Transcatheter closure of five atrial septal communications in the presence of severe pulmonary arterial hypertension and severe left ventricular non-compliance

Michael P. Flaherty, Sameh Sayfo, Jon Resar

Research output: Contribution to journalArticlepeer-review

Abstract

Closure of congenital atrial communications in the presence of either severe pulmonary arterial hypertension (PAH) with pulmonary-to-systemic (right-to-left) shunting, or severe left ventricular (LV) non-compliance with left-to-right shunting is often considered prohibitive. Thus, the recognition of durable reversibility of these physiologic conditions is crucial. We describe a hemodynamic conundrum in a patient with five septal communications in whom the coexistence of unmasked bidirectional physiologic shunting, severe PAH, and worsening left-sided overload dissuaded initial closure. We report our strategy for hemodynamic evaluation and successful closure of all defects.

Original languageEnglish (US)
Pages (from-to)E51-E55
JournalJournal of Invasive Cardiology
Volume27
Issue number4
StatePublished - Apr 1 2015

Keywords

  • atrial septal defect
  • pulmonary hypertension

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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