Key result
Transcatheter closure of an iatrogenic atrial septal defect in a patient with a left ventricular assist device resolved post-ablation hypoxemia, improving PaO2 from 94 mmHg to 198 mmHg.
Case Report (n=1)
Transseptal puncture for catheter ablation in patients with a left ventricular assist device can cause severe hypoxemia due to a right-to-left shunt, which can be successfully managed with percutaneous atrial septal defect closure.
Iatrogenic ASD may cause refractory hypoxemia in LVAD patients; leaves open optimal shunt management strategies.
A 59-year-old male with an implantable cardiac defibrillator, left ventricular assist device, and refractory ventricular tachycardia presented with hypoxemia due to a post-ablation iatrogenic atrial septal defect. Left ventricular assist devices generate pressure gradients that may exacerbate intracardiac shunts and can precipitate significant hypoxemia.
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Mainville et al. (2023) conducted a case report in Electrical storm and iatrogenic atrial septal defect after LVAD (n=1). Atrial septal defect closure vs. Pre-closure (baseline) was evaluated on PaO2 on 100% FiO2 (mmHg). Transcatheter closure of an iatrogenic atrial septal defect in a patient with a left ventricular assist device resolved post-ablation hypoxemia, improving PaO2 from 94 mmHg to 198 mmHg.
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