Premium
A modified technique of stent fenestration of the interatrial septum improves patients with pulmonary hypertension
Author(s) -
Troost Els,
Delcroix Marion,
Gewillig Marc,
Van Deyk Kristien,
Budts Werner
Publication year - 2008
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21760
Subject(s) - medicine , fenestration , interatrial septum , surgery , pulmonary hypertension , stent , chronic thromboembolic pulmonary hypertension , cardiology , left atrium , atrial fibrillation
Aims: A significant number of patients with pulmonary hypertension are resistant to medical therapy. We wanted to evaluate whether the modified technique of stent fenestration of the interatrial septum would be feasible and safe, and offer clinical benefit. Methods and Results: The medical records of all patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension who underwent a stent fenestration of the interatrial septum between 2001 and 2008 were reviewed. In all fifteen patients (12 female, mean age 48.2 ± 20.5 years) a successful fenestration procedure could be performed. Median follow‐up time between diagnosis and fenestration was 2.3 years (range from 0.5 to 18.6 years). Mean event free survival since diagnosis and after septostomy was 9.8 ± 2.9 and 3.2 ± 0.8 years, respectively. When one extreme outlier was excluded, the 6 min walk distance improved significantly from 309 ± 69 m immediately before fenestration to 374 ± 84 m, 3–4 months after fenestration ( n = 8, paired t ‐test, P = 0.03). No stent occlusion occurred. Conclusion: The modified stent fenestration technique is feasible and safe in patients with severe pulmonary hypertension. In a selected group of patients, functional capacity might improve although disease progression continues. © 2008 Wiley‐Liss, Inc.