Real-time evaluation of the hemodynamic effects of atrial septal defect closure in adults with left ventricular dysfunction

Transcatheter closure of atrial septal defects with left-to-right shunt induces an abrupt overload of the left ventricle that may cause acute heart failure in patients with left ventricular dysfunction. We report two cases of ostium secundum atrial septal defects associated with left ventricular dysfunction of different etiology. The hemodynamic evaluation of left ventricular function during transient abolition of the shunt with the sizing balloon of the Amplatzer system helped to establish the most correct therapeutic strategy.