Percutaneous PFO closure in adult patient with Ebstein anomaly and cyanosis

Abstract

Ebstein anomaly is a congenital malformation of the tricuspid valve (TV) that is rarely diagnosed in adult population. It is associated with interatrial communication whether by an atrial septal defect (ASD) or parent foramen oval (PFO) in 80–90% of patients. In non surgical candidates, percutaneous closure of the interatrial communication is not always tolerated. Herein we present the case of 61 year-old man who was diagnosed with Ebstein anomaly that was associated with large patent foramen oval resulting in right to left shunt and causing dyspnea, exercise intolerance and peripheral cyanosis which was not corrected with oxygen administration. Our patient was treated with percutaneous closure of PFO by deployment of Amplatzer septal occluder. We noted a dramatic improvement of the pulse oxygen saturation while in the catheterization laboratory and marked clinical improvement of the dyspnea and exercise tolerance at 2 and 4 week follow-up.

Keywords

• Ebstein anomaly
• Right to left shunt
• Congenital heart defect
• Right heart failure
• Percutaneous closure