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Case Reports
. 2017 Jul;10(7):e004160.
doi: 10.1161/CIRCHEARTFAILURE.117.004160.

Atrial Septostomy to Treat Stiff Left Atrium Syndrome

Pranav Chandrashekar  1 , Jae Yoon Park  1 , Mohammad A Al-Hijji  1 , Yogesh N V Reddy  1 , Chad J Zack  1 , Guy S Reeder  1 , Robert F Rea  1 , Barry A Borlaug  2
Affiliations
Case Reports

Atrial Septostomy to Treat Stiff Left Atrium Syndrome

Pranav Chandrashekar et al. Circ Heart Fail. 2017 Jul.
No abstract available

Keywords: atrial fibrillation; atrial septal defect; left atrial pressure; left atrium; pulmonary hypertension.

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Conflict of interest statement

Conflict of Interest Disclosures: None

Figures

Figure 1
Figure 1
Direct left atrial hemodynamic pressure tracings obtained following transseptal puncture: (A) prior to septostomy, demonstrating giant V waves to 39 mmHg (red arrow); (B) immediately following septostomy, demonstrating significantly decreased V-wave to 20 mmHg; and (C) 1 year post procedure tracing showing sustained decrease in V-wave pressure.
Figure 2
Figure 2
Post-septostomy transthoracic echocardiogram demonstrates an inter-atrial shunt with blood flow from left to right.
Figure 3
Figure 3
Hypothetical left atrial (LA) pressure-volume loops in this patient prior to septostomy (A) and following septostomy (B). The LA diastolic pressure volume relationship is steep at higher volumes, thus a small increase in LA volume in this range leads to a large increase in LA pressure with increase in the peak of the V wave. With the shunt induced by septostomy, LA volume shifts down to the more compliant range in the pressure-volume relationship, where V wave pressure amplitude is decreased.
See this image and copyright information in PMC

References

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