Shi Xiaoqing, Wang Kaiyang, Li Jinhui, Wu Jinlin, Zhou Kaiyu, Hua Yimin, Li Yifei
Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Medicine (Baltimore). 2020 Nov 20;99(47):e22576. doi: 10.1097/MD.0000000000022576.
Left ventricle-right atrium (LV-RA) shunt is a rare case and surgical repair has been the routine procedure to correct this defect. With the rapid development of transcatheter technology, some of the cases can be closed with transcatheter technique. Here, we would like to report a congenital LV-RA case who received transcatheter closure using the Amplazter duct occluder II (ADO II) and the short-term outcomes of this procedure.
A 2-year-old female presented a systolic murmur between the 2 to 3 sternal rib during the routine examination before kindergarten administration.
The patient denied any cardiac surgery, endocarditis, trauma or cardiomyopathy. The echocardiography confirmed an abnormal shunt between left ventricle and right atrium located in the superior part of ventricular septum which is closed to septal tricuspid valve and anterior mitral valve, and the diameter of this shunt is 2 mm. Besides, the dilation of right atrium (40 mm) has been identified which was not a common clinical manifestation of typical ventricular septal defect. Angiography demonstrated the shunt driven from left ventricle to right atrium.
An AGA ADO II device had been delivered to close the defect.
Follow-up kept for 3 months. Echocardiography revealed completed closure of the shunt with normal movement and function valves. And no complication of arrhythmia has been recorded.
This case report highlighted the administration of ADO II in some ventricular septal defect with superior location, and provided an essential experience of using ADO II to close long tunnel type LV-RA shunt.
左心室-右心房（LV-RA）分流是一种罕见病例，外科修复一直是纠正该缺陷的常规手术。随着经导管技术的迅速发展，部分病例可用经导管技术闭合。在此，我们报告1例先天性LV-RA病例，其使用Amplatzer封堵器II（ADO II）进行经导管闭合及该手术的短期结果。
一名2岁女性在幼儿园入园前的常规检查中，于胸骨第2至3肋间出现收缩期杂音。
患者否认有任何心脏手术、心内膜炎、外伤或心肌病病史。超声心动图证实左心室与右心房之间存在异常分流，位于室间隔上部，靠近三尖瓣隔叶和二尖瓣前叶，分流直径为2毫米。此外，已发现右心房扩张（40毫米），这并非典型室间隔缺损的常见临床表现。血管造影显示分流从左心室流向右心房。
植入一枚AGA ADO II装置以闭合缺损。
随访3个月。超声心动图显示分流完全闭合，瓣膜活动及功能正常。且未记录到心律失常并发症。
本病例报告强调了ADO II在一些位置较高的室间隔缺损中的应用，并提供了使用ADO II闭合长隧道型LV-RA分流的重要经验。
