title: Percutaneous closure of left ventricular-to-right atrial fistula after prosthetic mitral valve rereplacement using the Amplatzer duct occluder.
abstract: A 70-year-old female with a history of rheumatic heart disease underwent rereplacement of mitral valve mechanical prosthesis in May 2003. Seven months later, she presented with progressive exertional dyspnea, exercise intolerance, and a new holosystolic/diastolic murmur. Echocardiography confirmed a large shunt through a fistula in the inferior limbus of the atrial septum with left ventricular-to-right atrial communication. We report the novel use of the Amplatzer duct occluder for closure of the fistulous tract.
authors.affiliation: Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN 55905, USA. cabalka.allison@mayo.edu
authors.forename: Allison K
authors.initials: AK
authors.lastname: Cabalka
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Hagler
authors.forename: Farouk
authors.initials: F
authors.lastname: Mookadam
authors.forename: Krishnaswamy
authors.initials: K
authors.lastname: Chandrasekaran
authors.forename: R Scott
authors.initials: RS
authors.lastname: Wright
mesh_terms: D000368:Aged; D021721:Balloon Occlusion / Q000379:methods*; D002932:Cineangiography; D017548:Echocardiography, Transesophageal; D005260:Female; D005402:Fistula / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D005500:Follow-Up Studies; D006325:Heart Atria; D006331:Heart Diseases / Q000209:etiology* / Q000628:therapy*; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006352:Heart Ventricles; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D012214:Rheumatic Heart Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D018570:Risk Assessment; D016896:Treatment Outcome