TRANSTHORACIC COLOR ECHOCARDIOGRAPHIC EVALUATION OF OPERATED ATRIAL SEPTAL DEFECT IN A PATIENT OF LUTEMBACHER’S SYNDROME: CASE REPORT AND REVIEW OF LITERATURE

Lutembacher syndrome (LS) is an uncommon cardiac condition involving the co-occurrence of an atrial septal defect (ASD) and mitral stenosis. While some individuals may not exhibit symptoms for extended periods, timely intervention significantly improves outcomes. Delayed diagnosis, however, often leads to severe complications such as heart failure and pulmonary hypertension, resulting in a worse prognosis. We are reporting a 47-year-old female who underwent surgical repair for a large secundum ASD in March 2025. A subsequent transthoracic echocardiogram (TTE) revealed an enlarged Coronary sinus (CS) and a residual ASD patch without a detectable shunt.

• Vaideeswar P, Marathe S. Lutembacher's syndrome: Is the mitral pathology always rheumatic? Indian Heart J., 2017; 69: 20-23.
• Adam AM, Godil A, Ali Mallick MS, Khan F, Rizvi AH, Makhdoom IM. Lutembacher syndrome with mitral valve calcification in a 31-year old male. J Pak Med Assoc., 2018; 68: 340-342.
• Aminde LN, Dzudie A, Takah NF, Ngu KB, Sliwa K, Kengne AP. Current diagnostic and treatment strategies for Lutembacher syndrome: the pivotal role of echocardiography. Cardiovasc Diagn Ther., 2015; 5: 122-32.
• Kulkarni SS, Sakaria AK, Mahajan SK, Shah KB. Lutembacher's syndrome. J Cardiovasc Dis Res., 2012; 3: 179-81.
• Bari MA, Haque MS, Uddin SN, Shamsuzzaman M, Khan GK, Sutradhar SR. Lutembacher's Syndrome. Mymensingh Med J., 2005; 14: 206-8.
• Mahajan K, Oliver TI. Lutembacher Syndrome. [Updated 2023 Mar 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Available from: https://www.ncbi.nlm.nih.gov/books/NBK470307/
• Garcia JA, Krajcer Z, Pechacek LW, et al. Echocardiography in the diagnosis of Lutembacher syndrome. Cathet Cardiovasc Diagn, 1978; 4: 283-8.
• Baumgartner H, Hung J, Bermejo J, et al. Echocardiographic assessment of valve stenosis: EAE/ ASE recommendations for clinical practice. J Am Soc Echocardiogr, 2009; 22: 1-23; quiz 101-2.
• Black IW, Hopkins AP, Lee LC, et al. Left atrial spontaneous echo contrast: a clinical and echocardiographic analysis. J Am Coll Cardiol, 1991; 18: 398-404.
• Faletra F, Pezzano A Jr, Fusco R, et al. Measurement of mitral valve area in mitral stenosis: four echocardiographic methods compared with direct measurement of anatomic orifices. J Am Coll Cardiol, 1996; 28: 1190-7.
• American College of Cardiology; American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease); Society of Cardiovascular Anesthesiologists, et al. ACC/ AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol, 2006; 48: e1-148.
• Vahanian A, Baumgartner H, Bax J, et al. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J., 2007; 28: 230-68.
• Kengne AP, Mayosi BM. Readiness of the primary care system for non-communicable diseases in sub-Saharan Africa. Lancet Glob Health, 2014; 2: e247-8.
• Kumar S, Walters TE, Halloran K, et al. Ten-year trends in the use of catheter ablation for treatment of atrial fibrillation vs. the use of coronary intervention for the treatment of ischaemic heart disease in Australia. Europace, 2013; 15: 1702-9.
• Mocumbi AO, Ferreira MB. Neglected cardiovascular diseases in Africa: challenges and opportunities. J Am Coll Cardiol, 2010; 55: 680-7.
• Nagamani AC, Nagesh CM. Lutembacher Syndrome (Ch. 64). In: Vijayalakshmi IB, Syamasundar Rao P, Chugh R. eds. A Comprehensive Approach to Congenital Heart Diseases. India: Jaypee Brothers Medical Publisher, 2013; 908-16.
• Bashi VV, Ravikumar E, Jairaj PS, et al. Coexistent mitral valve disease with left-to-right shunt at the atrial level: clinical profile, hemodynamics, and surgical considerations in 67 consecutive patients. Am Heart J., 1987; 114: 1406-14.
• Fadel BM, Hiatt BL, Kerins DM. Isolated Rheumatic Tricuspid Stenosis with Reverse Lutembacher's Physiology. Echocardiography, 1999; 16: 567-73.
• Jain VV, Gupta OP, Jain J. A rare case of situs inversus with dextrocardia, lutembacher syndrome, and pericardial effusion. Heart Views, 2011; 12: 107-11.
• Olivare-Reyes A. and Al-Kamme A., Lutembacher’s syndrome with small atrial septal defect diagnosed by transthoracic and transesophageal echocardiography that underwent mitral valve replacement, Journal of the American Society of Echocardiography, 2005; 10: 1105.
• Patil C. V., Vijaykumar M., Pande A. V., and Shah L. S., Familial Lutembacher’s syndrome in mother and daughter, Indian Heart Journal, 1997; 4:         415–417.
• Ananthasubramaniam K., Iyer G., and Karthikeyan V., Giant left atrium secondary to tight mitral stenosis leading to acquired Lutembacher syndrome: a case report with emphasis on role of echocardiography in assessment of Lutembacher syndrome, Journal of the American Society of Echocardiography, 2001; 10: 1033–1035.
• Varsha AV, George G, Sahajanandan R. Lutembacher syndrome: Dilemma of doing a tricuspid annuloplasty. Ann Card Anaesth, 2017; 20: 456-458.
• Aminde LN, Dzudie A, Takah NF, Ngu KB, Sliwa K, Kengne AP. Current diagnostic and treatment strategies for Lutembacher syndrome: the pivotal role of echocardiography. Cardiovascular Diagnosis and Therapy, 2015; 5: 122-132.
• Phan Q. T., Nguyen H. L., Le T. D., Lee W., Won H., Shin S., Sharmin S., Nguyen T. Q., and Kim S., Combined percutaneous procedure in patient with Lutembacher syndrome: a case report and real-world experience review, Cardiology Research, 2018; 6: 385–391.
• Mathur R, Sanghvi S, Baroopal A. Percutaneous transcatheter treatment of Lutembacher syndrome. J Assoc Physicians India, 2018; 66: 100-101.