What is the role of a balloon atrial septostomy in the treatment of pulmonary arterial hypertension (PAH)?

Updated: Apr 02, 2021
  • Author: Kristin E Schwab, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Balloon atrial septostomy involves creation of an atrial right-to-left shunt by graded balloon dilation of the atrial septum. The technique has been performed via a femoral catheter, with a Brockenbrough septal needle and Mansfield balloons to dilate the septostomy.

This has been used with success in carefully selected patients who are symptomatic despite maximal medical therapy. The benefit (improved exercise function) occurs at the cost of a fall in arterial SaO2. Important to note is that this should only be regarded as a palliative or bridging procedure (prior to transplantation) and is not part of the recommended pulmonary arterial hypertension (PAH) treatment guidelines at this time.

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