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Biventricular Interatrial Shunt With Desaturation After Atrial Septal Defect Repair

Year: 2025

Type: article

Abstract: BACKGROUND: Patients after atrial septal defect (ASD) repair with residual shunt, elevated pulmonary arterial pressure or arrhythmias, and those repaired at adult age should be followed on a regular basis. CASE SUMMARY: This case describes a 43-year-old female with previous ASD repair, who presented with breathlessness, tiredness, and evidence of desaturation on exercise with a mildly positive bubble echo. While local investigations were inconclusive, diagnostic tests performed at our center revealed an inferior sinus venosus ASD-type defect with bidirectional flow, even though neither right-heart dilatation, pulmonary hypertension nor hemodynamically significant shunt was identified. The patient was offered surgical repair of the residual interatrial communication to give the patient symptomatic benefit. DISCUSSION: This case demonstrates a rare presentation of a post-ASD repair patient with bidirectional shunt without right-heart overload and no pulmonary hypertension. TAKE-HOME MESSAGE: Patients with repaired congenital defects should be followed up by specialized congenital services at reasonable interval based on the lesion and the results of the repair.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105743

Authors: Oleksandr Danylenko, Sonya Babu-Narayan, Margarita Brida, Ee Ling Heng, Wei Li

Institutions: Guy's and St Thomas' NHS Foundation Trust, Royal Brompton Hospital

Language: English

Topic: Congenital Heart Disease Studies

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850