Outcomes of various palliative interventions in patients with pulmonary arterial hypertension (PAH)

First author [reference]Palliative procedureStudy design/sample sizePatient characteristicsOutcomes
Sandoval [42]Atrial septostomyRetrospective
85% had IPAH
9% had CTEPH
53% had WHO FC IV
41% had WHO FC III
11 patients received PAH-specific therapy after procedure
  • 1 patient died after the procedure due to refractory hypoxaemia

    Improved survival in those who received PAH-specific therapy after the procedure

    6MWD increased

    WHO FC improved

    mPAP and RVEDP decreased

    Cardiac index and LVEDP increased

Chiu [46]Atrial septostomyRetrospective
n=32 patients
No control group
All patients had PAH
63% had IPAH
78% had WHO FC III/IV
All patients were receiving PAH-specific therapy
No significant change in mPAP
No significant change in RAP
No significant change in BNP
Chen [44]PADNProspective
13 underwent PADN
8 patients refused PADN and served as control group
All patients had IPAH
13 underwent PADN
8 IPAH patients did not undergo PAH
All were on beraprost
Mean WHO FC 3.6
Survival was not assessed
Decrease in mPAP and PVR post-PADN
Increase in cardiac output post-PADN
Improvement in 6MWD and WHO FC

IPAH: idiopathic pulmonary arterial hypertension; CTEPH: chronic thromboembolic pulmonary hypertension; WHO: World Health Organization; FC: functional class; 6MWD: 6-min walking distance; mPAP: mean pulmonary artery pressure; RVEDP: right ventricular end-diastolic pressure; LVEDP: left ventricular end-diastolic pressure; RAP: right atrial pressure; BNP: brain natriuretic peptide; PADN: pulmonary artery denervation; PVR: pulmonary vascular resistance.