PERSISTENCE OF PULMONARY HYPERTENSION AFTER PERCUTANEOUS ASD CLOSURE – THERAPEUTIC OPTION

Abstract

ASD is a one of the most frequent congenital heart disease. Untreated defect can lead the development of pulmonary hypertension. The qualification to the ASD closure in patients with border line pulmonary pressure is difficult. Patients who have developed pulmonary hyper-tension after percutaneous closure of ASD do not have many therapeutic options apart from pharmacological treatment. In some of these doubtful cases a fenestrated ASD closure device can be useful. This allows the safety valve to be maintained in the event of increasing pressure in the pulmonary circulation and the develop- ment of pulmonary hypertension. It allows for controlled residual shunt in the event of critical increase of pulmonary artery pressure.

Conclusion: The stent implantation through the ASD device is an alternative palliation option for the patients with severe pulmonary hyper-tension after percutaneous ASD closure. We believe that stent implantation can be per- formed even in an unfenestrated (regular) ASD closure devices by transeptal puncture through the device.