Percutaneous closure of a large atrial septal defect in a child with severe dextroscoliosis: A case report

Linte,Adrian; Balanescu,Andra   Rodica; Onorato,Eustaquio; Balanescu,Dinu   Valentin; Bojinca,Violeta   Claudia; Drakonaki,Elena; Bojinca,Mihai; Balanescu,Serban   Mihai

doi:10.3892/etm.2018.6991

August-2019 Volume 18 Issue 2

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August-2019 Volume 18 Issue 2

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Case Report

Percutaneous closure of a large atrial septal defect in a child with severe dextroscoliosis: A case report

Authors:
- Adrian Linte
- Andra Rodica Balanescu
- Eustaquio Onorato
- Dinu Valentin Balanescu
- Violeta Claudia Bojinca
- Elena Drakonaki
- Mihai Bojinca
- Serban Mihai Balanescu
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Affiliations: Department of Cardiology, Elias Emergency University Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, 011461 Bucharest, Romania, Department of Internal Medicine and Rheumatology, ‘Sfanta Maria’ Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, 011172 Bucharest, Romania, Department of Cardiovascular, Humanitas Gavazzeni Clinic, I-24125 Bergamo, Italy, Independent Radiology Practice, 71202 Heraklion, Greece, Department of Internal Medicine and Rheumatology, ‘Dr. I. Cantacuzino’ Clinical Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest, Romania
Pages: 972-975
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Published online on: November 19, 2018

https://doi.org/10.3892/etm.2018.6991
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Abstract

In this study, we present the case of an 11-year-old child with cachexia, severe dextroscoliosis, pectus carinatum, secondary restrictive pulmonary disease, and an incidental finding of a large ostium secundum atrial septal defect (ASD) that was identified on preoperative assessment for surgical correction of the spinal deformity. Transthoracic and transesophageal echocardiography confirmed significant left‑to‑right shunting with a pulmonary blood flow to systemic blood flow ratio (Qp/Qs) of 3.18 through a 14 mm defect with good circumferential rims, larger than 5 mm. Despite significant left‑to‑right shunting, the defect was found prior to the development of pulmonary hypertension or right heart enlargement. The decision to close the atrial septal defect by percutaneous intervention was preferred over surgical closure, due to the restrictive pulmonary physiology and low body mass index (12.6 kg/m2). Percutaneous closure of the ASD was successfully performed under general anesthesia using an Occlutech Figulla Flex II ASD device, with no residual shunt. Surgical correction of the dextroscoliosis was subsequently performed with good results. A comprehensive clinical and echocardiographic evaluation is needed in patients with skeletal abnormalities in order to rule out associated congenital heart defects, which may impose therapeutic challenges.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Percutaneous closure of a large atrial septal defect in a child with severe dextroscoliosis: A case report

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Abstract

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