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

Overview