Atrial Septal Defect Closure: Not Always Straightforward.
W Jack WallenCarl L BackerPublished in: World journal for pediatric & congenital heart surgery (2024)
A nine-year old boy presented following a chest x-ray for COVID-19 infection that showed cardiomegaly. Transthoracic echocardiogram revealed a large atrial septal defect, dilated right heart, and normal function. Surgical repair was performed eight weeks after his COVID diagnosis. After weaning from cardiopulmonary bypass, pulmonary artery pressures were 2/3 systemic and ectopy was seen, requiring inotropes, nitric oxide, lidocaine, and amiodarone. He was discharged on postoperative day (POD) 5. On POD 6, he presented with acute right foot ischemia. Computed tomography showed a large aortic thrombus, requiring emergent thrombectomy. Coagulopathy workup was negative. Cardiac magnetic resonance imaging (CMR) and catheterization showed reduced biventricular function and diastolic dysfunction. Diuretics and β blockers were started, with gradual improvement in left ventricular systolic function.
Keyphrases
- left ventricular
- pulmonary artery
- magnetic resonance imaging
- computed tomography
- left atrial
- heart failure
- nitric oxide
- cardiac resynchronization therapy
- coronary artery
- hypertrophic cardiomyopathy
- pulmonary hypertension
- atrial fibrillation
- blood pressure
- pulmonary arterial hypertension
- coronavirus disease
- sars cov
- acute myocardial infarction
- dual energy
- oxidative stress
- contrast enhanced
- liver failure
- positron emission tomography
- aortic dissection
- single cell
- magnetic resonance
- intensive care unit
- drug induced
- transcatheter aortic valve replacement
- mechanical ventilation
- respiratory failure
- preterm birth
- pet ct
- ultrasound guided