We thank Dr Berger and colleagues for their interest in our paper and their important comments. We would first like to clarify the results of the study. We reported that 57% of patients with pulmonary arterial hypertension (PAH) did not have complete normalisation of right ventricular systolic pressures (RVSP <40 mm Hg as measured by echocardiography) in late follow-up. Although six of the patients had persistent severe PAH (range of RVSP 62–89 mm Hg), the majority of the patients with residual PAH had only mild PAH (range of RVSP 40–49 mm Hg). Second, the two late deaths that occurred were not clearly related to the intervention; one …