title: Pulmonary edema following transcatheter closure of atrial septal defect.
abstract: We describe an incident of development of acute pulmonary edema after the device closure of a secundum atrial septal defect in a 52-year-old lady, which was treated with inotropes, diuretics and artificial ventilation. Possibility of acute left ventricular dysfunction should be considered after the defect closure in the middle-aged patients as the left ventricular compliance may be reduced due to increased elastic stiffness and diastolic dysfunction. Baseline left atrial pressure may be > 10 mmHg in these patients. Associated risk factors for the left ventricular dysfunction are a large Qp:Qs ratio, systemic hypertension, severe pulmonary hypertension and paroxysmal atrial fibrillation.
authors.affiliation: Department of Cardiothoracic and Vascular Anaesthesia; Department of Cardiovascular and Thoracic Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
authors.forename: Keerthi
authors.initials: K
authors.lastname: Chigurupati
authors.forename: Liza Jose
authors.initials: LJ
authors.lastname: Reshmi
authors.forename: Shrinivas
authors.initials: S
authors.lastname: Gadhinglajkar
authors.forename: S
authors.initials: S
authors.lastname: Venkateshwaran
authors.forename: Rupa
authors.initials: R
authors.lastname: Sreedhar
mesh_terms: D006328:Cardiac Catheterization; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D011654:Pulmonary Edema / Q000628:therapy*; D012121:Respiration, Artificial; D055989:Septal Occluder Device
chemical_list: D002316:Cardiotonic Agents; D004232:Diuretics