Closure of a moderately large atrial septal defect with a self-fabricated fenestrated Amplatzer septal occluder in an 85-year-old patient with reduced diastolic elasticity of the left ventricle. uri icon

Overview

abstract

  • Percutaneous closure of an atrial septal defect (ASD) in the elderly with reduced diastolic elasticity of the left ventricle poses a significant management challenge. We report on the case of an 85-year-old patient who was admitted for percutaneous device closure of a moderately large secundum atrial septal defect. Hemodynamic evaluation documented an increase in left atrial pressure from a mean of 12 mm Hg to a mean of 32 mm Hg after balloon test occlusion of the ASD. Two months later, after adequate pretreatment with diuretics and afterload-reducing substances, he underwent successful closure of the ASD using a self-fabricated fenestrated Amplatzer septal occluder, which resulted in a postimplantation left atrial pressure of a mean of 18 mm Hg. Recovery was unremarkable and the fenestration has remained patent for 3 months since implantation of the device. This unique case highlights the feasibility of using a self-fabricated fenestrated Amplatzer septal occluder to close interatrial communications in elderly patients with diastolic dysfunction of the left ventricle.

publication date

  • April 1, 2005

Research

keywords

  • Balloon Occlusion
  • Heart Septal Defects, Atrial
  • Prostheses and Implants
  • Ultrasonography, Interventional
  • Ventricular Dysfunction, Left

Identity

Scopus Document Identifier

  • 16244379806

Digital Object Identifier (DOI)

  • 10.1002/ccd.20315

PubMed ID

  • 15789387

Additional Document Info

volume

  • 64

issue

  • 4