Intravascular ultrasound evaluation of pulmonary hypertension in high-altitude patients with ventricular septal defect: a case report

This case demonstrates the first reported use of intravascular ultrasound to assess pulmonary artery structure in a patient with patent ductus arteriosus-associated pulmonary hypertension at extreme altitude. Intravascular ultrasound provided unique real-time insight into vascular remodeling that critically influenced clinical decision-making. It may serve as a valuable adjunct to standard diagnostics in high-risk or borderline operability cases, particularly in settings where histological evaluation is unfeasible. Broader use of intravascular ultrasound in congenital heart disease with pulmonary hypertension may enhance individualized risk assessment and optimize therapeutic strategies.