{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T19:54:07Z","timestamp":1783713247658,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>We present a case of a 51\u2010year\u2010old woman with atrial septal defect (ASD) masked by pulmonary arterial hypertension (PAH). Three months after PAH treatment with a combination of endothelin receptor antagonist and phosphodiesterase five inhibitor, the transthoracic echocardiography revealed left\u2010to\u2010right shunting through a secundum ASD. The pulmonary vascular resistance decreased from 7.4 to 2.6 Wood units. Subsequent transcatheter closure of ASD using Occlutech Figulla Flex II device was successfully performed as a treat\u2010and\u2010repair strategy. Five months later, hemodynamics had normalized. Due to reduced shunt flow caused by PAH, ASD may not be detectable before treatment, so care must be taken not to overlook PAH associated with intracardiac defects.<\/jats:p>","DOI":"10.1002\/ccr3.71656","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T01:50:31Z","timestamp":1767145831000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Case of Atrial Septal Defect Unveiled by the Treatment for Pulmonary Arterial Hypertension"],"prefix":"10.1002","volume":"14","author":[{"given":"Takaaki","family":"Fujii","sequence":"first","affiliation":[{"name":"General Education and Clinical Research Center Nagoya City University Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1389-0423","authenticated-orcid":false,"given":"Sayuri","family":"Yamabe","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiro","family":"Tsuruta","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Kawada","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Mizoguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4952-9568","authenticated-orcid":false,"given":"Masashi","family":"Yokoi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Kitada","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigefumi","family":"Fukui","sequence":"additional","affiliation":[{"name":"Department of Cardiology Fujita Health University School of Medicine  Toyoake City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Izawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Fujita Health University School of Medicine  Toyoake City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medical Sciences, Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab646"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa554"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2021-319096"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeaa314"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2013.03.003"},{"issue":"1","key":"e_1_2_13_7_1","first-page":"93","article-title":"Atrial Septal Defects \u2013 Clinical Manifestations, Echo Assessment, and Intervention","volume":"8","author":"Martin S. 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