The Annals of Thoracic Surgery, Vol 48, 295-297, Copyright © 1989 by The Society of Thoracic Surgeons
Surgical implications of atrial septal defect complicating aortic balloon valvuloplasty
JH Lemmer Jr, MD Winniford and DW Ferguson
Department of Surgery, University of Iowa College of Medicine, Iowa City 52242.
An 80-year-old man underwent percutaneous transluminal balloon
valvuloplasty for critical aortic stenosis. The procedure was performed by
the antegrade atrial transseptal approach and was complicated by a
persistent atrial septal defect. Symptoms recurred 6 months later,
restenosis of the aortic valve was confirmed, and the atrial septal defect
yielded a substantially greater left-to-right shunt. This complication of
percutaneous transluminal balloon valvuloplasty poses important problems in
hemodynamic assessment and operative management of patients who undergo
subsequent aortic valve replacement.