Fenestration of a Gore Helex Septal Occluder device in a patient with diastolic dysfunction of the left ventricle

We report successful deployment of a fenestrated Helex Septal Occluder in a 46-year-old lady with a moderate-sized secundum atrial septal defect and elevated left-ventricular end diastolic pressure secondary to renovascular hypertension. Initial balloon occlusion of the defect lead to significant rise in left atrial pressure. Creation of a 4-mm fenestration offered controlled decompression of the left atrium while reducing the atrial shunt considerably.