Transcatheter Closure of a Rare Right Pulmonary Artery–Left Atrial Fistula in an Adult

Abstract

A 55-year-old Black man presented with ataxia and double vision after unintentional bleach inhalation at work. He was found to have multifocal infarcts on brain magnetic resonance imaging. Oxygen saturation (SpO2) was 82% on room air, requiring 11 L/min of oxygen to maintain an SpO2 of 90%. He had a history of hyperlipidemia and 40 pack-year tobacco use. Cardiac and pulmonary lung examination was unremarkable with no evidence of clubbing. His labs were notable for polycythemia with hemoglobin of 18.7 g/dL (normal 13.0-18.0 g/dL) and a hematocrit of 55.7% (normal 40%-52%).