title: Interventional and surgical therapeutic strategies for pulmonary arterial hypertension: Beyond palliative treatments.
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.
authors.affiliation: Department of Cardiopulmonary, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico City, Mexico. Electronic address: sandovalzarate@prodigy.net.mx.
authors.forename: Julio
authors.initials: J
authors.lastname: Sandoval
authors.affiliation: Department of Cardiopulmonary, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico City, Mexico; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University-School of Medicine, Baltimore, MD, USA.
authors.forename: Jose
authors.initials: J
authors.lastname: Gomez-Arroyo
authors.affiliation: Department of Interventional Cardiology, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico City, Mexico.
authors.forename: Jorge
authors.initials: J
authors.lastname: Gaspar
authors.affiliation: Department of Cardiopulmonary, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico City, Mexico.
authors.forename: Tomas
authors.initials: T
authors.lastname: Pulido-Zamudio
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D001013:Aorta, Thoracic / Q000601:surgery*; D054087:Atrial Septum / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary / Q000628:therapy*; D010166:Palliative Care; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life
keywords: Atrial septostomy; Palliative treatment; Pulmonary arterial hypertension; Pulmonary artery pressure