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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
Author(s) -
Holzer Ralf,
Cao QiLing,
Hijazi Ziyad M.
Publication year - 2005
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20315
Subject(s) - medicine , septum secundum , cardiology , ventricle , percutaneous , cardiac catheterization , diastole , afterload , catheter , heart septal defect , surgery , blood pressure
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. Catheter Cardiovasc Interv 2005;64:513–518. © 2005 Wiley‐Liss, Inc.