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You are here: Contents > 2017 > Volume 26 Number 3 May 2017 > CASE REPORTS > Iatrogenic Lutembacher Syndrome after Percutaneous Mitral Commissurotomy

Iatrogenic Lutembacher Syndrome after Percutaneous Mitral Commissurotomy

Theodoros D. Karamitsos1,3, Chrysovalantou Nikolaidou1, Athanasios Koutsakis1, Kyriakos Anastasiadis2, Charalambos Karvounis1, Stavros Hadjimiltiades1

1First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
2Cardiothoracic Department, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
3Electronic correspondence: tkaramitsos@auth.gr

Atrial septal defects (ASDs) are common immediately after percutaneous mitral commissurotomy (PMC). They are usually small, hemodynamically insignificant, and tend to decrease or disappear within 6 to 12 months. Herein, a case is described of persistent ASD in a patient with mitral valve stenosis who had undergone successful PMC three years previously. The patient had signs and symptoms of right heart failure and severe tricuspid regurgitation (TR) with borderline right ventricular systolic function on echocardiography, in addition to the ASD. Cardiac magnetic resonance (CMR) imaging played a significant role in decision-making by clarifying the anatomy of the
ASD and severity of the shunt, measuring right ventricular systolic function, and providing absolute quantification for TR. The right ventricular systolic function was normal on CMR, rendering the patient suitable for surgical treatment. Persistent iatrogenic ASDs have become an increasingly common finding after invasive procedures requiring trans-septal puncture and the manipulation of catheters. Multimodality imaging can provide significant aid in the management of patients with valvular heart disease complicated by iatrogenic shunts.

The Journal of Heart Valve Disease 2017;26:368-371


Iatrogenic Lutembacher Syndrome after Percutaneous Mitral Commissurotomy

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