Can "inoperable" congenital heart defects become operable in patients with pulmonary arterial hypertension? Dream or reality?
The decision whether to repair congenital heart defects in patients with raised pulmonary vascular resistance to alleviate pulmonary hypertension is a complex one. The degree of pulmonary vascular disease is of paramount importance. Operating on patients with pulmonary vascular resistance above a certain threshold runs the risk of postoperative persistent pulmonary hypertension and a worse long-term prognosis. This review focuses on patients deemed "borderline inoperable" or "inoperable" due to pulmonary vascular disease and asks whether they can be "converted to an operable status" with pulmonary arterial hypertension-specific drugs that potentially modify the pulmonary vascular lesions and resistance.
Pediatric Cardiology Unit, Department of the Child and Adolescent, Children's University Hospital, 6 Rue Willy Donzé, Geneva, Switzerland. maurice.beghetti@hcuge.ch
Maurice
M
Beghetti
Nazzareno
N
Galiè
Damien
D
Bonnet
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D019317:Evidence-Based Medicine; D065627:Familial Primary Pulmonary Hypertension; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents