Successful palliation of primary pulmonary hypertension by atrial septostomy

Hausknecht, Mark J.; Sims, Ronald E.; Nihill, Michael R.; Cashion, W.Richard

doi:10.1016/0002-9149(90)91016-y

Cited by 58 publications

(16 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[1][2][3][4] However, balloon dilatation on its own often results in early reclosure of the fenestration or excessive desaturation. [4][5][6] Difficulties experienced with standard techniques of stent placement include early stent occlusion, stent migration, and problems in adjusting stent size to achieve the desired haemodynamic effect.…”

mentioning

confidence: 99%

Modified technique of stent fenestration of the atrial septum

Stümper

2003

Heart

View full text Add to dashboard Cite

Objectives: To develop a modified technique for stenting the atrial septum in the treatment of patients with a failing Fontan operation or pulmonary hypertension. Setting: Two tertiary referral centres. Study design: Prospective collaborative clinical study. Patients and methods: A stent was mounted on a standard valvoplasty balloon catheter which was constricted to a predefined diameter by a loop created from a temporary pacing wire. Full balloon inflation created a diabolo shaped stent configuration. The technique was employed in 12 consecutive patients to relieve symptoms of a failing Fontan circulation (n = 6) or severe pulmonary hypertension (n = 6). Results: Ex vivo studies confirmed that a diabolo shaped stent configuration could be achieved using the above technique. Transcatheter stent implantation was successful in all 12 patients. All six Fontan patients showed significant clinical improvement. Right atrial pressure decreased from (mean (SD)) 16.8 (2.5) to 13.7 (1.9) mm Hg (p < 0.05), and arterial oxygen saturation from 92.8 (1.8)% to 82.7 (3.8)% (p < 0.01). Six patients underwent successful stent fenestration for treatment of pulmonary hypertension. All stents were patent and stable at the most recent follow up (mean 1.75 (1.05) years). No early or late stent related complications were encountered. Conclusions: This new technique allows placement of a diabolo shaped stent with a predefined diameter across the atrial septum. The diabolo shape increases stent stability, facilitates recrossing of the stent during future catheter interventions, and ensures medium term stent patency.

show abstract

mentioning

confidence: 99%

Modified technique of stent fenestration of the atrial septum

Stümper

2003

Heart

View full text Add to dashboard Cite

show abstract

“…To overcome such limitations, static balloon atrial dilation was first introduced in laboratory animals in 1986 by Mitchell et al 85 and then in humans in 1987 by Shrivastava et al 86 This technique was proved to be relatively safe and effective. 23,87 The use of oversized balloons to create a large defect was described by Ballerini et al 88 with very good results. Numerous cases in which the static balloon dilation technique was used have been reported in the medical literature.…”

Section: Static Balloon Atrial Dilationmentioning

confidence: 99%

Pediatric Therapeutic Cardiac Catheterization

Allen¹,

Beekman²,

Garson³

et al. 1998

Circulation

View full text Add to dashboard Cite

“…Although there is a worldwide experience in w100 patients, the procedure should still be considered investigational. Successful palliation of symptoms with atrial septostomy has been reported in several series [104][105][106][107][108]. In the current authors9 experience, patients with pulmonary arterial hypertension with recurrent syncope and/or right heart failure significantly improve clinically as well as haemodynamically following atrial septostomy; e.g.…”

Section: Atrial Septostomymentioning

confidence: 88%

Pulmonary arterial hypertension in children

2003

View full text Add to dashboard Cite

For physicians to admit that a group of patients remains for whom no cure is available in modern medicine is intellectually unsatisfying. Pulmonary arterial hypertension is a rare condition. Because the symptoms are nonspecific and the physical finding can be subtle, the disease is often diagnosed in its later stages. The natural history of pulmonary arterial hypertension is usually progressive and fatal.At the 1998 Primary Pulmonary Hypertension World Symposium, clinical scientists from around the world gathered to review and discuss the future of pulmonary arterial hypertension. Bringing together experts from a variety of disciplines provided the opportunity for a better understanding of the pathology, pathobiology, risk factors, genetics, diagnosis and treatment for pulmonary arterial hypertension.Remarkable progress has been made in the field of pulmonary arterial hypertension over the past several decades. The pathology is now better defined and significant advances have occurred in understanding the pathobiological mechanisms. Risk factors have been identified and the genetics have been characterised. Advances in technology allow earlier diagnosis as well as better assessment of disease severity. Therapeutic modalities such as new drugs, e.g. epoprostenol, treprostinil and bosentan, and surgical interventions, e.g. transplantation and blade septostomy, which were unavailable several decades ago, have had a significant impact on prognosis and outcome. Thus, despite the inability to really cure pulmonary arterial hypertension, therapeutic advances over the past two decades have resulted in significant improvements in the outcome for children with various forms of pulmonary arterial hypertension.This review of pulmonary arterial hypertension will highlight the key features of pulmonary hypertension in infants and children and the current understanding of pulmonary arterial hypertension with specific recommendations for current practice and future directions. Eur Respir J 2003; 21: 155-176.

show abstract

Successful palliation of primary pulmonary hypertension by atrial septostomy

Cited by 58 publications

References 4 publications

Modified technique of stent fenestration of the atrial septum

Modified technique of stent fenestration of the atrial septum

Pediatric Therapeutic Cardiac Catheterization

Pulmonary arterial hypertension in children

Contact Info

Product

Resources

About