Mechanism
There is no exact mechanism for Lutembachers syndrome but instead a combination of disorders as the result of Atrial septal defect (ASD) and/or Mitral valve stenosis.It is thought ASD is caused by the failure to close the hole (foramen ovale) between the right and left atrium normally found within the heart during fetal development; the creation of a hole between the atrium may also be acquired. There are two types of ASD: Ostium secundum and ASD Primum. Atrial Septal Defect Primum
The failure of the hole between the right and left atrium to close shortly after birth is the cause behind ASD primum. During fetal development blood will pass from the umbilical cord and flow into the left atrium through a hole between the two atria. Once a baby is born and the lungs begin to fill with air, the blood flow of the heart changes; a tissue flap (septum primum) normally closes the hole (foramen ovale) between the two atria and becomes part of the atrial wall. During ASD primum, after birth the hole is not completely closed allowing blood to flow into the right atria from the left atria.
Side effects
Possible side effects from this non-invasive procedure could be:
fever
Chest pain
Shortness of breath
Unusual swelling or weight gain
Swelling, bleeding, change in skin color at site of initial catheterization in groin, or pain in the groin.If any of the above symptoms occur, it is important to contact your doctor to prevent another lapse of mitral stenosis. To ensure good health, routine doctors visits, diet, weight loss, doctor-approved exercise, and use of antibiotics in dental and other procedures are recommended. Device closure
To treat ASD a device closure can be used. In fact an ASD closure is often recommended for certain cases such as with a patient who has significant left-to-right shunt with a pulmonary and/or systemic flow fraction of Qp/Qs >1.5. It is best to perform this procedure/surgery between the ages of 2–4 years. The closure is done by two methods: interventionally or surgically. Interventionally
This procedure is done by placing a device such as Amplatzer "umbrella", CardioSEAL similar to percutaneous transcatheter therapy. A catheter is inserted in the vessels and threaded to the heart and inserted into the ASD closing the defect. Other closure device that have been used is the GORE HELEX Septal Occluder. After the device has been inserted and covers the defect, over time tissue will grow over the implant device to make it become part of the heart. Anticoagulant medication will be given to the patient for the first six months following the surgery: aspirin, clopidogrel or warfarin (Coumadin).