1
|
Alexandre A, Luz A, de Frias AD, Santos RB, Brochado B, Oliveira F, Silveira J, Torres S. Temporary atrial septal defect balloon occlusion test as a must in the elderly. BMC Cardiovasc Disord 2023; 23:15. [PMID: 36635628 PMCID: PMC9836334 DOI: 10.1186/s12872-023-03046-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Atrial septal defect (ASD) can often remain asymptomatic until adulthood. It still remains unclear whether large ASD closure in senior people should be performed or not. Temporary ASD balloon occlusion test has been suggested as a tool to assess the risk of acute left ventricular heart failure post-ASD closure, and it allows to better distinguish responders from non-responders. CASE PRESENTATION An 83-year-old man with a long-standing uncorrected secundum ASD was admitted for recently decompensated right-sided heart failure. During hospitalization, this patient was studied with trans-esophageal echocardiography, cardiac magnetic resonance imaging, and right heart catheterization, showing high Qp:Qs ratio and favorable anatomical conditions for percutaneous closure. Because of patient's increasing need for intravenous diuretics and worsening renal function, it was considered that transcatheter ASD closure could improve symptoms, hence it was performed an attempt of percutaneous closure of the ASD with a fenestrated device. Unfortunately, irrespective of ASD being hemodynamically significant, it was found a very significant increase in pulmonary capillary wedge pressure during the temporary balloon occlusion test, supporting the existence of concealed left ventricular diastolic dysfunction. As a result, it was decided to abandon the procedure and not to close the ASD. CONCLUSION This clinical case illustrates the value of temporary balloon occlusion test before permanent percutaneous closure of ASD in elderly patients, regardless of left ventricular (systolic or diastolic) dysfunction.
Collapse
Affiliation(s)
- André Alexandre
- grid.5808.50000 0001 1503 7226Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal ,grid.5808.50000 0001 1503 7226ICBAS – School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - André Luz
- grid.5808.50000 0001 1503 7226Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal ,grid.5808.50000 0001 1503 7226ICBAS – School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Cardiovascular Research Group, UMIB – Unit for Multidisciplinary Research in Biomedicine, ICBAS – School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - André Dias de Frias
- grid.5808.50000 0001 1503 7226Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal
| | - Raquel Baggen Santos
- grid.5808.50000 0001 1503 7226Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal ,grid.5808.50000 0001 1503 7226ICBAS – School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Bruno Brochado
- grid.5808.50000 0001 1503 7226Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal ,grid.5808.50000 0001 1503 7226ICBAS – School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Filomena Oliveira
- grid.5808.50000 0001 1503 7226Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal ,grid.5808.50000 0001 1503 7226ICBAS – School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - João Silveira
- grid.5808.50000 0001 1503 7226Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal ,grid.5808.50000 0001 1503 7226ICBAS – School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Severo Torres
- grid.5808.50000 0001 1503 7226Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal ,grid.5808.50000 0001 1503 7226ICBAS – School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| |
Collapse
|
2
|
Vergara-Uzcátegui CE, Salinas P, Nombela-Franco L. Hipoxemia inducida por el ejercicio en una paciente adulta con comunicación interauricular. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 91:375-378. [PMID: 34310588 PMCID: PMC8351642 DOI: 10.24875/acm.20000225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
| | - Pablo Salinas
- Unidad de Cardiología Intervencionista, Hospital Clínico San Carlos. Madrid, España
| | - Luis Nombela-Franco
- Unidad de Cardiología Intervencionista, Hospital Clínico San Carlos. Madrid, España
| |
Collapse
|