case_images: PMC10810588_01
case_images: Echocardiography features in pregnant atrial septal defect patients. A transthoracic echocardiography showed a dilatation of the right atrium, right ventricle, main pulmonary artery (28.1 mm), and an oval-shaped 22 x 33 mm-sized secundum atrial septal defect, with an L-to-R shunt. (A) A four-chamber view. (B) A parasternal short-axis view. Ao, aorta; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.
case_images: ytae014f1.jpg
case_images: PMC10810588_01_ytae014f1.jpg
case_images: ytae014-F1
case_images: A transthoracic echocardiography showed a dilatation of the right atrium (RA), a dilated right ventricle, a dilated main pulmonary artery (28.1 mm; see Figure 1; see Supplementary material online, Video S1), and an oval-shaped 22 x 33 mm-sized secundum ASD with a left-to-right (L-to-R) shunt and transvalvular gradient (TVG) of the tricuspid valve of 55 mmHg (Figure 2A; see Supplementary material online, Video S2A).
case_images: Balloon-assisted non-fluoroscopy secundum atrial septal defect closure in pregnant women. (A) An oval-shaped 22 x 33 mm-sized secundum atrial septal defect with a left-to-right (L-to-R) shunt and transvalvular gradient of the tricuspid valve of 55 mmHg. (B) A transoesophageal echocardiography short-axis image indicates that the left atrial disc dislodged from the right atrium and could not engage correctly (green arrowhead). (C-E) A balloon-assisted approach using a sizing balloon of No. 34 mm (red arrowhead). After the device was finally stowed, a wiggle test was conducted to make sure that it remained stable (orange arrowhead), which was confirmed in a transoesophageal echocardiography bicaval view, (F) transthoracic echocardiography parasternal long-axis view (G), and apical four-chambered view (H).
case_images: ytae014f2.jpg
case_images: PMC10810588_01_ytae014f2.jpg
case_images: ytae014-F2
case_images: A transthoracic echocardiography showed a dilatation of the right atrium (RA), a dilated right ventricle, a dilated main pulmonary artery (28.1 mm; see Figure 1; see Supplementary material online, Video S1), and an oval-shaped 22 x 33 mm-sized secundum ASD with a left-to-right (L-to-R) shunt and transvalvular gradient (TVG) of the tricuspid valve of 55 mmHg (Figure 2A; see Supplementary material online, Video S2A). The device was deployed in the usual position; however, despite numerous placement adjustments, the LA disc kept getting dislodged to the RA and could not engage correctly (Figure 2B). Therefore, we decided to use a balloon-assisted approach using a sizing balloon of No. 34 mm (Figure 2C-E). After the device was finally stowed, a wiggle test was conducted to make sure that the device remained stable (Figure 2F-H; Supplementary material online, Video S2B and C).