Percutaneous closure of a hemodynamically significant connection between the inferior vena cava and the left atrium

Catheter Cardiovasc Interv. 2015 Oct;86(4):773-6. doi: 10.1002/ccd.25825. Epub 2015 Feb 12.

Abstract

Objective and background: A connection between the inferior vena cava (IVC) and the left atrium (LA) can occur as a rare complication after surgical atrial septum defect (ASD) repair. We demonstrate the first case of a percutaneous closure of this connection.

Methods and results: A 67-year-old female was admitted to hospital due to exertional dyspnea. A history of a surgical ASD repair in 1960 and 1966 with a residual shunt was already known. Transesophageal echocardiography and a CT scan revealed a hemodynamically significant drainage of the IVC into the LA. This connection was successfully closed percutaneously with an AMPLATEZR Duct Occluder I (St. Jude Medical, St. Paul, MN). Post-procedural CT-scan and transthoracic echocardiography demonstrated a stable position and there was also no evidence of a residual shunt. The patient reported a significant reduction of exertional dyspnea.

Conclusion: Percutaneous closure of an IVC to LA connection in this case was safe and feasible. The decision about which device is optimal must be made on an individual basis.

Keywords: AV fistula/AVM; closure; interventional devices/innovation; vena cava.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Balloon Occlusion / instrumentation*
  • Balloon Occlusion / methods
  • Cardiac Catheterization / methods
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiac Surgical Procedures / methods
  • Echocardiography, Transesophageal / methods
  • Female
  • Follow-Up Studies
  • Heart Atria*
  • Heart Septal Defects, Atrial / diagnostic imaging
  • Heart Septal Defects, Atrial / surgery*
  • Hemodynamics / physiology
  • Humans
  • Imaging, Three-Dimensional / methods
  • Risk Assessment
  • Septal Occluder Device*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Vascular Fistula / diagnostic imaging
  • Vascular Fistula / etiology
  • Vascular Fistula / therapy*
  • Vena Cava, Inferior