Pre-treatment with an oral endothelin receptor antagonist for 1 year may facilitate successful percutaneous closure of large ASDs in patients with severe PAH.
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May support bosentan pretreatment to enable ASD closure in severe PAH; hypothesis-generating and requires prospective validation.
The presence of severe pulmonary arterial hypertension (PAH) in patients with atrial septal defect (ASD) is still thought to preclude shunt closure, although there are several reports of good clinical outcomes after vasodilator therapy. We report the case of a young woman with ASD and severe PAH who was able to successfully undergo percutaneous shunt closure following 1 year use of the oral endothelin receptor antagonist, bosentan.
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Jung et al. (2013) studied this question.
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