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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:565-74 - Vol. 71 Num.07 DOI: 10.1016/j.rec.2018.02.002

Interventional Therapies in Pulmonary Hypertension

Julio Sandoval a,

a Departamento de Investigación Clínica, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico

Keywords

Pulmonary hypertension. Right heart failure. Interventional therapies.

Abstract

Despite advances in drug therapy, pulmonary hypertension—particularly arterial hypertension (PAH)—remains a fatal disease. Untreatable right heart failure (RHF) from PAH eventually ensues and remains a significant cause of death in these patients. Lowering pulmonary input impedance with different PAH-specific drugs is the obvious therapeutic target in RHF due to chronically increased afterload. However, potential clinical gain can also be expected from attempts to unload the right heart and increase systemic output. Atrial septostomy, Potts anastomosis, and pulmonary artery denervation are interventional procedures serving this purpose. Percutaneous balloon pulmonary angioplasty, another interventional therapy, has re-emerged in the last few years as a clear alternative for the management of patients with distal, inoperable, chronic thromboembolic pulmonary hypertension. The current review discusses the physiological background, experimental evidence, and potential clinical and hemodynamic benefits of all these interventional therapies regarding their use in the setting of RHF due to severe pulmonary hypertension.

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1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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