Management of a child with pulmonary arterial hypertension presenting with systemic hypertension

2015 ◽  
Vol 26 (2) ◽  
pp. 378-381 ◽  
Author(s):  
Saul Flores ◽  
Joshua Daily ◽  
Jayant “Nick” Pratap ◽  
Michelle C. Cash ◽  
Russel Hirsch
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Systemic Hypertension ◽  
Clear Understanding ◽  
Successful Therapy ◽  
Compensatory Mechanisms ◽  
Pulmonary Vasodilators ◽  
Atrial Septostomy ◽  
Pulmonary Arterial ◽  
Severe Pulmonary Arterial Hypertension

AbstractWe describe the course and management of a 12-year-old girl with severe pulmonary arterial hypertension who initially presented with severe systemic hypertension. Successful therapy included pulmonary vasodilators and an atrial septostomy, while ensuring adequate maintenance of her systemic vascular resistance to maintain cardiac output. Clear understanding of the physiology and judicious medical management in patients with severe pulmonary arterial hypertension using extreme compensatory mechanisms is vitally important.

scholarly journals Palliative balloon atrial septostomy in two pediatric patients with severe pulmonary arterial hypertension requiring extracorporeal membrane oxygenation support

2020 ◽  
Vol 10 (3) ◽  
pp. 004947552095973
Author(s):  
Samantha L. Brackett ◽  
Nina Deutsch ◽  
Chinwe Unegbu
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Extracorporeal Membrane Oxygenation ◽  
Arterial Hypertension ◽  
Pediatric Patients ◽  
Case Series ◽  
Balloon Atrial Septostomy ◽  
Membrane Oxygenation ◽  
Atrial Septostomy ◽  
Pulmonary Arterial ◽  
Severe Pulmonary Arterial Hypertension

Pulmonary arterial hypertension is a pernicious disease with a diverse etiology in the pediatric population. Despite the increased availability of drug therapies, pulmonary arterial hypertension continues to cause significant morbidity and mortality. In pediatric patients with severe pulmonary arterial hypertension who have failed medical therapy, a few studies have demonstrated the role of balloon atrial septostomy as a bridge to lung transplantation or a means of improving symptomatology. However, no data exists on the utilization of balloon atrial septostomy as a palliative intervention to wean from extracorporeal membrane oxygenation (ECMO) when all other therapies are exhausted. Here we describe a case series of two pediatric patients with severe pulmonary arterial hypertension, requiring ECMO support, who were successfully weaned from ECMO following balloon atrial septostomy.

Use of Atrial Septostomy to Treat Severe Pulmonary Arterial Hypertension in Adults

2016 ◽  
Vol 69 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Maite Velázquez Martín ◽  
Agustín Albarrán González-Trevilla ◽  
Carmen Jiménez López-Guarch ◽  
Julio García Tejada ◽  
Roberto Martín Asenjo ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Atrial Septostomy ◽  
Pulmonary Arterial ◽  
Severe Pulmonary Arterial Hypertension

Balloon Dilation Atrial Septostomy and Potts Anastomosis for Severe Pulmonary Arterial Hypertension: Why, When, and How

2016 ◽  
Vol 15 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Julio Sandoval ◽  
Tomás Pulido ◽  
Juan Pablo Sandoval ◽  
Nayeli Zayas ◽  
Jorge Gaspar
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Balloon Dilation ◽  
Hemodynamic Variables ◽  
Atrial Septostomy ◽  
Pulmonary Arterial ◽  
Therapeutic Alternatives ◽  
Severe Pulmonary Arterial Hypertension

Despite advances in pharmacologic treatment, pulmonary arterial hypertension (PAH) remains a fatal disease. In recent years, surgical/interventional approaches including balloon dilation atrial septostomy and Potts anastomosis have been applied to improve the hemodynamic variables associated with right ventricular failure in the setting of PAH. These interventions may improve quality of life and prolong survival in this population. In this review, we will discuss the role of these 2 therapeutic alternatives in the management of PAH.

scholarly journals Successful multimodality management of severe pulmonary arterial hypertension during pregnancy with VA-ECMO and atrial septostomy using stent

2019 ◽  
Vol 12 (12) ◽  
pp. e231916 ◽  
Author(s):  
Vorakamol Phoophiboon ◽  
Nattapong Jaimchariyatam ◽  
Suphot Srimahachota ◽  
Chayatat Sirinawin
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Early Period ◽  
Maximal Effect ◽  
Mechanical Support ◽  
Pulmonary Vasodilators ◽  
Atrial Septostomy ◽  
Pulmonary Arterial ◽  
Cardiac Circulation ◽  
Va Ecmo

A 30-year-old Thai woman (gravida 1, para 0) at 33 weeks gestation was referred to our hospital due to acute right ventricular failure. Pulmonary vasodilators were gradually administered before delivery. On the verge of sudden postpartum cardiac circulation collapse, she was resuscitated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Abdominal compartment syndrome was developed in the early period of the mechanical support. Knowledge of pathophysiology about pulmonary arterial hypertension during pregnancy was applied. Atrial septostomy was the effective procedure for discontinuing mechanical support (VA-ECMO) corresponding to the suitable timing for maximal effect of pulmonary vasodilators. The patient and her child were safe and discharged in 2 months after the admission.

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