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Published on: May 26, 2023
Percutaneous treatment of Lutembacher syndrome in a case with difficult mitral valve crossing
Anupam Bhambhani1, H S Somanath
1Department of Cardiology, Yashoda Hospital, Secunderabad, India. anupam.bhambhani@yahoo.in
Insights
Lutembacher syndrome, a heart defect combination, is challenging for percutaneous treatment. This study details overcoming difficulties in catheter-based closure for this rare condition.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Interventional Cardiology
Background:
- Lutembacher syndrome involves acquired mitral stenosis and congenital atrial septal defect.
- Open-heart surgery is common due to complex anatomy and catheterization challenges.
Observation:
- Percutaneous treatment of Lutembacher syndrome presents unique difficulties.
- The large atrial septal defect destabilizes the Inoue balloon catheter, hindering left ventricular access.
Findings:
- Successful percutaneous closure of Lutembacher syndrome was achieved.
- Technical strategies were employed to overcome mitral valve crossing challenges.
Implications:
- Percutaneous intervention is a viable option for Lutembacher syndrome.
- This case provides insights into managing complex congenital cardiac anomalies non-surgically.
Abstract:
Most cases of combination congenital cardiac anomalies are treated with open-heart surgeries because the coexisting anomalies change the cardiac anatomy in an adverse way, making catheter manipulations complex. Lutembacher syndrome is a combination of acquired mitral stenosis and congenital ostium secundum atrial septal defect. The large defect in the septum makes an Inoue balloon catheter unstable, which provides excessive space for free floatation of the catheter, making its passage into the left ventricle difficult by Inoue technique. We present a case of elective definitive percutaneous treatment of Lutembacher syndrome, discussing the technical difficulties faced in mitral valve crossing and reviewing the possible strategies to improve chances of success.
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