Treatment of Lateralizing Primary Aldosteronism in a Surgical Candidate Who Desires Surgery
This protocol applies to individuals with lateralizing primary aldosteronism who are confirmed surgical candidates and have chosen to pursue the surgical option.
Clinical situation
When primary aldosteronism lateralizes to a single adrenal gland and the individual is eligible for and desires surgery, a surgical approach is considered preferable over nonspecific antihypertensive therapy. The decision to operate is shaped by both lateralization findings and the patient's candidacy and preference.
Treatment approach (overview)
Management in this scenario involves a targeted surgical intervention on the affected adrenal gland. The complete procedure, approach, and perioperative details are outlined in the full structured protocol.
Treatment goals
Key clinical targets are complete biochemical resolution of primary aldosteronism at 6-month follow-up, together with normalization of blood pressure.
References
- In individuals with lateralizing PA who are surgical candidates and desire surgery, unilateral adrenalectomy should be considered preferable over nonspecific antihypertensive therapy.
- Surgical therapy by total unilateral adrenalectomy, usually by the laparoscopic approach, is mainly offered to individuals with lateralizing PA who choose to pursue the surgical option.
- All individuals who underwent unilateral adrenalectomy displayed complete biochemical resolution of PA at 6-month follow-up assessment.
- BP normalization occurs in a significant proportion of those who undergo surgery for lateralizing forms of PA.
DOI: 10.1210/clinem/dgaf284
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