title: Sustained reversal of right-to-left atrial septal defect flow after pulmonic valvuloplasty in an adult.
abstract: A 60-year-old man with Noonan's syndrome presented with generalized weakness, dyspnoea, and paresthesias. He was known to have pulmonic stenosis and atrial septal defect with right-to-left shunting and had refused therapy for many years. On presentation there was cyanosis and the haematocrit was 63%. After phlebotomy he was treated with balloon valvuloplasty. There was marked reduction in the transpulmonic gradient and oximetric evidence for reversal of his right-to-left atrial septal defect flow. After 18 months follow-up he remained system free and had no rise in haematocrit, consistent with no return of right-to-left shunting.
authors.affiliation: University of Chicago Hospital, Hans Hecht Hemodynamics Laboratory, IL 60637.
authors.forename: J E
authors.initials: JE
authors.lastname: Carter
authors.forename: T
authors.initials: T
authors.lastname: Feldman
authors.forename: J D
authors.initials: JD
authors.lastname: Carroll
mesh_terms: D002404:Catheterization; D003251:Constriction, Pathologic; D003326:Coronary Circulation; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009634:Noonan Syndrome; D011651:Pulmonary Artery