Eisenmenger syndrome, as an advanced manifestation of congenital heart disease, has been considered a contraindication to surgery for left-to-right shunt type of precordial disease because of the right-to-left shunt that occurs with the production of pulmonary hypertension. However, as new drugs for the treatment of pulmonary hypertension continue to emerge, and as advances in cardiac surgical treatment devices and techniques are refined, the understanding of the indications for surgery and case selection is deepening. The optimal combination of drug therapy, interventional therapy, and surgery may still enable a proportion of patients with Eisenmenger syndrome to strive for active treatment. 1.General treatment Oxygen absorption, oxygen during sleep can slow down the progress of erythrocytosis in patients with Eisenmenger syndrome; oxygen demand increases when patients exercise, and the ability of blood to deliver oxygen cannot increase accordingly, so oxygen absorption during exercise is beneficial to patients; oxygen demand is also greater in patients with right heart failure when they are quiet, and they should also be given oxygen therapy; in addition, oxygen absorption during acute respiratory tract infection can prevent further aggravation of hypoxemia. 2.Diuretics The application of diuretics to patients with Eisenmenger syndrome combined with right heart failure can relieve liver stasis and reduce blood volume. However, excessive diuresis should be avoided because some patients need a certain preload to maintain effective cardiac output. Patients with a significant increase in red blood cells should be alert to the increased risk of stroke or other complications due to increased blood viscosity after diuresis. Although the use of cardiac stimulants in patients with right heart failure is still controversial, some reports suggest that the use of digitalis in patients with pulmonary hypertension combined with right heart failure can increase cardiac output. The combined application of digitalis and diuretics in hypoxic patients should pay special attention to maintaining electrolyte balance, because electrolyte disorders can increase the risk of digitalis toxicity. 4.Other basic treatment Eisenmenger syndrome can lead to a significant increase of red blood cells due to severe hypoxia, and the restriction of activity leads to poor blood flow, right ventricular enlargement and slow pulmonary blood flow, etc. It is easy to complicate thromboembolism, so venous dissection and bleeding, anticoagulant treatment can improve the survival rate, exercise tolerance and quality of life of patients with Eisenmenger syndrome. 5.Endothelin antagonists, bosentan, endothelin progenitor cell autotransplantation. 6, prostacyclin analogues The prostacyclin preparations currently in clinical use include: intravenous epoprostenol (Epoprosteno1), subcutaneous treprostinil (Treprostinil), oral preparations of beprostacyclin, and inhaled preparations of iloprost. Prostacyclin is a metabolite of arachidonic acid, which is mainly produced by vascular endothelial cells and is a potent vasodilator. Prostacyclin binds to its receptor and activates adenylate cyclase, which increases the concentration of intracellular cyclic adenosine monophosphate, thus exerting a vasodilating effect. Studies have shown that prostacyclin also has the effect of inhibiting platelet aggregation and vascular smooth muscle proliferation. Intravenous prostacyclin derivatives were first used in the treatment of idiopathic pulmonary hypertension as early as the 1980s. 7.Type 5 phosphodiesterase inhibitors Type 5 phosphodiesterase inhibitors are used to increase the level of cyclic guanosine monophosphate (cGMP) in pulmonary vascular smooth muscle cells by inhibiting phosphodiesterase, which increases endogenous N0 production, thus highly selectively dilating pulmonary vessels, reducing pulmonary vascular resistance, effectively reducing pulmonary artery pressure and increasing cardiac output. And it has no significant effect on the hemodynamics of body circulation. The main drugs in this class are: Sildenafil (sildenafil), vardenafi1 and tadalafil. 8, nitric oxide Guanosine cyclic phosphate (cGMP) is an important regulator of vascular smooth muscle, regulating the tension, growth and composition of blood vessels. n0 is an endothelium-derived vasodilator, through the activation of guanylate cyclase, so that the CGMP concentration increases, thus exerting vasodilator effect. 9.Interventional treatment In recent years, domestic atrial septal defect blockers with holes have been produced to close the defect while preserving a small amount of shunt in order to relieve the pressure on the right heart. If necessary, the reserved small hole can be considered to be blocked again after a period of time. These results suggest that even in these patients with so-called “irreversible” pulmonary hypertension, who are considered to be lost to surgery, they should not be given up easily. However, the use of interventional therapy for these patients is not recommended by international guidelines for the treatment of pulmonary hypertension, mainly because it needs to be further observed whether the patients actually benefit and whether their prognosis improves.