PMC8305124_01
Interatrial Shunt Device and its Fluoroscopic and Echocardiographic Appearance. The more prominent profile is directed toward the right atrium, whereas the flat side stays toward the left atrium. This can be appreciated fluoroscopically in left anterior oblique projection (C, black arrow), while its 8-mm lumen diameter is best appreciated in right anterior oblique projection (D, black arrow). Intracardiac echocardiography shows a region of the fossa ovalis amenable to transseptal puncture inferior to the interatrial shunt device (E, white arrow). Color Doppler imaging confirms patent interatrial shunt device (red flow demonstrates left-to-right shunt, F); this view also shows the prominent right atrial (RA) profile of the interatrial shunt device. LA = left atrium
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IASD was percutaneously implanted across the fossa ovalis (FO), creating an iatrogenic left-to-right shunt (Figure 1). In addition, he had hypertension, coronary artery bypass 20 years prior, obstructive sleep apnea, and morbid obesity.