Rapid Left Ventricular Recovery After Correction of a Secundum Atrial Septal Defect: Understanding the Hemodynamics

Closure of an atrial septal defect (ASD) may lead to a change in the function of both ventricles. Although right ventricular function typically improves, the left ventricle (LV) may behave in different ways. This has been a matter of much debate, with some authors reporting a decline in LV function after ASD closure and others reporting delayed improvement or no identifiable change. We report the case of a 41-year-old female with a large left-to-right ASD shunt (Qp:Qs 2.3:1 and shunt volume 3.6 L/min) who presented with biventricular systolic dysfunction that improved within 24 hours of ASD closure. We also attempt to explain the underlying hemodynamics responsible for LV failure and recovery in this patient.