Dimopoulos Konstantinos, Peset Ana, Gatzoulis Michael A
Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital and National Heart & Lung Institute, Imperial College School of Medicine, London, United Kingdom.
Int J Cardiol. 2008 Sep 26;129(2):163-71. doi: 10.1016/j.ijcard.2008.02.004. Epub 2008 Mar 26.
Pulmonary arterial hypertension (PAH) associated with congenital heart disease remains a major problem despite advances in cardiac surgery. Recently, advanced therapies for PAH have become available and have been effective in reducing pulmonary vascular resistance and symptoms in patients with near-systemic pulmonary arterial pressures, previously thought to have irreversible pulmonary vascular disease. This has led to a new dilemma, namely could intracardiac communications previously considered inoperable due to severe pulmonary vascular disease become amenable to surgery after successful treatment with advanced therapy? We address, hereby, the potential merits and hazards of a "treat-and-repair" approach using advanced therapies in patients with PAH associated with congenital heart disease.
尽管心脏外科手术取得了进展，但与先天性心脏病相关的肺动脉高压（PAH）仍然是一个主要问题。最近，PAH的先进治疗方法已经出现，并有效地降低了肺动脉压接近体循环水平、以前被认为患有不可逆肺血管疾病患者的肺血管阻力和症状。这引发了一个新的困境，即由于严重肺血管疾病以前被认为无法手术的心脏内分流，在先进治疗成功后是否适合手术？在此，我们探讨在与先天性心脏病相关的PAH患者中使用先进治疗方法的“治疗-修复”方法的潜在益处和风险。
