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Brain & Heart Lipomatous hypertrophy of the septum secundum associated with PFO

A B Author contributions
Conceptualization: Alexandr G. Osiev, Eustaquio Maria
Onorato
Investigation: Sergey Terekhin, Dmitry Shchekochikhin
Methodology: Alexandr G. Osiev
Supervision: Eustaquio Maria Onorato
C D Writing – original draft: Alexandr G. Osiev
Writing – review & editing: Eustaquio Maria Onorato
Ethics approval and consent to participate

Permission was obtained from each of the subjects to
participate in the study.

Figure 4. At the 6-month follow-up, 2D transthoracic echocardiography Consent for publication
(A-C) color Doppler (D) in the apical four-chamber view showed a
correctly aligned, well-seated, and apposed the septum secundum device The patient consented to the publication of the data.
with no residual shunt.
Availability of data
of the occluder, residual shunt, and an increased risk of Data are fully available under explicit request to the
device embolization. To address this anatomical challenge, corresponding author.
utilizing a device with a wider waist that can encompass the
entire length of the septum is crucial, similar to techniques References
employed in atrial septal defect closure procedures. 10,11
1. De Vecchis R, Baldi C, Ariano C. Platypnea-orthodeoxia
Various devices, such as cribriform Amplatzer septal syndrome: Multiple pathophysiological interpretations of a
occluder (Abbott, USA) and the Amplatzer post-infarct clinical picture primarily consisting of orthostatic dyspnea.
12
muscular VSD occluder (Abbott, USA), have been J Clin Med. 2016;5:85.
13
considered for PFO closure in patients with LHSS. These doi: 10.3390/jcm5100085
options are based on the premise that longer or adjustable 2. Agrawal A, Palkar A, Talwar A. The multiple dimensions
waist lengths may optimize the positioning of the two of platypnea-orthodeoxia syndrome: A review. Respir Med.
device disks over the hypertrophied rims of the septum 2017;129:31-38.
secundum.
doi: 10.1016/j.rmed.2017.05.016
4. Conclusion 3. Prior JT. Lipomatous hypertrophy of cardiac interatrial
Our case nicely illustrates the effectiveness of a third-generation septum. A lesion resembling hibernoma, lipoblastomatosis
atrial septal defect device in achieving optimal apposition of and infiltrating lipoma. Arch Pathol. 1964;78:11-15.
the discs to the rims of LHSS. This success is attributed to the 4. Laura DM, Donnino R, Kim EE, Benenstein R, Freedberg RS,
device’s unique flexible nitinol braiding technology, which Saric M. Lipomatous atrial septal hypertrophy: A review
offers an ideal technical solution for RLS abolition. of its anatomy, pathophysiology, multimodality imaging,
and relevance to percutaneous interventions. J Am Soc
Acknowledgments Echocardiogr. 2016;29:717-723.
The authors would like to acknowledge Dr Alexey Knigin, doi: 10.1016/j.echo.2016.04.014
Senior Clinical Specialist, Department of Clinical Support 5. Pochis WT, Saeian K, Sagar KB. Usefulness of transesophageal
and Therapy Development, Cardiomedics, Moscow, echocardiography in diagnosing lipomatous hypertrophy
Russia, for his assistance and logistic help with this case. of the atrial septum with comparison to transthoracic
echocardiography. Am J Cardiol. 1992;70:396-398.
Funding doi: 10.1016/0002-9149(92)90629-d

None. 6. Patsia L, Lartsuliani K, Intskirveli N, Ratiani L. Lipomatous
hypertrophy of the interatrial septum - a benign heart
Conflict of interest anomaly causing unexpected problem in electrophysiology

Eustaquio Maria Onorato is a consultant for Occlutech. (case report). Georgian Med News. 2021;318:72-74.
The remaining authors declare no conflicts of interest. 7. Xanthos T, Giannakopoulos N, Papadimitriou L. Lipomatous

Volume 2 Issue 2 (2024) 4 doi: 10.36922/bh.2190