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Outcomes of Atrioseptostomy with Stenting in Patients with Pulmonary Arterial Hypertension from a Large Single-Institution Cohort

Authors
  • Gorbachevsky, Sergey V.1
  • Shmalts, Anton A.1
  • Dadabaev, Gulomjon M.1
  • Nishonov, Nasirullo A.1
  • Pursanov, Manolis G.1
  • Shvartz, Vladimir A.1
  • Zaets, Sergey B.2
  • 1 (V.A.S.)
  • 2 Retired from A.N. Bakoulev National Medical Research Center of Cardiovascular Surgery, 135 Roublevskoye Shosse, 121552 Moscow, Russia
Type
Published Article
Journal
Diagnostics
Publisher
MDPI
Publication Date
Sep 21, 2020
Volume
10
Issue
9
Identifiers
DOI: 10.3390/diagnostics10090725
PMID: 32967148
PMCID: PMC7555652
Source
PubMed Central
Keywords
License
Green

Abstract

The aim of this study was to analyze results of stenting atrioseptostomy in patients with pulmonary arterial hypertension and a different level of risk for one-year mortality that is not well described. Patients that underwent atrioseptostomy with stenting were retrospectively divided in two groups: “intermediate” ( n = 55) or “high” risk ( n = 13), according to the 2015 ESC/ESR guideline. Results of atrioseptostomy were assessed during hospital period and at follow-up. Patients from “intermediate” risk group demonstrated lower mortality rate (10/55, vs. 6/13) during the course of the study period, as well as higher freedom from lung transplantation or Potts shunt. At discharge, patients of both groups presented improvement in functional class and mobility. Patients from “intermediate” risk group showed longer 6-min walking distance, and lower levels of brain natriuretic peptide. At the latest follow-up, stable position and full patency of stents with right-to-left or bidirectional shunt at atrial level and absence of syncope was confirmed in patients of both groups. Patients from the “intermediate” risk group demonstrated higher functional class, better performance of walking test, and lower levels of brain natriuretic peptide. Stenting atrioseptostomy reliably secured interatrial communication and improved clinical condition in patients with idiopathic pulmonary arterial hypertension. Mid-term results were better in “intermediate” risk group.

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