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Surgical Treatment of Atrial Septal Defect by Occluder Device

  • Laura Gomes Flores
  • Cassiana Tomazoni
  • Patrícia Freitag
  • Evandro Luis Queiroz Flores
  • Rui M. S. Almeida
Chapter

Abstract

Interatrial communication (ASD) is an acyanogenic congenital heart disease characterized by left-right shunt, with a prevalence of 5–10% among all congenital heart defects, rarely diagnosed in infancy and predominant in females. Clinical manifestations usually begin between the third and fourth decades of life and consist of dyspnea, fatigue, and palpitation. Electrocardiogram, chest X-ray, magnetic resonance imaging, and nuclear medicine may aid in diagnosis. However, the echocardiogram is the complementary exam that allows the characterization of the location, size, degree of hemodynamic repercussion of the defect, associated anomalies, and possible complications. In the absence of contraindications, such as significant pulmonary hypertension, the occlusion of atrial septal defects with significant pulmonary systemic flow is recommended by surgical or endovascular procedure. We report a case of a male patient with complaints of palpitations, physical examination with prominent systolic impulses in the chest region, palpable pulmonary artery pulsations in the second left intercostal space, mid-diastolic tinnitus in the lower left sternal margin, previous history of mesenteric venous thrombosis, and prior diagnosis of thrombophilia. After investigation, the diagnosis of ostium secundum ASD was confirmed by echocardiography. Due to its size and shape, and significant shunt from left to right, and since there was not the development of severe pulmonary hypertension, we chose percutaneous closure of the ASD by occluder device. After the procedure, the patient remained stable and was discharged with instructions for the use of aspirin (200 mg) and prophylactic antibiotic therapy for 6 months. During clinical follow-up, there were no recurrences of the symptoms, and echocardiographic evaluations showed no alterations.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Laura Gomes Flores
    • 1
  • Cassiana Tomazoni
    • 1
  • Patrícia Freitag
    • 1
  • Evandro Luis Queiroz Flores
    • 1
  • Rui M. S. Almeida
    • 2
  1. 1.Assis Gurgacz Foundation University (FAG)CascavelBrazil
  2. 2.Department of Cardiology and Cardiovascular SurgeryUniversity Center Assis Gurgacz FoundationCascavelBrazil

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