Successful Percutaneous Device Closure of a Large Secundum Atrial Septal Defect in an Elderly Female with COPD and Atrial Fibrillation: A Case Report
Kalyan Munde
Department of Cardiology, JJ Hospital, Mumbai, India.
Rahul Sonawane *
Department of Cardiology, JJ Hospital, Mumbai, India.
Samkit Mutha
Department of Cardiology, JJ Hospital, Mumbai, India.
Anant Munde
Department of Cardiology, JJ Hospital, Mumbai, India.
Ruchit Shah
Department of Cardiology, JJ Hospital, Mumbai, India.
Khalil Shaikh
Department of Cardiology, JJ Hospital, Mumbai, India.
Jaykrishna Nihari
Department of Cardiology, JJ Hospital, Mumbai, India.
Anagh T S
Department of Cardiology, JJ Hospital, Mumbai, India.
Prasad Jain
Department of Cardiology, JJ Hospital, Mumbai, India.
Vaishali Gaba
Department of Cardiology, JJ Hospital, Mumbai, India.
Divya Kantak
Department of Cardiology, JJ Hospital, Mumbai, India.
Sandip Ghoti
Department of Cardiology, JJ Hospital, Mumbai, India.
Suvarna Thorat
Department of Cardiology, JJ Hospital, Mumbai, India.
Dhanlaxmi Chettiar
Department of Cardiology, JJ Hospital, Mumbai, India.
*Author to whom correspondence should be addressed.
Abstract
We describe a 72-year-old female with chronic obstructive pulmonary disease (COPD), atrial fibrillation, and a large ostium secundum atrial septal defect (ASD), who presented with progressive dyspnea, hypoxemia, and acute COPD exacerbation. Despite advanced age, lung disease, arrhythmia, and a high surgical risk score, the defect was successfully closed percutaneously using a 46 mm Lifetech CERA device. ASD and COPD both have synergistic effect on Right heart volume overload leading to Right heart failure. This case demonstrates that transcatheter ASD closure can be safely and effectively performed in carefully selected elderly patients with significant left-to-right shunting and without Eisenmenger physiology, even in the presence of multiple comorbidities (1–3). Transcatheter ASD closure has less adverse events and faster recovery rates with reduction in duration of Hospital stay as compared to surgical closure.
Keywords: Percutaneous device closure, COPD, atrial fibrillation, fluoroscopy, pulmonary hypertension, right heart failure