Combined percutaneous atrial septal defect occlusion and pulmonary balloon valvuloplasty in adult patients.

Severe pulmonary stenosis in association with a large atrial septal defect is uncommon. When these 2 conditions are present, significant left-to-right shunt is often prevented by the outflow obstruction, which protects the pulmonary bed until adulthood. This report shows our initial experience of percutaneous treatment of both congenital malformations, either staged or combined in the same procedure, in 2 adult patients whose treatments yielded effective atrial septal defect occlusion and right ventricular pressure relief that persisted at mid-term follow-up. Although these opposite procedures (opening and closing) have been applied as isolated methods of treatment, this preliminary experience appears to demonstrate the feasibility and effectiveness of a combined percutaneous treatment.