Figure 3.

Restrictive cardiomyopathy (RCM), effects of a restrictive interatrial communication. Two-dimensional (2-D) echocardiography (apical four-chamber view) and continuous wave (CW)-Doppler measurements (tricuspid regurgitation, TR) of a toddler with RCM referred for heart transplantation (HTx); the 2-D echocardiography shows massive left atrial enlargement associated with a ‘out-of-proportional’ left atrial pressure related pulmonary hypertension at a suprasystemic level (systolic pressure gradient of 97 mm Hg, upper panel). The creation of a restrictive atrial septum defect, by placing a stent within the perforated atrial septum, led to a decreased left atrial dimension/pressure as well as reduced pulmonary artery pressures (lower panel). Placement of an assist device could be avoided, a successful HTx performed.