Natural history of growth of secundum atrial septal defects and implications for transcatheter closure

McMahon, Colin J.; Feltes, Timothy F.; Fraley, J. Kennard; Bricker, J. Timothy; Grifka, Ronald G.; Tortoriello, Tia A.; Blake, R. S.; Bezold, Louis I.

doi:10.1136/heart.87.3.256

Cited by 195 publications

(99 citation statements)

References 25 publications

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“…This fact can sometimes be an obstacle to further non-surgical treatment. Therefore, there is an agreement that small defects tend to close spontaneously, while the bigger ones -to increase [5].…”

Section: Discussionmentioning

confidence: 83%

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Transcatheter closure of atrial septal defect in children up to 10 kg of body weight with Amplatzer device

Knop

Szkutnik²,

Fiszer

et al. 2014

Cardiol J

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Section: Discussionmentioning

confidence: 83%

“…These procedures are a challenge in younger children. For practical purposes, any defect of 8 mm or larger with evidence of significant left to right shunt should be closed when identified, even in very young patients, because such a defect will likely never close spontaneously and may in fact even get larger [4,5].…”

Section: Introductionmentioning

confidence: 99%

Transcatheter closure of atrial septal defect in children up to 10 kg of body weight with Amplatzer device

Knop

Szkutnik²,

Fiszer

et al. 2014

Cardiol J

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“…It is caused by underdevelopment of the secundum septum or over-reabsorption of the primum septum. In most cases, ASDs close spontaneously during infancy [4,5]; however, if persistent, their clinical impact is related to their location, size, and association with other defects [5,6]. Small ASDs usually cause a left-to-right shunt without significant structural consequences in the right-sided heart chambers.…”

Section: Discussionmentioning

confidence: 99%

“…ASD is one of the most common adult congenital heart defects [3,4]. It is caused by underdevelopment of the secundum septum or over-reabsorption of the primum septum.…”

Section: Discussionmentioning

confidence: 99%

Improvement in Pulmonary Function After Closure of Atrial Septal Defect in a Patient With Cystic Fibrosis

Bratincsák¹,

Rhee²,

Alstine³

et al. 2017

jshd

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Atrial septal defect (ASD) is a major cause of left-toright intracardiac shunting. If persisting into adulthood, an ASD can lead to a larger shunt, which may eventually cause pulmonary hypertension and right ventricular failure. Large intracardiac shunts cannot be tolerated in patients with underlying lung disease such as cystic fibrosis. Although the association between an intracardiac shunt and cystic fibrosis has been reported in the literature, the impact of ASD closure on the clinical course of patients with cystic fibrosis has not been studied. Here, we report a case of ASD closure in a patient with cystic fibrosis with hypoxemia out of proportion to his lung disease. Closure of the ASD shunt resulted in significant improvement of his symptoms and pulmonary function testing.Copyright © 2017 Science International Corp. Key WordsAtrial septal defect • Septal closure device • Cystic fibrosis when significant, can cause dyspnea on exertion, which may not be well tolerated in patients with an underlying pulmonary condition such as cystic fibrosis. It is unknown whether ASD closure could lead to symptomatic improvement in these patients. Here, we report a case of ASD closure resulting in improved pulmonary function testing in a patient with cystic fibrosis with a bidirectional shunt and worsening functional capacity. Case PresentationOur patient was a 36-year-old man with cystic fibrosis diagnosed at birth with a dF508/dF508 genotype. His symptoms could be characterized as moderate airway disease complicated by chronic airway infections, pancreatic insufficiency, diabetes, and malnutrition. Progression of his clinical condition caused dyspnea with minimal exertion. He was referred to our cardiology service to be evaluated for hypoxemia out of proportion to his chronic pulmonary disease. Pulmonary function testing showed a forced expiratory volume in 1 s (FEV1) of 1.71 (43% predicted). Transesophageal echocardiography (TEE) showed a small ASD with a bidirectional shunt seen at rest (Figure 1). Right heart catheterization showed a pulmonary artery pressure of 26/7/16 mmHg and pulmonary vascular resistance of 1.7 Wood units. A decision was made to proceed with ASD closure, which

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“…Based The echocardiogram is an ultrasound scan of the heart that may be used for assessing ASD patients [7,8]. Using standard ultrasound scans, two-dimensional slices of the heart can be imaged that can be used in flow visualization.…”

Section: Introductionmentioning

confidence: 99%

Motion Estimation of Vortical Blood Flow Within the Right Atrium in a Patient with Atrial Septal Defect

Wong

Molaee

Kuklik

et al. 2007

2007 IEEE/ICME International Conference on Complex Medical Engineering

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Abstract-Patients with an atrial septal defect (ASD) have a left to right shunt with associated complications. Currently, various imaging modalities, including echocardiography and invasive cardiac catheterization, are utilized in the management of these patients. Cardiac magnetic resonance (CMR) imaging provides a novel and non-invasive approach for imaging patients with ASDs. A study of vortices generated within the right atrium (RA) during the diastolic phase of the cardiac cycle can provide useful information on the change in the magnitude of vorticity pre-and post-ASD closure. The motion estimation of blood applied to CMR is performed. In this study we present, a two dimensional (2D) visualization of in-vivo right atrial flow. This is constructed using flow velocities measured from the intensity shifts of turbulent blood flow regions in MRI. In particular, the flow vorticities can be quantified and measured, against controls and patients with ASD, to extend medical knowledge of septal defects and their haemodynamic effects.

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Natural history of growth of secundum atrial septal defects and implications for transcatheter closure

Cited by 195 publications

References 25 publications

Transcatheter closure of atrial septal defect in children up to 10 kg of body weight with Amplatzer device

Transcatheter closure of atrial septal defect in children up to 10 kg of body weight with Amplatzer device

Improvement in Pulmonary Function After Closure of Atrial Septal Defect in a Patient With Cystic Fibrosis

Motion Estimation of Vortical Blood Flow Within the Right Atrium in a Patient with Atrial Septal Defect

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