Staged transcatheter closure for atrial septal defect and patent ductus arteriosus: A case report

Yusuke Soma, Yasuyuki Shiraishi, Hideaki Kanazawa, Keiichi Fukuda

研究成果: ジャーナルへの寄稿学術論文査読

1 被引用数 (Scopus)

抄録

Background Atrial septal defect (ASD) and patent ductus arteriosus (PDA) are both common congenital heart diseases, but the combination of these two cardiac defects is extremely rare, and the therapeutic strategy is controversial. Case summary We treated an adult patient with combined ASD and PDA, and safely attained a successful outcome with two-stage transcatheter closure, which is PDA closure preceding ASD closure, to prevent serious complications. Discussion Transcatheter closure of one of the defects is now widely accepted as an alternative to surgical closure. In addition, adults with both ASD and PDA are better suited for transcatheter closure than surgical closure. One of the reasons is the difficulty to ligate the ductus arteriosus of an adult patient due to its friability and calcification. Meanwhile, simultaneous combined transcatheter closure of ASD and PDA can result in serious complications, such as thrombocytopenia and haemolysis, whose mechanism is considered to be the destruction of platelets and red blood cells by the residual shunt through implanted devices. Additionally, antiplatelet therapy that prevents device-related thrombus formation after ASD closure can possibly exacerbate thrombocytopenia and haemolysis. Therefore, the staged strategy is reasonable from the perspectives of antiplatelet therapy and haemodynamic changes.

本文言語英語
ジャーナルEuropean Heart Journal - Case Reports
3
2
DOI
出版ステータス出版済み - 01-06-2019
外部発表はい

All Science Journal Classification (ASJC) codes

  • 循環器および心血管医学

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