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Correspondence
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Volume 334:1477-1478 May 30, 1996 Number 22
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Intravenous Epoprostenol for Primary Pulmonary Hypertension

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 by Barst, R. J.
To the Editor: Barst et al. (Feb. 1 issue)1 report better clinical improvement and survival in 41 patients with primary pulmonary hypertension treated with a 12-week continuous intravenous infusion of epoprostenol (no deaths) than in 40 patients receiving conventional therapy (20 percent mortality). We wish to comment on the possible risks of treatment and the treatment strategy in this study.

The placement of a permanent catheter may lead to life-threatening complications, such as catheter-induced sepsis or thromboembolism (a total of five such events in this study). Selective pulmonary application of inhaled vasodilators may offer an attractive alternative, preventing the above . . . [Full Text of this Article]

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