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Semin Respir Crit Care Med · Aug 2009
ReviewPulmonary arterial hypertension in congenital heart diseases.
- Maurice Beghetti and Cecile Tissot.
- Pediatric Cardiology Unit, Department of the Child and Adolescent, Children's University Hospital, 1211 Geneva, 14 Switzerland. maurice.beghetti@hcuge.ch
- Semin Respir Crit Care Med. 2009 Aug 1;30(4):421-8.
AbstractPulmonary hypertension complicates the course of many children and adults with congenital heart diseases (CHDs). The increase in pulmonary pressure associated with CHD is secondary to either increased pulmonary blood flow or increased postcapillary pressures. Pulmonary arterial hypertension is in the vast majority associated with congenital cardiac shunts. Despite major advances in the understanding of the regulation of the pulmonary vascular bed and the pulmonary endothelial lesions leading to pulmonary vascular disease, despite the advances in surgical repair and the discovery of potential therapies in the pre- and postoperative period, pulmonary hypertension still carries a significant mortality and morbidity in patients with CHD. The recent introduction of targeted therapies in other forms of pulmonary arterial hypertension has led to a renewed interest in pulmonary hypertension associated with CHD and this particularly for the most advanced form, the so-called Eisenmenger syndrome (ES). This review summarizes the current knowledge on pulmonary hypertension associated with CHD, focusing on the pathophysiology and treatment of ES.
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