title: Long-term follow-up of a fenestrated Amplatzer atrial septal occluder in pulmonary arterial hypertension.
abstract: Pulmonary arterial hypertension (PAH) is a progressive disease, with right-heart failure being the main cause of death. In patients refractory to conventional drug therapy, atrial septostomy can serve as palliative treatment or as a bridge to transplantation. A 41-year-old woman with a 15-year history of PAH associated with a corrected atrial septal defect presented with severe deterioration of symptoms. Echocardiography confirmed reocclusion of an atrial septal stoma that had been created several months before. After performing a repeat atrial septostomy, we implanted a custom-made atrial septostomy device, an Amplatzer septal occluder that had been fenestrated to serve as a custom-made atrial septostomy device. This resulted in an improvement in cardiac output and a marked symptomatic relief. During the 6-year follow-up, the patient was clinically stable with limited but constant exercise tolerance, under specific medical therapy. Repeated echocardiography confirmed long-term patency of the device.
authors.affiliation: Department of Cardiology and Angiology, Charité Universitätsmedizin Berlin, Campus Mitte, Charité-Platz 1, 10177 Berlin, Germany. till.althoff@charite.de
authors.forename: Till F
authors.initials: TF
authors.lastname: Althoff
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
authors.forename: Alexander
authors.initials: A
authors.lastname: Panda
authors.forename: John
authors.initials: J
authors.lastname: McArdle
authors.forename: Volker
authors.initials: V
authors.lastname: Gliech
authors.forename: Ines
authors.initials: I
authors.lastname: Franke
authors.forename: Christian
authors.initials: C
authors.lastname: Witt
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Borges
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000601:surgery*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D013997:Time Factors