Killing Two Birds in One Stone-Percutaneous Treatment of a Large ASD and Pulmonary Stenosis in the Same Setting in an Adult Patient-a Case Report.

Pulmonary stenosis (PS) associated with a huge ostium secundum Atrial septal defect (ASD) is relatively uncommon. In such condition, a significant left-to-right shunt across ASD is prevented by significant obstruction at pulmonary valve level and hence it protects the pulmonary bed until adulthood. Transcatheter intervention is the treatment of choice when they occur separately but when they occur together, ideal treatment option is not clear. As per literature, percutaneous transcatheter pulmonary valvuloplasty was performed first, followed by transcatheter closure of the secundum atrial septal defect. We report a case of combined ASD (Atrial septal defect) with moderate PS (Pulmonary stenosis), where we performed percutaneous BPV. (Balloon Pulmonary Valvuloplasty) with Inoue balloon first followed by transcatheter ASD device closure in the same setting.