Creation of atrial communication in patients with pulmonary hypertension: from balloon atrioseptostomy to atrial flow regulator

Abstract

Pulmonary hypertension (PH) affects about 1 % of the world’s population, with a three-year survival rate of 70 %. The pathogenetic causes of death are the remodeling of the pulmonary arteries (PA) and the development of right ventricular heart failure (HF), therefore, the main goal of the treatment of pulmonary arterial hypertension (PAH) is to relieve the right chambers of the heart by reducing the pressure in the PA. For this purpose, it is possible to prescribe specific drug therapy to the patient, and in severe cases, surgical intervention — lung transplantation or cardiopulmonary organ complex. However, recently, due to the development and improvement of endovascular methods of treatment of PH, palliative endovascular interventions on the atrial septum are increasingly used, which have undergone significant changes over the past decades. This article presents a literature review of all currently available palliative X-ray endovascular methods for the treatment of PAH, as well as PH developed in patients with left ventricular HF. Objective. The purpose of the review is to assess the role of X-ray endovascular intervention in the treatment of PH.