title: An 84-year-old patient with an atrial septal defect rescued using the Amplatzer septal occluder device.
abstract: We report the case of a rescued 84-year-old patient with atrial septal defect (ASD) who was emergently admitted to our intensive care unit with progressive dyspnea requiring mechanical ventilation for severe anoxia and respiratory arrest. She had no history of congenital heart diseases. ECG and chest X-ray revealed overload of the right atrium and ventricle, and severe increase in pulmonary vascular markings. Transesophageal echocardiography showed a moderately large size ASD (18 x 23 mm(2)). Hemodynamic evaluation documented an increase in PA pressure of 37/16 mm Hg and Q(p)/Q(s) of 2.33. Her systemic condition did not improve following diuretics, cathecholamine, and afterload-reducing substances. She required mechanical ventilation for severe hypoxia. She underwent successful closure of the ASD using an Amplatzer septal occluder on day 17. Hemodynamics and findings on chest X-ray dramatically improved after this procedure. She was discharged from the hospital on foot.
authors.affiliation: Department of Cardiology, Okayama Red Cross General Hospital, Okayama, Japan. tesato@ta3.so-net.ne.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sato
authors.forename: Toru
authors.initials: T
authors.lastname: Hioka
authors.forename: Teiji
authors.initials: T
authors.lastname: Akagi
mesh_terms: D000369:Aged, 80 and over; D021721:Balloon Occlusion / Q000295:instrumentation*; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans