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Surgical implications of atrial septal defect complicating aortic balloon valvuloplasty
J H Lemmer1, M D Winniford, D W Ferguson
1Department of Surgery, University of Iowa College of Medicine, Iowa City 52242.
Insights
Percutaneous transluminal balloon valvuloplasty for aortic stenosis can lead to a persistent atrial septal defect. This complication complicates future hemodynamic assessments and aortic valve replacement surgery.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Critical aortic stenosis necessitates intervention.
- Percutaneous transluminal balloon valvuloplasty (PTBV) is a treatment option.
- The antegrade atrial transseptal approach for PTBV carries potential complications.
Abstract:
An 80-year-old man underwent percutaneous transluminal balloon valvuloplasty for critical aortic stenosis. The procedure was performed by the antegrade atrial transseptal approach and was complicated by a persistent atrial septal defect. Symptoms recurred 6 months later, restenosis of the aortic valve was confirmed, and the atrial septal defect yielded a substantially greater left-to-right shunt. This complication of percutaneous transluminal balloon valvuloplasty poses important problems in hemodynamic assessment and operative management of patients who undergo subsequent aortic valve replacement.