular filling pressures has a very poor short-term prognosis. Atrial septostomy is a useful palliative procedure and can serve as a bridge to heart and/or lung transplantation. It is not free of risk and the resultant systemic hypoxemia can lead to dead; that is why we recommend progressive balloon diameters, stopping the procedure when improvement of cardiac index is achieved with the minimal systemic oxygen desaturation.
Sobrino
N
N
Unidad Médico-Quirúrgica de Cardiología Hospital La Paz, Madrid.
Frutos
A
A
Calvo
L
L
Casamayor
L M
LM
Arcas
R
R
D000328:Adult; D002404:Catheterization / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011660:Pulmonary Heart Disease / Q000150:complications / Q000628:therapy*