The following measures may be available if there is an inadequate response.
- Balloon atrioseptostomy (rupture of the atrial septum by balloon catheter) to relieve right ventricular pressure by right-to-left shunt
- Lung Transplantation (LUTX).
Further notes
- Chronic thromboembolic pulmonary hypertension (CTEPH) – Symptoms: Exertional dyspnea, chest pain, fatigue, edema, or syncope (brief loss of consciousness); Diagnosis: echocardiography followed by ventilation-perfusion scintigram; right heart catheterization if necessaryTherapy: surgical excision of thrombotic material, ie. i.e. pulmonary endarterectomy (PEA) using the heart–lung machine is the treatment of choice; a new treatment option is pulmonary balloon angioplasty (pulmonary artery balloon angioplasty, BPA) for patients with in operable CTEPH.
- Double-sided isolated lung transplantation (LUTX) for pulmonary hypertension is preferred for patients with PAH (group 1) and pulmonary hypertension associated with lung parenchymal disease (group 3).
