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Idiopathic pulmonary arterial hypertension (IPAH) has a poor prognosis although there have been recent advances in medical treatment. Atrial septostomy has been used in adults with IPAH who have usually been critically ill with recurrent syncope or right heart failure. The procedure induces right to left shunting, thus decreasing the strain on the right side of the heart and maintaining left ventricular output. Improvements in survival and quality of life have been reported but at a cost of high …
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