Balloon occlusion testing of an ASD in a patient with acute extensive anterior MI revealed that closure would precipitate severe left ventricular failure, contraindicating surgery.
ASD closure may precipitate LV failure in acute anterior MI; leaves open prospective validation of occlusion testing.
A 58 year old man with an acute, extensive anterior myocardial infarction was found to also have an atrial septal defect secundum. A cardiac catheterization study showed a large left to right shunt (Qp/Qs: 6.0). Since other clinical findings were not consistent with the prolonged existence of a large shunt, we considered it to be secondary to the myocardial infarction. Balloon occlusion of the ASD was carried out to predict the hemodynamics after the surgical correction, which soon resulted in severe left ventricular failure. Therefore, an operation was not feasible in this case.
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Funazaki et al. (1986) studied this question.
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