Cargando…
Severe and Apparently Irreversible Pulmonary Arterial Hypertension in a Patient with Ostium Secundum Atrial Septal Defect – A Successful Case of Treat and Close Strategy
Irreversible pulmonary arterial hypertension is considered a contraindication for surgical or percutaneous closure of atrial septal defects (ASD) due to risk of right heart failure. We present a case of 37 years-old woman who was referred to our center due to progressive worsening fatigue and high p...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749546/ https://www.ncbi.nlm.nih.gov/pubmed/36531910 http://dx.doi.org/10.1177/11795484221141298 |
_version_ | 1784850056556314624 |
---|---|
author | Briosa, Alexandra Ferreira, Filipa Santos, João Alegria, Sofia Loureiro, Maria José Repolho, Débora Pereira, Hélder |
author_facet | Briosa, Alexandra Ferreira, Filipa Santos, João Alegria, Sofia Loureiro, Maria José Repolho, Débora Pereira, Hélder |
author_sort | Briosa, Alexandra |
collection | PubMed |
description | Irreversible pulmonary arterial hypertension is considered a contraindication for surgical or percutaneous closure of atrial septal defects (ASD) due to risk of right heart failure. We present a case of 37 years-old woman who was referred to our center due to progressive worsening fatigue and high probability of pulmonary hypertension on a transthoracic echocardiogram. The diagnostic work-up revealed the presence of an ostium secundum atrial septal defect and severe pre-capillary pulmonary hypertension on right heart cathetherization (RHC). The patient was considered inoperable and started medical therapy with sildenafil and bosentan. After one year of treatment, she repeated RHC that showed a significant reduction in pulmonary vascular resistance making her eligible for closure. Surgical closure of ASD with a fenestra was performed with success. Our case emphasizes the importance of individual assessment even if cases where initial evaluation is unfavorable to closure in accordance with the guidelines. |
format | Online Article Text |
id | pubmed-9749546 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-97495462022-12-15 Severe and Apparently Irreversible Pulmonary Arterial Hypertension in a Patient with Ostium Secundum Atrial Septal Defect – A Successful Case of Treat and Close Strategy Briosa, Alexandra Ferreira, Filipa Santos, João Alegria, Sofia Loureiro, Maria José Repolho, Débora Pereira, Hélder Clin Med Insights Circ Respir Pulm Med Case Report Irreversible pulmonary arterial hypertension is considered a contraindication for surgical or percutaneous closure of atrial septal defects (ASD) due to risk of right heart failure. We present a case of 37 years-old woman who was referred to our center due to progressive worsening fatigue and high probability of pulmonary hypertension on a transthoracic echocardiogram. The diagnostic work-up revealed the presence of an ostium secundum atrial septal defect and severe pre-capillary pulmonary hypertension on right heart cathetherization (RHC). The patient was considered inoperable and started medical therapy with sildenafil and bosentan. After one year of treatment, she repeated RHC that showed a significant reduction in pulmonary vascular resistance making her eligible for closure. Surgical closure of ASD with a fenestra was performed with success. Our case emphasizes the importance of individual assessment even if cases where initial evaluation is unfavorable to closure in accordance with the guidelines. SAGE Publications 2022-12-13 /pmc/articles/PMC9749546/ /pubmed/36531910 http://dx.doi.org/10.1177/11795484221141298 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Report Briosa, Alexandra Ferreira, Filipa Santos, João Alegria, Sofia Loureiro, Maria José Repolho, Débora Pereira, Hélder Severe and Apparently Irreversible Pulmonary Arterial Hypertension in a Patient with Ostium Secundum Atrial Septal Defect – A Successful Case of Treat and Close Strategy |
title | Severe and Apparently Irreversible Pulmonary Arterial Hypertension in
a Patient with Ostium Secundum Atrial Septal Defect – A Successful Case of Treat
and Close Strategy |
title_full | Severe and Apparently Irreversible Pulmonary Arterial Hypertension in
a Patient with Ostium Secundum Atrial Septal Defect – A Successful Case of Treat
and Close Strategy |
title_fullStr | Severe and Apparently Irreversible Pulmonary Arterial Hypertension in
a Patient with Ostium Secundum Atrial Septal Defect – A Successful Case of Treat
and Close Strategy |
title_full_unstemmed | Severe and Apparently Irreversible Pulmonary Arterial Hypertension in
a Patient with Ostium Secundum Atrial Septal Defect – A Successful Case of Treat
and Close Strategy |
title_short | Severe and Apparently Irreversible Pulmonary Arterial Hypertension in
a Patient with Ostium Secundum Atrial Septal Defect – A Successful Case of Treat
and Close Strategy |
title_sort | severe and apparently irreversible pulmonary arterial hypertension in
a patient with ostium secundum atrial septal defect – a successful case of treat
and close strategy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749546/ https://www.ncbi.nlm.nih.gov/pubmed/36531910 http://dx.doi.org/10.1177/11795484221141298 |
work_keys_str_mv | AT briosaalexandra severeandapparentlyirreversiblepulmonaryarterialhypertensioninapatientwithostiumsecundumatrialseptaldefectasuccessfulcaseoftreatandclosestrategy AT ferreirafilipa severeandapparentlyirreversiblepulmonaryarterialhypertensioninapatientwithostiumsecundumatrialseptaldefectasuccessfulcaseoftreatandclosestrategy AT santosjoao severeandapparentlyirreversiblepulmonaryarterialhypertensioninapatientwithostiumsecundumatrialseptaldefectasuccessfulcaseoftreatandclosestrategy AT alegriasofia severeandapparentlyirreversiblepulmonaryarterialhypertensioninapatientwithostiumsecundumatrialseptaldefectasuccessfulcaseoftreatandclosestrategy AT loureiromariajose severeandapparentlyirreversiblepulmonaryarterialhypertensioninapatientwithostiumsecundumatrialseptaldefectasuccessfulcaseoftreatandclosestrategy AT repolhodebora severeandapparentlyirreversiblepulmonaryarterialhypertensioninapatientwithostiumsecundumatrialseptaldefectasuccessfulcaseoftreatandclosestrategy AT pereirahelder severeandapparentlyirreversiblepulmonaryarterialhypertensioninapatientwithostiumsecundumatrialseptaldefectasuccessfulcaseoftreatandclosestrategy |