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Surgical Treatments/Interventions for Pulmonary Arterial Hypertension^*

ACCP Evidence-Based Clinical Practice Guidelines

^* From Stanford University (Dr. Doyle), Stanford, CA; University of California, San Diego (Dr. Channick), San Diego, CA; Duke University Medical Center (Dr. McCrory), Durham, NC; Hôpital Antoine Béclère (Dr. Simonneau), Clamart, France; and Johns Hopkins University (Dr. Conte), Baltimore, MD.

Correspondence to: Ramona L. Doyle, MD, FCCP, Pulmonary And Critical Care Medicine, H3147 Stanford University School Of Medicine, Palo Alto, CA 94305; e-mail: rldoyle{at}stanford.edu

While considerable advances have been achieved in the medical treatment of pulmonary arterial hypertension (PAH) over the past decade, surgical and interventional approaches continue to have important roles in those patients for whom medical therapy is unavailable or has been unsuccessful. These techniques include pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension, thoracic transplantation, and atrial septostomy. This chapter will provide evidence-based recommendations for the selection and timing of surgical and interventional treatments of PAH for physicians involved in the care of these complex patients.

Key Words: atrial septostomy • balloon angioplasty • heart-lung transplantation • lung transplantation • pulmonary hypertension • pulmonary thromboembolic disease • pulmonary thromboendarterectomy • survival

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