Abstract

A 73-year-old woman known to have multiple atrial septal defects (mASD) since 2006 rejected cardiac surgery and was referred to our department with signs of right heart failure. Echocardiography demonstrated one defect located in the inferior portion of the atrial septum that led to an overriding inferior vena cava (IVC) – an inferior sinus venosus defect (SVD) and two additional ostium secundum ASDs (ASDII; Figure 1). Furthermore, a significant left-to-right atrial shunt and dilation of the right ventricle were observed.

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