Long-term follow-up of a fenestrated Amplatzer atrial septal occluder in pulmonary arterial hypertension

Chest. 2008 Jan;133(1):283-5. doi: 10.1378/chest.07-1222.


Pulmonary arterial hypertension (PAH) is a progressive disease, with right-heart failure being the main cause of death. In patients refractory to conventional drug therapy, atrial septostomy can serve as palliative treatment or as a bridge to transplantation. A 41-year-old woman with a 15-year history of PAH associated with a corrected atrial septal defect presented with severe deterioration of symptoms. Echocardiography confirmed reocclusion of an atrial septal stoma that had been created several months before. After performing a repeat atrial septostomy, we implanted a custom-made atrial septostomy device, an Amplatzer septal occluder that had been fenestrated to serve as a custom-made atrial septostomy device. This resulted in an improvement in cardiac output and a marked symptomatic relief. During the 6-year follow-up, the patient was clinically stable with limited but constant exercise tolerance, under specific medical therapy. Repeated echocardiography confirmed long-term patency of the device.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Heart Septal Defects, Atrial / complications
  • Heart Septal Defects, Atrial / surgery*
  • Humans
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / surgery*
  • Prostheses and Implants*
  • Prosthesis Design
  • Time Factors