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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Staged transcatheter closure for atrial septal defect and patent ductus arteriosus: a case report

Yusuke Soma1, Yasuyuki Shiraishi1, Hideaki Kanazawa1

  • 1Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo, Japan.

European Heart Journal. Case Reports
|August 27, 2019
PubMed

Insights

A staged transcatheter closure, first patent ductus arteriosus (PDA) then atrial septal defect (ASD), is a safe strategy for adults with combined cardiac defects, avoiding complications from simultaneous procedures.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Interventional Cardiology

Background:

  • Atrial septal defect (ASD) and patent ductus arteriosus (PDA) are common congenital heart diseases.
  • The combination of ASD and PDA is rare, with controversial therapeutic strategies.
  • Adult patients present unique challenges for surgical intervention.

Purpose of the Study:

  • To present a successful treatment strategy for a rare combination of congenital heart defects in an adult.
  • To evaluate the safety and efficacy of a staged transcatheter closure approach.
  • To provide insights into the management of combined ASD and PDA in adults.

Main Methods:

  • A two-stage transcatheter closure was performed.
  • Patent ductus arteriosus (PDA) closure preceded atrial septal defect (ASD) closure.
  • This staged approach aimed to prevent serious complications.

Main Results:

  • The patient with combined ASD and PDA achieved a successful outcome.
  • The two-stage transcatheter closure was safely attained.
  • The staged strategy mitigated risks associated with simultaneous closure.

Conclusions:

  • Transcatheter closure is a viable alternative to surgery for adults with combined ASD and PDA.
  • A staged closure strategy is recommended to prevent complications like thrombocytopenia and hemolysis.
  • The staged approach optimizes antiplatelet therapy and hemodynamic management.
Abstract

Keywords:
Atrial septal defectCase reportCongenital heart diseasePatent ductus arteriosus

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