Balloon atrial septostomy in pulmonary arterial hypertension: Effect on survival and associated outcomes
Section snippets
Methods
Approval for this study was obtained from the institutional review board of Columbia University Medical Center, New York, NY. We identified patients with PAH who had undergone BAS at the New York-Presbyterian/Columbia University Medical Center Pulmonary Hypertension Center from 2002 to 2013. In addition to baseline demographic data, we obtained patient characteristics at 4 points: just before BAS; immediately post-BAS; 1 year post-BAS; and the most recent documented follow-up at the time of the
Results
At our center, from January 1, 2002 to December 31, 2013, 46 BAS were performed in 32 patients (Table 1). Eleven patients required repeat BAS with 3 of these patients requiring a third BAS. There was a female predominance (74%) with a median age at the time of BAS of 23 years (range 1 to 56 years). There were 17 (37%) procedures performed in patients ≤17 years of age. There were 41 procedures with patient World Health Organization (WHO) functional class status documented; 32 (78%) were
Discussion
BAS has been utilized as a palliative measure for almost 30 years in patients with severe PAH on maximal medical therapy. However, it is only offered in experienced centers given the potential hazards of the procedure. There are limited data on outcomes of BAS in large cohorts of PAH patients, although it remains an important management option in the treatment of advanced PAH. These data support the use of BAS in patients with advanced PAH, particularly in the setting of syncope refractory to
Disclosure statement
The authors have no conflicts of interest to disclose.
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