ROLE OF PROSTACYCLIN IN THE TREATMENT OF PRIMARY PULMONARY-HYPERTENSION

Over the last decade, new medical and surgical treatments have become available for primary pulmonary hypertension that have influenced the natural history of the disease. Vasodilator therapy is aimed at overco ming pulmonary vasoconstriction with consequent decrease in after-load and improved right ventricular output. The endpoint of vasodilator th erapy is therefore to reduce pulmonary vascular resistance, without ca using significant systemic hypotension. Prostacyclin, a potent vasodil ator and antiaggregating agent, has been successfully used by continuo us infusion in the treatment of severe pulmonary hypertension. The mar ked improvement in quality of life observed with the use of prostacycl in in these patients, as well as the increased survival time on the wa iting list for transplantation, has influenced us to adopt prostacycli n infusion as a fundamental element of our therapeutic strategy for th e management of this rare but fatal condition.