Abstract:
BACKGROUND:IV epoprostenol treatment of pulmonary arterial hypertension (PAH) has been believed to require an indefinite duration of therapy OBJECTIVE:To describe the successful discontinuation of long-term epoprostenol therapy in four patients DESIGN:Case reports SETTING:Outpatient clinic, tertiary-care hospital PATIENTS:Four patients with acutely nonvasoreactive, World Health Organization (WHO) functional class IV PAH received long-term epoprostenol therapy. All patients subsequently demonstrated normalization of pulmonary arterial pressures on epoprostenol treatment. These patients were selected for epoprostenol withdrawal INTERVENTION:Down-titration and discontinuation of epoprostenol RESULTS:All four patients were safely transitioned from epoprostenol to oral therapies and have maintained WHO functional class I-II for a mean of 11 months (range, 8 to 16 months). The duration of epoprostenol therapy prior to discontinuation averaged 5.7 years (range, 2.4 to 13.5 years) CONCLUSION:Epoprostenol may sufficiently reverse the pathogenic process in select patients with PAH to allow a transition to less complex and less invasive treatment modalities.
journal_name
Chestjournal_title
Chestauthors
Kim NH,Channick RN,Rubin LJsubject
Has Abstractpub_date
2003-10-01 00:00:00pages
1612-5issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(16)48713-1journal_volume
124pub_type
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