Percutaneous closure of patent foramen ovale and atrial septal defect

A case report

  • Maja Rojko, MD International heart center Medicor
  • Nataša Černič Šuligoj, MD International heart center Medicor, Department of internal medicine - General hospital Izola
  • Metka Zorc, MD, PhD International heart center Medicor
  • Saibal Kar, MD International heart center Medicor, Cardiovascular Interventional Center Cedars-Sinai Heart Institute
  • Marko Noč, MD, PhD International heart center Medicor, Center for intensive internal medicine University medical center Ljubljana
Keywords: atrial septal defect, patent foramen ovale, percutaneous closure

Abstract

A 67-year old man with a hemodynamically significant type secundum atrial septal defect (ASD), large patent foramen ovale (PFO) and significant septal aneurism presented with shortness of breath and limited exercise tolerance. There was no evidence of additional structural abnormalities nor significant coronary artery disease. Simultaneous percutaneous closure of both defects was planned. Since the wire could have been passed only through PFO and the second wire not through the ASD, only PFO was closed with 35 mm Amplatz PFO occluder. After 3 months, which served for tissue ingrowth of Amplatz PFO occluder and aneurism stabilization, ASD located in posterior-inferior part of fossa ovalis documented by three-dimensional transesophageal echocardiography (3D-TEE) was easily crossed and successfully closed with a 12 mm Amplatz ASD occluder. Stable position without unwanted interference between the devices was obtained. There was noresidual shunting on color Doppler and no bubble shunting during Valsalva maneuver.  Within 6 months after the procedure, symptoms significantly improved and right heart chambers decreased. 3D-TEE revealed both devices in good position with only trivial shunting through PFO occluder documented by color Doppler.

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Published
2020-01-09
How to Cite
1.
Rojko M, Černič Šuligoj N, Zorc M, Kar S, Noč M. Percutaneous closure of patent foramen ovale and atrial septal defect. ZdravVestn [Internet]. 9Jan.2020 [cited 27Feb.2020];88(11-12):576-81. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2872
Section
Case report, short scientific article