Open AccessAtrial Septostomy: A Contemporary Review
Author(s) -
Al Maluli Hayan,
DeStephan Christine M.,
Alvarez René J.,
Sandoval Julio
Publication year - 2015
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22398
Subject(s) - medicine , intracardiac injection , intensive care medicine , modalities , heart disease , shunt (medical) , palliative care , ventricle , psychological intervention , medical therapy , pulmonary hypertension , surgery , cardiology , social science , nursing , psychiatry , sociology
Pulmonary arterial hypertension ( PAH ) is a rare disease, but it boasts significant morbidity and mortality. Although remarkable achievements have been made in the medical treatment of PAH , there is a role for invasive or surgical procedures in patients with progressive disease despite optimal medical therapy or with no access to such therapy. Atrial septostomy creates a right‐to‐left intracardiac shunt to decompress the overloaded right ventricle. Despite significant advances to validate and improve this palliative procedure, as well as recent reports of improved outcomes, it is only slowly being adopted. This article aims to detail the history, indications, contraindications, procedural techniques, and outcomes of atrial septostomy. We will also shed light on some of the newer interventions, inspired by the same physiological concept, that are being evaluated as potential palliative modalities in patients with PAH .