Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, London SW3 6NP, UK.
Expert Rev Respir Med. 2011 Jun;5(3):363-76. doi: 10.1586/ers.11.25.
Treatment options for patients with advanced pulmonary hypertension (PH) are limited. Iatrogenic creation of an interatrial communication (i.e., atrial septostomy [AS]) has been suggested as a possible treatment option or as a bridge to transplantation in selected patients and has been incorporated into current PH guidelines. Uptake of the procedure has been slow and the worldwide experience with AS is limited to approximately 280 published cases, over a period of more than 25 years. The rationale for creating an AS has been provided by the observation that patients with congenital heart disease, shunt lesions and PH have a better survival compared with patients with idiopathic PH. We review pathophysiologic data and the published clinical experience and discuss the rationale, indication and potential pitfalls of AS in patients with severe PH.
治疗晚期肺动脉高压（PH）患者的选择有限。有创性房间隔造口术（即房间隔切开术[AS]）已被建议作为一种可能的治疗选择，或作为某些患者移植的桥梁，并已纳入当前的 PH 指南。该手术的应用进展缓慢，全球范围内 AS 的经验仅限于 25 年以上的 280 例左右发表的病例。进行 AS 的理由是观察到患有先天性心脏病、分流病变和 PH 的患者的存活率高于特发性 PH 患者。我们回顾了病理生理学数据和已发表的临床经验，并讨论了严重 PH 患者进行 AS 的原理、适应证和潜在问题。
