Suzuki Makiko, Matsumoto Kensuke, Suto Makiko, Taniguchi Yayoi, Tanaka Hidekazu, Otake Hiromasa, Shinke Toshiro, Hirata Ken-Ichi
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Intern Med. 2020 Apr 15;59(8):1059-1063. doi: 10.2169/internalmedicine.4070-19. Epub 2020 Feb 1.
A 92-year-old man was referred to our hospital with decompensated heart failure. He was treated with diuretics and inotropic agents, but the clinical response was unsatisfactory. Echocardiography incidentally revealed an atrial septal defect (ASD) with a significant left-to-right shunt and pulmonary-to-systemic-blood-flow ratio of 2.36. Because the ASD was considered to be the primary cause of his treatment-resistant heart failure, the patient underwent transcatheter ASD closure. Shortly after shunt closure, his hemodynamics significantly improved, and he was discharged nine days later. This is an extremely rare case of a nonagenarian who showed an excellent clinical course after transcatheter ASD closure.
一名92岁男性因失代偿性心力衰竭被转诊至我院。他接受了利尿剂和正性肌力药物治疗，但临床反应并不理想。超声心动图偶然发现房间隔缺损（ASD），伴有明显的左向右分流，肺循环与体循环血流量之比为2.36。由于ASD被认为是其难治性心力衰竭的主要原因，该患者接受了经导管ASD封堵术。分流关闭后不久，他的血流动力学显著改善，九天后出院。这是一例极为罕见的病例，一名九旬老人在经导管ASD封堵术后临床过程良好。
