Atrial septostomy for PAH?

[DarkProtonics]

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Why are atrial septostomies performed for refractory PAH? Does it decompress the overloaded RV, and increase CO, at the cost of lowering arterial O2 sats (which should be at least partially cancelled out by the increase in CO)?

I heard sometimes diuretics are given for PAH...if the RV is failing, don't you want to increase preload? But, the prescriber knows more than I; s/he must have a good reason.

I'll be starting my cardiac sonography degree in the fall. Then I'll have a really fascinating job I'll do to save up money for my bachelor's degree program, or work part-time.

 

[howelljolly]

Why are atrial septostomies performed for refractory PAH? Does it decompress the overloaded RV, and increase CO, at the cost of lowering arterial O2 sats (which should be at least partially cancelled out by the increase in CO)?

I heard sometimes diuretics are given for PAH...if the RV is failing, don't you want to increase preload? But, the prescriber knows more than I; s/he must have a good reason.

I'll be starting my cardiac sonography degree in the fall. Then I'll have a really fascinating job I'll do to save up money for my bachelor's degree program, or work part-time.

Theres a delicate balance between physiological compensatory mechanisms and pathophysiology. This is one of those cases where you dont want to do this: (the horse being the RV)