Congenital Aorta Right Atrial Fistula: Successful Transcatheter Closure With the Amplatzer Occluder
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Sharad Chandra • Sudarshan Vijay • Daljeet Kaur • Sudhanshu Dwivedi
- چاپ و سال / کشور: 2011
Description
A 12-year-old girl with a 4-year history of effort dyspnea and palpitations was referred to our institution for evaluation. Physical examination of the patient showed a continuous grade 3/6 heart murmur best heard along the right upper sternal border. A two-dimensional echocardiogram exhibited a small interatrial septal defect (diameter, 4 mm) with a bidirectional shunt and a high velocity jet in the dilated right atrium. A computed tomographic (CT) angiogram of the patient showed anomalous tortuous communication between the ascending aorta and the right atrium arising adjacent to the right coronary artery (Fig. 1). An ascending aortogram combined with selective angiography confirmed the presence of a large fistula with a broad origin (diameter, 5.6 mm) from the right aortic sinus anterior to the right coronary artery and a narrow termination into the posterior wall of the right atrium (Fig. 2). Cardiac catheterization showed the presence of a left-toright shunt with a pulmonary-to-systemic blood flow ratio (Qp:Qs) of 3:1. Coronary angiography demonstrated normal coronary arteries arising from the respective sinuses. Because the fistula had a separate anterior origin and a narrow terminal ending into the right atrium, a decision was made in favor of transcatheter device closure.
Pediatr Cardiol DOI 10.1007/s00246-011-0026-5 Received: 24 March 2011 / Accepted: 19 May 2011
