Sandeep Goel1, Ranjit Nath2, Ajay Sharma3, Neeraj Pandit4, Harsh Wardhan5. 1. Senior Resident, Department of Cardiology, Dr RML Hospital and PGIMER, New Delhi, India. Electronic address: dr_sandeepgoel@yahoo.com. 2. Associate Professor, Department of Cardiology, Dr RML Hospital and PGIMER, New Delhi, India. Electronic address: ranjitknath@yahoo.com. 3. Assistant Professor, Department of Cardiology, Dr RML Hospital and PGIMER, New Delhi, India. Electronic address: drajayabss@gmail.com. 4. Professor, Department of Cardiology, Dr RML Hospital and PGIMER, New Delhi, India. Electronic address: neerajpandit@gmail.com. 5. Professor, Department of Cardiology, Dr RML Hospital and PGIMER, New Delhi, India. Electronic address: hwardhan@hotmail.com.
Abstract
BACKGROUND: The surgical management of Lutembacher syndrome is straight forward but percutaneous management, though technically demanding, is always desirable. METHODS: A 17 year old unmarried female presented with severe Mitral stenosis and a 19 mm almost circular Ostium secundum ASD with moderate pulmonary artery hypertension and dilated right sided chambers. She was managed in a staged manner. Percutaneous trans mitral commissurotomy (PTMC) was done first, using a 26 mm Inoue balloon catheter set, and after 48 h, ASD was closed with a 20 mm Cocoon Septal Occluder. RESULTS: The mitral valve area increased after PTMC from 0.8 cm2 to 2.1 cm2 and QP/QS decreased from 4.9 to 2. ASD was successfully closed under echocardiographic and fluoroscopic guidance. CONCLUSION: Percutaneous management of the Lutembacher syndrome (PTMC and ASD device closure) is an effective and low risk procedure and avoids considerable morbidity and mental trauma for the patients.
BACKGROUND: The surgical management of Lutembacher syndrome is straight forward but percutaneous management, though technically demanding, is always desirable. METHODS: A 17 year old unmarried female presented with severe Mitral stenosis and a 19 mm almost circular Ostium secundum ASD with moderate pulmonary artery hypertension and dilated right sided chambers. She was managed in a staged manner. Percutaneous trans mitral commissurotomy (PTMC) was done first, using a 26 mm Inoue balloon catheter set, and after 48 h, ASD was closed with a 20 mm Cocoon Septal Occluder. RESULTS: The mitral valve area increased after PTMC from 0.8 cm2 to 2.1 cm2 and QP/QS decreased from 4.9 to 2. ASD was successfully closed under echocardiographic and fluoroscopic guidance. CONCLUSION: Percutaneous management of the Lutembacher syndrome (PTMC and ASD device closure) is an effective and low risk procedure and avoids considerable morbidity and mental trauma for the patients.
Authors: Carole A Warnes; Roberta G Williams; Thomas M Bashore; John S Child; Heidi M Connolly; Joseph A Dearani; Pedro Del Nido; James W Fasules; Thomas P Graham; Ziyad M Hijazi; Sharon A Hunt; Mary Etta King; Michael J Landzberg; Pamela D Miner; Martha J Radford; Edward P Walsh; Gary D Webb Journal: J Am Coll Cardiol Date: 2008-12-02 Impact factor: 24.094