Combined Double-Lung Transplantation and Percutaneous Septal Defect Closure for End-Stage Atrial Septal Defect-Associated Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is a rare but severe complication of unrepaired atrial septal defect (ASD) and carries a worse prognosis than posttricuspid shunt. In patients with ASD complicated by PAH and right ventricular failure, heart-lung transplantation (HLT) is currently viewed as the best option despite high postoperative mortality. However, the severe donor organ shortage results in high waiting-list mortality. Our objective here was to compare the safety and benefits of double-lung transplantation (DLT) followed by percutaneous ASD closure versus HLT for end-stage ASD-associated PAH.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (399) Source Type: research

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This article intended to review all aspects of ASD; anatomy, pathophysiology, clinical presentation, natural history, and indication for treatment. Also, we covered the transcatheter therapy in detail, including the procedural aspect, available devices, and outcomes. EXPERT OPINION: There has been a remarkable improvement in the treatment strategy of ASD over the last few decades. Transcatheter closure of ASD is currently accepted as the treatment of choice in most patients with appropriately selected secundum ASDs. This review will focus on the most recent advances in diagnosis and treatment strategy of secundum ASD. ...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
Surgical closure of atrial septal defect (ASD) is contraindicated in the condition with severe pulmonary arterial hypertension (PAH), whereas ASD closure in an effective intervention to normalize the structure...
Source: Journal of Cardiothoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Research article Source Type: research
AbstractElective closure of atrial septal defect (ASD) is usually recommended during preschool ages. However, ASD may contribute to deteriorating health in the presence of significant comorbidity and, thus, may need earlier closure. There is a lack of clarity regarding the indications for and outcomes after ASD closure in infancy and early childhood. We investigated the benefits and safety of surgical ASD closure in symptomatic patients under 2  years of age. Retrospective chart review was conducted in patients who underwent surgical ASD closure within the first 2 years of life. Of 31 symptomatic ASD patients, 22...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
Abstract Methods: The study design was cross-sectional. The subjects were adult uncorrected secundum ASD with PAH. Pulmonary artery pressure was measured with right heart catheterization. Pulmonary venous blood was obtained during catheterization for measuring endothelin-1, prostacyclin, and nitric oxide. Correlation tests were performed to determine any association between biomarkers and mean pulmonary artery pressure (mPAP). The levels of biomarkers were compared based on the severity of PAH. Statistical significance was determined at p
Source: Cardiology Research and Practice - Category: Cardiology Authors: Tags: Cardiol Res Pract Source Type: research
This study assesses changes in tricuspid regurgitation after isolated atrial septal defect closure. METHODS: Retrospectively, records were examined of 100 patients who underwent isolated ostium secundum atrial septal defect closure without tricuspid valve repair. Echocardiograms were done preoperatively and 3 days, 3 months, and 1 year after surgery. Data on tricuspid regurgitation status, right ventricle dimensions, and pulmonary artery hypertension status were collected and analyzed. RESULTS: After surgical closure, echocardiography showed a regression of tricuspid regurgitation to mild or less in 76% of patien...
Source: The Heart Surgery Forum - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Heart Surg Forum Source Type: research
Pulmonary artery systolic pressure – MCQ – Answer Normal pulmonary artery systolic pressure – Correct Answer: b) 15 – 30 mm Hg Pulmonary circulation is a low pressure circulation and the pressures are much lower than that of systemic circulation. An acute rise in systolic pressure to 50 mmHg can cause right heart failure in conditions like pulmonary embolism. But gradually rising pressures are better tolerated as the right ventricle has time to compensate by hypertrophy. In severe primary pulmonary hypertension and atrial septal defect with severe pulmonary hypertension, pulmonary pressures can eve...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Medicine MCQ - CVS Source Type: blogs
PULMONARY HEMODYNAMICS AND WAVE REFLECTIONS IN ADULTS WITH ATRIAL SEPTAL DEFECTS. Am J Physiol Heart Circ Physiol. 2020 Mar 06;: Authors: Ting CT, Chen JW, Chang MS, Yin FCP Abstract Using high-fidelity micromanometers and flow velocity sensors at right heart catheterization, we compared pulmonary hemodynamics and wave reflections in age-matched normal adults and those with atrial septal defects, separated into three subgroups based on levels of mean pulmonary artery pressure: low ( 26 mmHg). We made baseline measurements in all groups and after intravenous sodium nitroprusside in the subgroups. All t...
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Tags: Am J Physiol Heart Circ Physiol Source Type: research
We report the case of a patient with a large atrial septal defect (65 mm) and hemodynamic instability who underwent laparoscopic cholecystectomy under total intravenous anesthesia with careful hemodynamic monitoring. Thorough surveillance and effort could help to make the surgery successful.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Publication date: Available online 11 February 2020Source: Journal of Veterinary CardiologyAuthor(s): Takeshi Mizuno, Masashi Mizuno, Kayoko Harada, Hiroshi Takano, Asako Shinoda, Arane Takahashi, Kazuya Mamada, Kazuki Takamura, Ayaka Chen, Koji Iwanaga, Shin Ono, Masami UechiAbstractA 5-year-old male Toy Poodle was referred for corrective surgery of an atrial septal defect. A sinus venosus-type atrial septal defect (ASD) with partial anomalous venous connection, suspected pulmonary hypertension and pulmonary edema was confirmed by radiography, echocardiography, and cardiac computed tomography. Thoracic radiographs showed ...
Source: Journal of Veterinary Cardiology - Category: Veterinary Research Source Type: research
AbstractTranscatheter closure of large atrial septal defects (ASDs) remains controversial. The aim of this study was to evaluate the feasibility and safety of transthoracic echocardiography (TTE)-guided transcatheter closure of large ASDs. Patients with large secundum ASDs ( ≥ 30 mm) who underwent device closure were retrospectively reviewed. TTE was performed to guide ASD occluder positioning and assess the immediate and long-term outcomes. A total of 60 patients (median age 43.5 years, range 15–78 years) were enrolled in the study. The median ASD size was 35  mm (range 30–42 ...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
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