RT Book, Section
A1 Pineda, Andres M.
A1 Sommer, Robert J.
A1 Rhodes III, John F.
A1 Beohar, Nirat
A2 Baliga, R. R.
A2 Lilly, Scott M.
A2 Abraham, William T.
SR Print(0)
ID 1160207394
T1 Defects of the Atrial Septum
T2 Color Atlas and Synopsis of Interventional Cardiology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071749350
LK accesscardiology.mhmedical.com/content.aspx?aid=1160207394
RD 2022/08/19
AB A  34-year-old  woman  was  seen  in  the  outpatient  clinic  for  a  1-year  history  of  worsening  dyspnea  on  exertion  (New  York  Heart  Association  class  III),  2-pillow  orthopnea,  bilateral  pedal  edema,  and  occasional  episodes  of  palpitations.  Her  transthoracic  echocardiogram  revealed  an  ostium  secundum  atrial  septal  defect  (ASD),  significant  enlargement  of  the  right  ventricle,  evidence  of  left-­to-right  shunt  with  a  pulmonary  to  systemic  flow  (Qp/Qs)  ratio  of  2.3,  and  normal  left  ventricular  ejection  fraction  (Figure  26-1).  Transesophageal  echocardiogram  confirmed  an  ostium  secundum  ASD  of  18-mm  diameter  with  sufficient  tissue  rims  and  ruled  out  additional  congenital  defects  (Figure  26-2).  She  underwent  successful  percutaneous  closure  of  her  ostium  secundum  ASD  with  a  22-mm  atrial  septal  occluder  device  using  intracardiac  echocardiography  guidance.  After  6  months,  she  remains  asymptomatic  and  a  repeat  transthoracic  echocardiogram  revealed  no  residual  shunt  across  the  interatrial  septum  and  significant  reduction  in  right  ­ventricular  volume.