Treat and Repair Strategy in Patients With Atrial Septal Defect and Significant Pulmonary Arterial Hypertension

Background:A therapeutic strategy in patients with atrial septal defect (ASD) and significant pulmonary arterial hypertension (PAH) remains controversial. This study aimed to assess the effect of PAH-specific medications and subsequent transcatheter shunt closure (ie, a treat and repair strategy) in...

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Bibliographic Details
Published in:Circulation Journal 2015/12/25, Vol.80(1), pp.227-234
Main Authors: Kijima, Yasufumi, Akagi, Teiji, Takaya, Yoichi, Akagi, Satoshi, Nakagawa, Koji, Kusano, Kengo, Sano, Shunji, Ito, Hiroshi
Format: Article
Language:English
Subjects:
Adult
Aged
Atrial septal defect
Catheter intervention
Decision Making
Female
Heart Septal Defects, Atrial - therapy
Humans
Hypertension, Pulmonary - therapy
Male
Middle Aged
Pulmonary hypertension
Treat and repair strategy
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Summary:Background:A therapeutic strategy in patients with atrial septal defect (ASD) and significant pulmonary arterial hypertension (PAH) remains controversial. This study aimed to assess the effect of PAH-specific medications and subsequent transcatheter shunt closure (ie, a treat and repair strategy) in these patients.Methods and Results:Among 646 patients with ASD, 22 patients (mean age of 56±20 years) who had PAH [mean pulmonary artery pressure ≥25 mmHg and pulmonary vascular resistance (PVR) ≥3 Wood units] underwent successful transcatheter ASD closure. Prior to the procedure, 8 patients received PAH-specific medications (PHM group) and 14 patients did not (non-PHM group). Initially, the PHM group had higher PVR compared with non-PHM group (9.6±3.8 vs. 4.2±1.0 Wood units, P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-15-0599