TY - JOUR
T1 - Transcatheter closure of five atrial septal communications in the presence of severe pulmonary arterial hypertension and severe left ventricular non-compliance
AU - Flaherty, Michael P.
AU - Sayfo, Sameh
AU - Resar, Jon
PY - 2015/4/1
Y1 - 2015/4/1
N2 - 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.
AB - 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.
KW - atrial septal defect
KW - pulmonary hypertension
UR - http://www.scopus.com/inward/record.url?scp=84926500502&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84926500502&partnerID=8YFLogxK
M3 - Article
C2 - 25840408
AN - SCOPUS:84926500502
SN - 1042-3931
VL - 27
SP - E51-E55
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 4
ER -