Key result
Percutaneous ASD closure raises resting SpO2 by ~4 percentage points in adult Ebstein's anomaly.
Why the study?
In Ebstein's anomaly, percutaneous atrial septal defect closure for the treatment of hypoxemia due to a right-to-left interatrial shunt remains controversial.
Case Report (n=1)
No
May support percutaneous ASD closure after hemodynamic testing in select Ebstein's cases; leaves open need for prospective studies.
In Ebstein's anomaly, percutaneous atrial septal defect (ASD) closure for the treatment of hypoxemia due to a right-to-left interatrial shunt remains controversial. We report the case of a 40-year-old woman with Ebstein's anomaly who developed cyanosis and shortness of breath on exercise. Her symptoms improved after percutaneous ASD closure and her clinical course has been good during follow-up. The balloon ASD occlusion test, combined with dobutamine stimulation before the procedure, is useful to confirm treatment indication. A prior electrophysiological evaluation is also important because Ebstein's anomaly is often complicated by atrioventricular recurrent tachycardia.
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Oka et al. (2020) conducted a case report in Adult Ebstein's anomaly with exertional hypoxemia and ostium secundum atrial septal defect (n=1). Percutaneous atrial septal defect (ASD) closure with a 17-mm AMPLATZER Septal Occluder (preceded by catheter ablation for AVRT and balloon occlusion test with dobutamine stimulation) was evaluated on Improvement in NYHA functional class and percutaneous oxygen saturation (SpO2). Percutaneous ASD closure improved symptoms from NYHA class II to I and increased resting SpO2 from 93% to 97% without heart failure exacerbation over 3 years in an adult with Ebstein's anomaly.
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