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Iatrogenic Lutembacher Syndrome after Percutaneous Mitral Commissurotomy.

TitleIatrogenic Lutembacher Syndrome after Percutaneous Mitral Commissurotomy.
Publication TypeJournal Article
Year of Publication2017
AuthorsKaramitsos, T. D., Nikolaidou C., Koutsakis A., Anastasiadis K., Karvounis C., & Hadjimiltiades S.
JournalJ Heart Valve Dis
Volume26
Issue3
Pagination368-371
Date Published2017 05
ISSN0966-8519
KeywordsAged, Cardiac Catheterization, Coronary Angiography, Echocardiography, Transesophageal, Heart Failure, Heart Valve Prosthesis Implantation, Hemodynamics, Humans, Iatrogenic Disease, Lutembacher Syndrome, Magnetic Resonance Imaging, Male, Mitral Valve, Mitral Valve Annuloplasty, Mitral Valve Stenosis, Treatment Outcome
Abstract

Atrial septal defects (ASDs) are common immediately after percutaneous mitral commissurotomy (PMC). They are usually small, hemodynamically insignificant, and tend to decrease or disappear within 6 to 12 months. Herein, a case is described of persistent ASD in a patient with mitral valve stenosis who had undergone successful PMC three years previously. The patient had signs and symptoms of right heart failure and severe tricuspid regurgitation (TR) with borderline right ventricular systolic function on echocardiography, in addition to the ASD. Cardiac magnetic resonance (CMR) imaging played a significant role in decision-making by clarifying the anatomy of the ASD and severity of the shunt, measuring right ventricular systolic function, and providing absolute quantification for TR. The right ventricular systolic function was normal on CMR, rendering the patient suitable for surgical treatment. Persistent iatrogenic ASDs have become an increasingly common finding after invasive procedures requiring trans-septal puncture and the manipulation of catheters. Multimodality imaging can provide significant aid in the management of patients with valvular heart disease complicated by iatrogenic shunts.

Alternate JournalJ. Heart Valve Dis.
PubMed ID29092127

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