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Catheter Cardiovasc Interv. 2019 Mar 6. doi: 10.1002/ccd.28169. [Epub ahead of print]

Novel shunt modification with an adjustable stent-embedded "fenestrated" septal occluder in a patient with pulmonary hypertension.

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Bluhm Cardiovascular Institute and the Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.


A 60-year-old woman with progressive dyspnea and cyanosis, O2-dependent pulmonary hypertension despite optimal medical therapy and remote atrial septostomy presented with worsening cyanosis and right-to-left shunting. The creation of a "fenestrated" ASD closure device with the insertion of a peripheral stent through an AMPLATZERâ„¢ ASD closure device was deployed to minimize right to left shunting and allow for enlargement of the shunt if needed. This case demonstrates the benefit of diminishing a right to left shunt with a self-fabricated fenestrated AMPLATZER device to improve symptoms in pulmonary hypertension patients with a pre-existing ASD.


adjustable; fenestrated ASD; pulmonary hypertension; shunt


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