Abstract
A 57-year-old woman required repetitive hospitalization because of decompensated heart failure. She has an atrial septal defect (ASD) with midventricular obstruction (MVO) type of hypertrophic cardiomyopathy (HCM) confirmed by echocardiography. A pressure study documented an increased left ventricular (LV) end-diastolic pressure (20 mmHg) and pulmonary hypertension. Examinations of oxymetry revealed the left-to-right atrial shunt ratio of 52.8% with the pulmonary to systemic flow rate of 2.58. Temporally ASD closure using an occlusion balloon catheter induced an abrupt increase in left atrial pressure from 22 mmHg to 53 mmHg as shown in Figure.
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