Simultaneous Transcatheter Pulmonary Balloon Valvuloplasty and Atrial Septal Defect Closure in Adult Patient

D. E. Wardhani, Eka Prasetya Budi Mulia, D. Rachmi
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Abstract

Background: Percutaneous pulmonary balloon valvuloplasty (PBV) has become the first choice of management in patients with valvular pulmonary stenosis, while transcatheter closure in secundum atrial septal defect (ASD) is an alternative therapy besides surgical closure. The combination of PBV and transcatheter ASD closure is an action that is possible to do, but rarely done.Case Illustration: We present a case of 26-year-old woman with severe pulmonary stenosis and secundum ASD.  Echocardiographic examination revealed the presence of severe pulmonary stenosis (mean gradient 99.19 mmHg) and defects in the intra atrial septum (with a size of 1.3 cm). Cardiac catheterization revealed right ventricular pressure of 160 mmHg. This patient then successfully corrected with both procedures ASD closure and PBV simultaneously. Discussion: These procedures have high feasibility, good safety, and shows good effectiveness. There were no complications during the procedures, and a satisfying immediate outcome was obtained.Conclusion: Pulmonary stenosis and atrial septal defects are rare forms of congenital heart disease. Transcatheter pulmonary balloon valvuloplasty and atrial septal defect closure performed simultaneously are promising alternatives, apart from surgical correction.
经导管肺动脉球囊瓣膜成形术与房间隔缺损合并术的研究
背景:经皮肺球囊瓣膜成形术(PBV)已成为瓣膜性肺狭窄患者的首选治疗方法,而经导管闭合术治疗继发性房间隔缺损(ASD)是除手术闭合术外的另一种治疗方法。PBV联合经导管ASD闭合是一种可行的方法,但很少被采用。病例说明:我们报告一例26岁女性严重肺狭窄伴继发性ASD。超声心动图检查发现严重肺动脉狭窄(平均梯度99.19 mmHg),房间隔缺损(大小1.3 cm)。心导管检查显示右心室压160 mmHg。该患者随后成功地同时进行了ASD闭合和PBV两种手术。讨论:该方法可行性高,安全性好,效果好。手术过程中无并发症发生,术后即刻效果满意。结论:肺动脉狭窄和房间隔缺损是罕见的先天性心脏病。经导管肺球囊瓣膜成形术和房间隔缺损关闭同时进行是有希望的选择,除了手术矫正。
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