Key result
Transcatheter closure of a secundum atrial septal defect in a 52-year-old woman was complicated by acute pulmonary edema, likely due to reduced left ventricular compliance.
Case Report (n=1)
No
Acute left ventricular dysfunction and pulmonary edema can occur after transcatheter ASD closure in middle-aged patients, highlighting the need to consider baseline left atrial pressure and LV compliance.
Answers are grounded in this paper and cite their sources.
Pulmonary edema may complicate ASD closure with reduced LV compliance; this case report leaves open whether pre-procedural LA pressure assessment improves safety.
We describe an incident of development of acute pulmonary edema after the device closure of a secundum atrial septal defect in a 52-year-old lady, which was treated with inotropes, diuretics and artificial ventilation. Possibility of acute left ventricular dysfunction should be considered after the defect closure in the middle-aged patients as the left ventricular compliance may be reduced due to increased elastic stiffness and diastolic dysfunction. Baseline left atrial pressure may be > 10 mmHg in these patients. Associated risk factors for the left ventricular dysfunction are a large Qp:Qs ratio, systemic hypertension, severe pulmonary hypertension and paroxysmal atrial fibrillation.
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Chigurupati et al. (2015) conducted a case report in Atrial septal defect (n=1). Transcatheter closure of atrial septal defect was evaluated on Development of acute pulmonary edema. Transcatheter closure of a secundum atrial septal defect in a 52-year-old woman was complicated by acute pulmonary edema, likely due to reduced left ventricular compliance.
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