Evaluating operability in adults with congenital heart disease and the role of pretreatment with targeted pulmonary arterial hypertension therapy.
Pulmonary arterial hypertension (PAH) associated with congenital heart disease remains a major problem despite advances in cardiac surgery. Recently, advanced therapies for PAH have become available and have been effective in reducing pulmonary vascular resistance and symptoms in patients with near-systemic pulmonary arterial pressures, previously thought to have irreversible pulmonary vascular disease. This has led to a new dilemma, namely could intracardiac communications previously considered inoperable due to severe pulmonary vascular disease become amenable to surgery after successful treatment with advanced therapy? We address, hereby, the potential merits and hazards of a "treat-and-repair" approach using advanced therapies in patients with PAH associated with congenital heart disease.
Dimopoulos
Konstantinos
K
Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital and National Heart & Lung Institute, Imperial College School of Medicine, London, United Kingdom.
Peset
Ana
A
Gatzoulis
Michael A
MA
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006330:Heart Defects, Congenital / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011651:Pulmonary Artery / Q000473:pathology*; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents