Document Detail

Bidirectional shunt through a residual atrial septal defect after percutaneous transvenous mitral commissurotomy.
MedLine Citation:
PMID:  8281535     Owner:  NLM     Status:  MEDLINE    
A residual atrial septal defect with bidirectional shunt was detected by transesophageal echocardiography in a 28-year-old man 3 years after percutaneous transluminal mitral commissurotomy (PTMC) with the antegrade transseptal technique. He had had severe mitral stenosis, pulmonary hypertension, and tricuspid regurgitation before the procedure. The result of PTMC was suboptimal, the pulmonary hypertension regressed only partially, and the tricuspid regurgitation remained severe. These factors contributed to the bidirectional shunt. A bidirectional shunt is known to be associated with systemic desaturation and a higher risk of paradoxical embolization and brain abscess. When PTMC is considered in patients with pulmonary hypertension and tricuspid regurgitation, a retrograde left ventricular approach with or without transseptal puncture can avoid the atrial septotomy, decrease the incidence of significant shunt, and should be a rational alternative.
L P Lai; K G Shyu; K L Hsu; F T Chiang; C D Tseng; Y Z Tseng
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cardiology     Volume:  83     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  1993  
Date Detail:
Created Date:  1994-02-15     Completed Date:  1994-02-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  205-7     Citation Subset:  IM    
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
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MeSH Terms
Balloon Dilatation*
Blood Flow Velocity / physiology
Blood Pressure / physiology
Echocardiography, Doppler
Echocardiography, Transesophageal
Heart Septal Defects, Atrial / therapy*,  ultrasonography
Mitral Valve Stenosis / therapy*,  ultrasonography
Rheumatic Heart Disease / therapy*,  ultrasonography
Tricuspid Valve Insufficiency / therapy,  ultrasonography

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