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Managing a Challenge Case: Transesophageal Echocardiography-Guided Transcatheter Closure of a Large Secundum Atrial Septal Defect in a Pregnant Woman

Heart Science Journal · Vol. 5 No. 2 (2024) · pp. 67–71

DOI
10.21776/ub/hsj.2024.005.02.12
ISSN
2721-9984, 2721-9976
Published
2024-04-28
Publisher
Universitas Brawijaya
Language
en

Abstract

Background: The management of complex cardiovascular conditions during pregnancy poses unique challenges, and in the case of a large secundum atrial septal defect (ASD), achieving successful closure through a transcatheter approach guided by transesophageal echocardiography (TEE) requires careful navigation and expertise. This study sought to present a case that exemplifies the contemporary approach of using TEE guidance for the closure of an ASD in pregnant womenCase presentation: A 31-year-old woman with multigravida, diagnosed with secundum ASD and pulmonary hypertension, underwent TEE. The TEE examination revealed a significant ASD measuring 2.8-3.1 cm with inadequate surrounding rims. Subsequently, our intention was to employ a device to address this defect. TEE was utilized to guide the placement of a 14F delivery sheath into the left upper pulmonary vein and left atrium. Using a catheter, we successfully deployed a 40 mm ASD Occluder (MemoPart), concluding the intervention without any complications. Given the concerns regarding the potential risks of radiation exposure and teratogenic effects on fetal development, particularly in young patients and during pregnancy, it is crucial to prioritize TEE-guided closure of ASD for the safety of both the mother and the fetus.Conclusion: Closure of ASD with zero fluoroscopy proved to be a safe and effective procedure, demonstrating feasibility and significant benefits for pregnant women with ASD.

Keywords

Collaboration network of the authors

40 authors · 294 co-authorship links · showing the 40 most connected

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  • University of Brawijaya
  • Affiliation unknown
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  • Same organisation
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Mohammad Saifur RohmanAffiliation unknown29
Ardian RizalAffiliation unknown24
Cholid Tri TjahjonoAffiliation unknown20
Indra PrasetyaAffiliation unknown20
Novi KurnianingsihAffiliation unknown15
Djanggan SargowoAffiliation unknown14
Budi SatrijoAffiliation unknown12
Setyasih AnjarwaniAffiliation unknown12
Wella KarolinaAffiliation unknown9
Sasmojo WiditoAffiliation unknown8
Valerinna YogibuanaAffiliation unknown8
Lukitasari Ayu GaluhAffiliation unknown6
Nikhen NoverikeAffiliation unknown4
Yoga WaranugrahaAffiliation unknown4
Tri AstiawatiAffiliation unknown4
Imelda KrisnasariAffiliation unknown3
Ayu Asri Devi AdityawatiAffiliation unknown3
Muhammad Rizki FadlanAffiliation unknown3
Seprian WidasmaraAffiliation unknown3
Nur Kaputrin DwigustiningrumAffiliation unknown3
Lutfi Hafiz ZunardiAffiliation unknown3
Indra Jabbar AzizAffiliation unknown3
Adhika Prastya WikanandaAffiliation unknown3
Veny KurniawatiAffiliation unknown2
Taufieq Ridlo MakhmudAffiliation unknown2
Faris Wahyu NugrohoAffiliation unknown2
Zainal FathurohimAffiliation unknown2
Teguh AryanugrahaAffiliation unknown2
Muhammad FirdausAffiliation unknown2
Putri Annisa KamilaUniversity of Brawijaya2
Dea Arie KurniawanAffiliation unknown2
Akhmad Isna NurudinullohAffiliation unknown2
Ratna PancasariAffiliation unknown2
Fandy Hazzy AlfataAffiliation unknown2
Saskia Dyah HandariAffiliation unknown2
Imam Mi'raj SuprayogaAffiliation unknown2

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Managing a Challenge Case: Transesophageal Echocardiography-Guided Transcatheter Closure of a Large Secundum Atrial Septal Defect in a Pregnant Woman</dc:title>
	<dc:creator xml:lang="en">Fathoni, Emil</dc:creator>
	<dc:creator xml:lang="en">Martini, Heny</dc:creator>
	<dc:creator xml:lang="en">Rahimah, Anna Fuji</dc:creator>
	<dc:creator xml:lang="en">Putri, Valerinna Yogibuana Swastika</dc:creator>
	<dc:subject xml:lang="en">Atrial Septal Defect</dc:subject>
	<dc:subject xml:lang="en">Transcatheter Closure</dc:subject>
	<dc:subject xml:lang="en">Pregnant Woman</dc:subject>
	<dc:subject xml:lang="en">Transesophageal Echocardiography</dc:subject>
	<dc:description xml:lang="en">Background: The management of complex cardiovascular conditions during pregnancy poses unique challenges, and in the case of a large secundum atrial septal defect (ASD), achieving successful closure through a transcatheter approach guided by transesophageal echocardiography (TEE) requires careful navigation and expertise. This study sought to present a case that exemplifies the contemporary approach of using TEE guidance for the closure of an ASD in pregnant womenCase presentation: A 31-year-old woman with multigravida, diagnosed with secundum ASD and pulmonary hypertension, underwent TEE. The TEE examination revealed a significant ASD measuring 2.8-3.1 cm with inadequate surrounding rims. Subsequently, our intention was to employ a device to address this defect. TEE was utilized to guide the placement of a 14F delivery sheath into the left upper pulmonary vein and left atrium. Using a catheter, we successfully deployed a 40 mm ASD Occluder (MemoPart), concluding the intervention without any complications. Given the concerns regarding the potential risks of radiation exposure and teratogenic effects on fetal development, particularly in young patients and during pregnancy, it is crucial to prioritize TEE-guided closure of ASD for the safety of both the mother and the fetus.Conclusion: Closure of ASD with zero fluoroscopy proved to be a safe and effective procedure, demonstrating feasibility and significant benefits for pregnant women with ASD.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2024-04-28</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/12875</dc:identifier>
	<dc:identifier>10.21776/ub/hsj.2024.005.02.12</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases; 67-71</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2024.005.02</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/12875/408</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2024 Emil Fathoni, Heny Martini, Anna Fuji Rahimah, Valerinna Yogibuana Swastika Putri</dc:rights>
</oai_dc:dc>