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Atrial septostomy in the treatment of severe pulmonary arterial hypertension
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In their recent paper on atrial septostomy as a treatment for severe pulmonary arterial hypertension, Reichenberger et al1 measured cardiac output before and after this intervention using both the thermal dilution and Fick methods. We were interested by their choice of dilution technique. In these patients atrial septostomy was intended to produce a right to left interatrial shunt, as evidenced by the fall in arterial oxygen saturation following the procedure. Cardiac output measurement by the thermal dilution method described in their paper relies upon calculation of the area under the temperature curve, measured by a thermistor placed in the pulmonary artery, following an injection of cold saline …