Eisenmenger’s syndrome surgery: Difference between revisions
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==Overview== | ==Overview== | ||
[[Congenital heart defects]] should undergo surgical repair before progression to [[Eisenmenger's syndrome]]. Once the condition develops into [[Eisenmenger's syndrome]], no surgical cure is available except for heart and lung [[transplantation]]. However, [[Palliative care|palliative]] interventions may prolong the [[lifespan]] and improve the [[quality of life]]. | [[Congenital heart defects]] should undergo surgical repair before progression to [[Eisenmenger's syndrome]]. Once the condition develops into [[Eisenmenger's syndrome]], no surgical cure is available except for heart and lung [[transplantation]]. However, [[Palliative care|palliative]] interventions (as creation of an artificial [[Atrial septal defect|ASD]]) may prolong the [[lifespan]] and improve the [[quality of life]]. | ||
==Surgery== | ==Surgery== | ||
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* [[Congenital heart defects]] should undergo surgical repair before progression to [[Eisenmenger's syndrome]].<ref name="pmid30586767">Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM et al. (2019) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=30586767 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.] ''Circulation'' 139 (14):e698-e800. [http://dx.doi.org/10.1161/CIR.0000000000000603 DOI:10.1161/CIR.0000000000000603] PMID: [https://pubmed.gov/30586767 30586767]</ref> | * [[Congenital heart defects]] should undergo surgical repair before progression to [[Eisenmenger's syndrome]].<ref name="pmid30586767">Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM et al. (2019) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=30586767 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.] ''Circulation'' 139 (14):e698-e800. [http://dx.doi.org/10.1161/CIR.0000000000000603 DOI:10.1161/CIR.0000000000000603] PMID: [https://pubmed.gov/30586767 30586767]</ref> | ||
* Once the condition develops into [[Eisenmenger's syndrome]], no surgical cure is available except for heart and lung [[transplantation]]. | * Once the condition develops into [[Eisenmenger's syndrome]], no surgical cure is available except for heart and lung [[transplantation]]. | ||
*This is because the defect itself may prevent worsening of the [[pulmonary vascular resistance]] in the face of increasing right ventricular pressure.<ref name="pmid30031003">{{cite journal| author=Fathallah M, Krasuski RA| title=A Multifaceted Approach to Pulmonary Hypertension in Adults With Congenital Heart Disease. | journal=Prog Cardiovasc Dis | year= 2018 | volume= 61 | issue= 3-4 | pages= 320-327 | pmid=30031003 | doi=10.1016/j.pcad.2018.07.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30031003 }}</ref> | |||
* However, [[Palliative care|palliative]] interventions may prolong the [[lifespan]] and improve the [[quality of life]]. | * However, [[Palliative care|palliative]] interventions may prolong the [[lifespan]] and improve the [[quality of life]]. | ||
* For example, creation of an artificial [[Atrial septal defect|ASD]] can decompress the high systolic right ventricular pressure in patients with suprasystemic [[pulmonary artery]] pressures and impending [[right ventricular failure]]. | * For example, creation of an artificial [[Atrial septal defect|ASD]] can decompress the high systolic right ventricular pressure in patients with suprasystemic [[pulmonary artery]] pressures and impending [[right ventricular failure]]. | ||
* | *In children, [[pulmonary vascular resistance]] > 6 Woods units/m2 and poor vasodilator response are predictors of post-surgical [[Complication (medicine)|complications]] as [[right heart failure]], [[pulmonary hypertension]], and [[Hypertensive crisis resident survival guide|hypertensive crises]]. | ||
*However, [[surgery]] in general is though to lack benefit with a plethora of potential [[Complication (medicine)|complications]].<ref name="pmid22348268">{{cite journal| author=Huang JB, Liang J, Zhou LY| title=Eisenmenger syndrome: not always inoperable. | journal=Respir Care | year= 2012 | volume= 57 | issue= 9 | pages= 1488-95 | pmid=22348268 | doi=10.4187/respcare.01418 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22348268 }}</ref> | |||
==References== | ==References== | ||
Latest revision as of 11:03, 20 January 2020
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Eisenmenger’s syndrome Microchapters |
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Diagnosis |
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Eisenmenger’s syndrome ACC/AHA Guidelines for Evaluation of Patients |
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Treatment |
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Eisenmenger’s syndrome surgery On the Web |
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American Roentgen Ray Society Images of Eisenmenger’s syndrome surgery |
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Risk calculators and risk factors for Eisenmenger’s syndrome surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Abdelrahman Ibrahim Abushouk, MD[2], Cafer Zorkun, M.D., Ph.D. [3]
Overview
Congenital heart defects should undergo surgical repair before progression to Eisenmenger's syndrome. Once the condition develops into Eisenmenger's syndrome, no surgical cure is available except for heart and lung transplantation. However, palliative interventions (as creation of an artificial ASD) may prolong the lifespan and improve the quality of life.
Surgery
- Congenital heart defects should undergo surgical repair before progression to Eisenmenger's syndrome.[1]
- Once the condition develops into Eisenmenger's syndrome, no surgical cure is available except for heart and lung transplantation.
- This is because the defect itself may prevent worsening of the pulmonary vascular resistance in the face of increasing right ventricular pressure.[2]
- However, palliative interventions may prolong the lifespan and improve the quality of life.
- For example, creation of an artificial ASD can decompress the high systolic right ventricular pressure in patients with suprasystemic pulmonary artery pressures and impending right ventricular failure.
- In children, pulmonary vascular resistance > 6 Woods units/m2 and poor vasodilator response are predictors of post-surgical complications as right heart failure, pulmonary hypertension, and hypertensive crises.
- However, surgery in general is though to lack benefit with a plethora of potential complications.[3]
References
- ↑ Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM et al. (2019) 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 139 (14):e698-e800. DOI:10.1161/CIR.0000000000000603 PMID: 30586767
- ↑ Fathallah M, Krasuski RA (2018). "A Multifaceted Approach to Pulmonary Hypertension in Adults With Congenital Heart Disease". Prog Cardiovasc Dis. 61 (3–4): 320–327. doi:10.1016/j.pcad.2018.07.017. PMID 30031003.
- ↑ Huang JB, Liang J, Zhou LY (2012). "Eisenmenger syndrome: not always inoperable". Respir Care. 57 (9): 1488–95. doi:10.4187/respcare.01418. PMID 22348268.