Effectual Physiotherapy Treatment in a 16 Year Old Case of Atrial Septal Defect- A Single Case Study

Background: Paediatric cardiac surgeries have an immense survival rate and rehabilitation plays a major role in such cases. Many patients are diagnosed with septal defects or valve defects at birth which come sunder cardiac surgeries. Case Presentation: This is a case of 16 year old boy who had atrial septal defect and underwent atrial septal defect closure. Investigations: 2D echocardiography revealed atrial septal defect. Management: Physiotherapy intervention included patient education, breathing retraining, airway clearance techniques, positioning, and psychological support and mobility program. Outcome measures have shown enhancement in functional independence and performance of activities of daily living. Conclusion: The evidence from this study suggest that paediatric cardiac rehabilitation found to play a pivotal role in managing a patient who had atrial septal defect.

Combined transcatheter treatment of severe mitral regurgitation and secundum atrial septal defect in an inoperable patient: a case report

Background Chronic mitral regurgitation is one of the most common valvular heart diseases and is associated with poor outcome. Although other structural diseases are regularly seen in such patients, concomitant atrial septal defects remain a rarity in the elderly. Case summary We report a case of an 82-year old woman with progressive right-sided heart failure due to mitral regurgitation and an atrial septal defect of secundum type, despite optimal medical therapy. Combined transcatheter mitral valve repair by utilizing a separate transseptal puncture and atrial septal defect closure was performed resulting in amelioration of symptoms. Discussion Procedural planning for simultaneous transcatheter therapies of coupled structural heart disease entities remains complex. Our case illustrates feasibility of percutaneous edge-to-edge mitral valve repair and consecutive closure of a large secundum atrial septal defect. Different options of accessing the left atrium should be discussed on an individual basis, while additional atrial septal defect closure may be beneficial in terms of right ventricular function and symptoms of right heart failure.

Percutaneous treatment of a huge patent ductus venosus and severe portal vein hypoplasia using a Figulla Flex ll ASD-occluder in a two-year-old infant: a case report

Background Intra- or extrahepatic porto-caval shunts can account for multiorgan dysfunction with pulmonary arterial hypertension and portosystemic encephalopathy as the most serious consequences of bypass of the hepatic circulation. The ductus venosus represents a rare Foetal porto-caval shunt and might be persistently patent in newborns after birth. Treatment strategies include surgical ligation and percutaneous device closure. The degree of portal vein hypoplasia limits therapy making liver transplantation the only option in some of them. Case summary In a newborn female patient a huge persistently patent ductus venosus, known already prenatally, resulted in severe secondary portal vein hypoplasia. She presented with hyperammonemia, elevated liver enzymes and pulmonary hypertension. With only diminutive portal venous branches and exceedingly high portal venous pressures during test-occlusion of the ductus venosus, shunt closure was not possible. At the age of two years more favorable portal venous pressures allowed transcatheter device closure with a nitinol ASD-occlusion device. Pulmonary artery pressures and ammonia levels normalized after the procedure without any signs of portal hypertension. Discussion The case highlights the importance of meticulous imaging using balloon occlusion angiography of porto-caval shunts like the ductus venosus, to search for intrahepatic portal veins. Moreover, portal vein pressure during test-occlusion can identify patients amenable for surgical or endovascular shunt closure. Occlusion devices licensed for other indications like atrial septal defect closure can be used safely in huge porto-caval shunt vessels in a one-step or staged procedure. Optimal timing of the intervention should be tailored to the patient’s needs

Cryoballoon pulmonary vein isolation in a patient with paroxysmal atrial fibrillation after atrial septal defect closure using the “Amplatzer” occluder

A case report of cryoballoon ablation for atrial fibrillation in a patient after atrial septal defect closure is presented.

Remodeling Process in the Right and Left Atria and Ventricles Following Percutaneous Closure of the Atrial Septal Defect in Children and Adolescents: A Mid-term Study

Background: Atrial septal defect and its closure can lead to changes in the right and left cardiac cavities' function and size. In this study, Z-scores of the cardiac chambers and the heart function were assessed, and the important complications were mentioned. Methods: This interventional cross-sectional study was done on patients who had atrial septal defect closure aged younger than 18 years. All patients were recruited for transthoracic echocardiography. About half of the patients were randomly selected. The information of angiography and its side effects belong to all patients, but the echocardiographic parameters and Z-scores belong only to the selected group. Results: A total of 370 patients underwent the atrial septal defect closure, of whom 150 patients participated in the study. The patients' average age and weight were 9.25 ± 3.44 years and 15.12 ± 11.83 kg, respectively, and the mean follow-up time was 2.56 years. Z-scores of the interventricular septal dimension in diastole, the left ventricular posterior wall dimension in diastole, the left ventricular internal dimension in systole, and Z-scores of the size of the right atrium, right ventricle, pulmonary valve annulus, and the main pulmonary artery were more than Z-scores of the normal population. Furthermore, Z-scores of the E/A and the Eat/Aat of the tricuspid valve were less than their peers. Besides, the correlation between Z-scores and the atrial septal defect size and weight of the patients was assessed, which was statistically significant, and patients who underwent atrial special defect closure at the age of fewer than three years and less than 15 kg had more normal cardiac Z-scores. Conclusions: Z-scores of the cardiac chambers and pulmonary artery were more than normal after successful closure of the atrial septal defect in the mid-term follow-up.