Normalisation of hypoxaemia following successful percutaneous closure of a bidirectional shunting secundum atrial septal defect without pulmonary hypertension in a patient with severe non-ischaemic cardiomyopathy and refractory ventricular tachycardia

2016 ◽  
Vol 46 (8) ◽  
pp. 969-972
Author(s):  
R. D. Anderson ◽  
W. Wilson ◽  
J. Morton ◽  
A. Aggarwal
2018 ◽  
Vol 3 (2) ◽  
pp. 106
Author(s):  
Jessica Wiryanto ◽  
Ingrid M. Pardede ◽  
Sunanto Ng

Pulmonary hypertension is a common complication of congenital heart disease due to systemic – pulmonary circulation shunt which if left uncorrected leads to increased pulmonary artery pressure, vascular remodeling and further increase of pulmonary vascular resistance. Percutaneous closure of the defect interrupts this shunt thus reducing right heart and pulmonary circulation load and pulmonary artery pressure. In this paper we present two cases of percutaneous secundum atrial septal defect closure complicated by pulmonary hypertension along with echocardiographic evaluation of cardiopulmonary hemodynamic changes before and shortly after device closure. Forty years old and thirty three years old females presented to our clinics with classical symptoms of atrial septal defects, assessment revealed TVG of 37 mmHg and 30 mmHg,shortly after the procedure patient was re-evaluated and revealed TVG of 39 mmHg and 23 mmHg respectively. From these cases we conclude that changes in pulmonary artery pressure is not constantly found after device closure. However both patients display improvements in functional capabilities.


CHEST Journal ◽  
1986 ◽  
Vol 89 (5) ◽  
pp. 694-698 ◽  
Author(s):  
Shigeo Yamaki ◽  
Togo Horiuchi ◽  
Makoto Miura ◽  
Yasuyuki Suzuki ◽  
Eiji Ishizawa ◽  
...  

2020 ◽  
Vol 10 (2) ◽  
pp. 204589402091583 ◽  
Author(s):  
Reza S. Pratama ◽  
Anggoro B. Hartopo ◽  
Dyah W. Anggrahini ◽  
Vera C. Dewanto ◽  
Lucia K. Dinarti

Uncorrected atrial septal defect undergoes right ventricle chronic volume overload which may lead to pulmonary hypertension and Eisenmenger Syndrome. The soluble suppression of tumorigenicity-2 is a left ventricle strain biomarker; however, its role in right ventricle strain is unclear. This study aimed to investigate the implication of serum soluble suppression of tumorigenicity-2 in adult uncorrected atrial septal defect. This was a cross-sectional study. We enrolled 81 adult uncorrected secundum atrial septal defect patients. Clinical and hemodynamic data were collected. Serum samples were withdrawn from the pulmonary artery during right heart catheterization. Serum soluble suppression of tumorigenicity-2 and NT-proBNP levels were measured. Subjects were divided into three groups based on clinical and hemodynamic severity. The correlation of soluble suppression of tumorigenicity-2 with patients' data and comparison among groups were analyzed. A p value <0.05 was considered statistically significant. Results showed that, there were significant correlations between serum soluble suppression of tumorigenicity-2 and mean pulmonary artery pressure ( r = 0.203, p = 0.035) and right ventricle end-diastolic diameter ( r = 0.203, p <0.05). Median serum soluble suppression of tumorigenicity-2 level was incrementally increased from group I (atrial septal defect and no-pulmonary hypertension), group II (left-to-right atrial septal defect and pulmonary hypertension), to group III (Eisenmenger Syndrome): (17.4 ng/mL, 21.8 ng/mL, and 29.4 ng/mL, respectively). A post-hoc analysis showed that serum soluble suppression of tumorigenicity-2 level was significantly different between groups I and III ( p = 0.01). Serum N terminal pro brain natriuretic peptide (NT-proBNP) level was consistently associated with worse clinical and hemodynamic parameters. No correlation was found between serum soluble suppression of tumorigenicity-2 and NT-proBNP level. In conclusion, serum soluble suppression of tumorigenicity-2 level had significant positive correlation with mean pulmonary artery pressure and right ventricle end-diastolic diameter in uncorrected secundum atrial septal defect patients. Higher serum soluble suppression of tumorigenicity-2 level was associated with the presence of pulmonary hypertension and Eisenmenger Syndrome in uncorrected secundum atrial septal defect patients.


2016 ◽  
Vol 33 (12) ◽  
pp. 1891-1896 ◽  
Author(s):  
Jorge Cossío-Aranda ◽  
Karina Del Valle Zamora ◽  
Navin C. Nanda ◽  
Anezi Uzendu ◽  
Candace Keirns ◽  
...  

CHEST Journal ◽  
1983 ◽  
Vol 84 (5) ◽  
pp. 598-600 ◽  
Author(s):  
Markku J. Ikäheimo ◽  
Risto E. Pokela ◽  
Pentti J. Kärkölä ◽  
Juha T. Takkunen

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
N E Z Espinola-Zavaleta ◽  
N E A V Antonio-Villa ◽  
E C G Guerra ◽  
E A R Alexanderson-Rosas ◽  
G B C Bracamontes-Castelo ◽  
...  

Abstract Background Ostium-secundum atrial septal defect (OS-ASD) increases pulmonary arterial systolic pressure (PSAP) and eventually leads to pulmonary hypertension (PH). Nevertheless, whether the characteristics of OS-ASD could serve as an alleviator within chronic-volume overload in the right atrium (RA) is unclear. Aims To evaluate a potential interaction of OS-ASD diameter and the shunt (Qp/Qs ratio) on PSAP values in patients with secondary PH. Methods We designed a cross-sectional study of 63 adult patients with OS-ASD. A conventional transthoracic echocardiography was performed using Vivid 9X-clear equipment (GE Vingmed Ultrasound, Horten, Norway) to evaluate the OS-ASD diameter and the Qp/Qs ratio. The PSAP was calculated by tricuspid regurgitation velocity with continuous-wave Doppler in the apical four-chamber view. Polynomic adjusted correlations were performed between the RA volume and the PSAP; we evaluated a double and triple interaction-effect of the OS-ASD diameter and Qp/Qs ratio, respectively adjusted for age, sex and body surface area. Results In our study population, 78% (n=49) were female, with a mean age of 41.8 (±15) years. 44% (n=28) with mild-PH, 38% (n=24) with moderate-PH and 17% (n=11) with severe-PH. Mean echocardiographic parameters were: RA volume 58.8 (±26.4) mL, PSAP of 55.9 (±20.7) mmHg, OS-ASD diameter 30.1 (±7.8) mm and Qp/Qs 2.9 (±0.9). We observed a cubic relationship between RA volume and PSAP (r=0.354, p=0.006; Figure 1A). ASD-Diameter had a negative interaction effect (β=−0.0231 95% CI: −0.043 to −0.003, p=0.03) of the relationship between RA volume and PSAP (Figure 1B). Furthermore, the addition of Qp/Qs ratio displayed a positive triple interaction effect (β=0.021 95% CI: 0.001–0.043, p=0.048) on the previously mentioned variables (Figure 1C) after adjusting for covariates. Conclusions The increase in OS-ASD diameter and shunt decreases PSAP values. Our results could indicate that OS-ASD could potentially ameliorate chronic-volume overload in patients with secondary PH. FUNDunding Acknowledgement Type of funding sources: None. Figure 1


2017 ◽  
Vol 7 (3) ◽  
pp. 336-339 ◽  
Author(s):  
Michael B. Stokes ◽  
Bo Xu ◽  
Nitesh Nerlekar ◽  
Siobhan M. Lockwood ◽  
Richard W. Harper

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