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Atrial septal defect closure with an Amplatzer septal occluder fenestrated with a coronary stent in a child with pulmonary arterial hypertension

Published online by Cambridge University Press:  23 October 2012

Gregory J. Skinner ,
Robert M. Tulloh ,
Andrew J. Tometzki ,
Ingram Schulze-Neick  and
Gareth J. Morgan
Gregory J. Skinner
Affiliation:
Department of Paediatric Cardiology, Bristol Children's Hospital, Bristol, London, United Kingdom
Robert M. Tulloh
Affiliation:
Department of Paediatric Cardiology, Bristol Children's Hospital, Bristol, London, United Kingdom
Andrew J. Tometzki
Affiliation:
Department of Paediatric Cardiology, Bristol Children's Hospital, Bristol, London, United Kingdom
Ingram Schulze-Neick
Affiliation:
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, United Kingdom
Gareth J. Morgan*
Affiliation:
Department of Paediatric Cardiology, Bristol Children's Hospital, Bristol, London, United Kingdom
*
Correspondence to: Dr G. Morgan, Consultant Congenital Cardiologist, Bristol Children's Hospital, Upper Maudlin Street, Bristol BS2 8BJ, United Kingdom. Tel: +44 117 342 8853; Fax: +44 117 342 8857; E-mail: Gareth.Morgan@UHBristol.nhs.uk
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Abstract

The presence of an atrial septal defect in pulmonary hypertension has benefits and detractions. Even in idiopathic pulmonary arterial hypertension, a significant left-to-right shunt at atrial level may increase the pulmonary arterial pressure and exacerbate the disease. However, it is well recognised that the presence of an atrial communication may be protective in subgroups with severe disease, allowing maintenance of cardiac output during times of increased pulmonary resistance. In the present paper, we present the case of a young boy with significant idiopathic pulmonary arterial hypertension and an atrial septal defect. We report our technique of septal occlusion using a device to decrease left-to-right shunting with concomitant stent insertion in that device to maintain the potential for right-to-left shunting during times of high pulmonary arterial pressure.

Keywords

Devicecatheterinterventionidiopathic pulmonary arterial hypertension
Type
Original Articles
Information
Cardiology in the Young , Volume 23 , Issue 5 , October 2013 , pp. 692 - 696
Copyright
Copyright © Cambridge University Press 2012 

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