Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-27T00:27:34.316Z Has data issue: false hasContentIssue false
  • English
  • Français

Atrial septal defect closure with an Amplatzer septal occluder fenestrated with a coronary stent in a child with pulmonary arterial hypertension

Published online by Cambridge University Press:  23 October 2012

Gregory J. Skinner ,
Robert M. Tulloh ,
Andrew J. Tometzki ,
Ingram Schulze-Neick  and
Gareth J. Morgan
Gregory J. Skinner
Affiliation:
Department of Paediatric Cardiology, Bristol Children's Hospital, Bristol, London, United Kingdom
Robert M. Tulloh
Affiliation:
Department of Paediatric Cardiology, Bristol Children's Hospital, Bristol, London, United Kingdom
Andrew J. Tometzki
Affiliation:
Department of Paediatric Cardiology, Bristol Children's Hospital, Bristol, London, United Kingdom
Ingram Schulze-Neick
Affiliation:
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, United Kingdom
Gareth J. Morgan*
Affiliation:
Department of Paediatric Cardiology, Bristol Children's Hospital, Bristol, London, United Kingdom
*
Correspondence to: Dr G. Morgan, Consultant Congenital Cardiologist, Bristol Children's Hospital, Upper Maudlin Street, Bristol BS2 8BJ, United Kingdom. Tel: +44 117 342 8853; Fax: +44 117 342 8857; E-mail: Gareth.Morgan@UHBristol.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

The presence of an atrial septal defect in pulmonary hypertension has benefits and detractions. Even in idiopathic pulmonary arterial hypertension, a significant left-to-right shunt at atrial level may increase the pulmonary arterial pressure and exacerbate the disease. However, it is well recognised that the presence of an atrial communication may be protective in subgroups with severe disease, allowing maintenance of cardiac output during times of increased pulmonary resistance. In the present paper, we present the case of a young boy with significant idiopathic pulmonary arterial hypertension and an atrial septal defect. We report our technique of septal occlusion using a device to decrease left-to-right shunting with concomitant stent insertion in that device to maintain the potential for right-to-left shunting during times of high pulmonary arterial pressure.

Keywords

Devicecatheterinterventionidiopathic pulmonary arterial hypertension
Type
Original Articles
Information
Cardiology in the Young , Volume 23 , Issue 5 , October 2013 , pp. 692 - 696
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Galiè, N, Hoeper, MM, Humbert, M, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J 2009; 34: 1219–1263.Google Scholar
2. Kenny, D, Cao, Q-L, Hijazi, ZM. Fenestration of a Gore Helex Septal Occluder device in a patient with diastolic dysfunction of the left ventricle. Catheter Cardiovasc Interv 2011; 78: 594–598.Google Scholar
3. Kretschmar, O, Sglimbea, A, Corti, R, Knirsch, W. Shunt reduction with a fenestrated Amplatzer device. Catheter Cardiovasc Interv 2010; 76: 564–571.Google Scholar
4. Holzer, R, Cao, Q-L, Hijazi, ZM. 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. Catheter Cardiovasc Interv 2005; 64: 513–518.Google Scholar
5. Schneider, HE, Jux, C, Kriebel, T, Paul, T. Fate of a modified fenestration of atrial septal occluder device after transcatheter closure of atrial septal defects in elderly patients. J Interv Cardiol 2011; 24: 485–490.Google Scholar
6. Bruch, L, Winkelmann, A, Sonntag, S, et al. Fenestrated occluders for treatment of ASD in elderly patients with pulmonary hypertension and/or right heart failure. J Interv Cardiol 2008; 21: 44–49.Google Scholar
7. Dell'Avvocata, F, Rigatelli, G, Cardaioli, P, Giordan, M. Home-made fenestrated amplatzer occluder for atrial septal defect and pulmonary arterial hypertension. J Geriatr Cardiol 2011; 8: 127–129.Google Scholar