Bidirectional shunt through a residual atrial septal defect after percutaneous transvenous mitral commissurotomy
Journal
Cardiology (Switzerland)
Journal Volume
83
Journal Issue
3
Pages
205-207
Date Issued
1993
Author(s)
Abstract
A residual atrial septal defect with bidirectional shunt was detected by transesophageal echocardiography in a 28-year- old man 3 years after percutaneous transluminal mitral commissurotomy (PTMC) with the antegrade transseptal technique. He had had severe mitral stenosis, pulmonary hypertension, and tricuspid regurgitation before the procedure. The result of PTMC was suboptimal, the pulmonary hypertension regressed only partially, and the tricuspid regurgitation remained severe. These factors contributed to the bidirectional shunt. A bidirectional shunt is known to be associated with systemic desaturation and a higher risk of paradoxical embolization and brain abscess. When PTMC is considered in patients with pulmonary hypertension and tricuspid regurgitation, a retrograde left ventricular approach with or without transseptal puncture can avoid the atrial septotomy, decrease the incidence of significant shunt, and should be a rational alternative. ? 1993 S. Karger AG, Basel.
SDGs
Other Subjects
adult; article; artificial embolism; blood vessel shunt; brain abscess; case report; heart atrium septum defect; human; male; mitral valve commissurotomy; mitral valve stenosis; priority journal; pulmonary hypertension; transesophageal echocardiography; tricuspid valve regurgitation; Adult; Balloon Dilatation; Blood Flow Velocity; Blood Pressure; Case Report; Echocardiography, Doppler; Echocardiography, Transesophageal; Heart Septal Defects, Atrial; Human; Male; Mitral Valve Stenosis; Rheumatic Heart Disease; Tricuspid Valve Insufficiency
Type
journal article