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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...

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Autores principales: Briosa, Alexandra, Ferreira, Filipa, Santos, João, Alegria, Sofia, Loureiro, Maria José, Repolho, Débora, Pereira, Hélder
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
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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.
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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
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