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      A Very Late Atrial Septal Erosion After an Ostium Secundum Percutaneous Closure

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          Abstract

          Complications after device closure of ostium secundum defects are rare but possible. We present a very late erosion of the interatrial septum after a percutaneous closure of an ostium secundum defect. Identification of early clinical and imaging clues associated with this condition is fundamental for a timely diagnosis and treatment. ( Level of Difficulty: Intermediate.)

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          Surgery for complications of trans-catheter closure of atrial septal defects: a multi-institutional study from the European Congenital Heart Surgeons Association.

          Christian Schreiber, Constantine Mavroudis, Giovanni Stellin … (2010)
          This study aims to analyse the collective experience of participating European Congenital Heart Surgeons Association centres in the surgical management of complications resulting from trans-catheter closure of atrial septal defects (ASDs). The records of all (n=56) patients, aged 3-70 years (median 18 years), who underwent surgery for complications of trans-catheter ASD closure in 19 participating institutions over a 10-year period (1997-2007) were retrospectively reviewed. Risk factors for surgical complications were sought. Surgical outcomes were compared with those reported for primary surgical ASD closure in the European Association of Cardio-thoracic Surgery Congenital Database. A wide range of ASD sizes (5-34mm) and devices of various types and sizes (range 12-60mm) were involved, including 13 devices less than 20mm. Complications leading to surgery included embolisation (n=29), thrombosis/thrombo-embolism/cerebral ischaemia or stroke (n=12), significant residual shunt (n=12), aortic or atrial perforation or erosion (n=9), haemopericardium with tamponade (n=5), aortic or mitral valve injury (n=2) and endocarditis (n=1). Surgery (39 early emergent and 17 late operations) involved device removal, repair of damaged structures and ASD closure. Late operations were needed 12 days to 8 years (median 3 years) after device implantation. There were three hospital deaths (mortality 5.4%). During the same time period, mortality for all 4453 surgical ASD closures reported in the European Association of Cardio-Thoracic Surgery Congenital Database was 0.36% (p=0.001). Trans-catheter device closure of ASDs, even in cases when small devices are used, can lead to significant complications requiring surgical intervention. Once a complication leading to surgery occurs, mortality is significantly greater than that of primary surgical ASD closure. Major complications can occur late after device placement. Therefore, lifelong follow-up of patients in whom ASDs have been closed by devices is mandatory. Copyright 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
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            ACC/AHA 2008 guidelines for the management of adults with congenital heart disease

            T.M. Bashore, J.S. CHILD, H.M. Connolly … (2008)
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              ASD Closure in Structural Heart Disease.

              Dominik Wiktor, John Carroll (2018)
              While the safety and efficacy of percutaneous ASD closure has been established, new data have recently emerged regarding the negative impact of residual iatrogenic ASD (iASD) following left heart structural interventions. Additionally, new devices with potential advantages have recently been studied. We will review here the potential indications for closure of iASD along with new generation closure devices and potential late complications requiring long-term follow-up.
              Article 0 comments Cited 5 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Antonio Micari
                Journal
                Journal ID (nlm-ta): JACC Case Rep
                Journal ID (iso-abbrev): JACC Case Rep
                Title: JACC Case Reports
                Publisher: Elsevier
                ISSN (Electronic): 2666-0849
                Publication date PMC-release: 16 June 2023
                Publication date Collection: 19 July 2023
                Publication date (Electronic): 16 June 2023
                Volume: 18
                Electronic Location Identifier: 101925
                Affiliations
                [a ]Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinic G. Martino, Cardiology Unit, Messina, Italy
                [b ]Division of Cardiac Surgery, Department of Cardio-Thoraco-Vascular Surgery, Papardo Hospital, Messina, Italy
                Author notes
                [∗ ] Address for correspondence: Prof Antonio Micari, Policlinico G. Martino, via C. Valeria 1, Messina, Italy. antonio.micari@ 123456unime.it
                Article
                Publisher Item ID: S2666-0849(23)00230-9 Publisher ID: 101925
                DOI: 10.1016/j.jaccas.2023.101925
                PMC ID: 10401174
                SO-VID: 60474118-f728-4e0f-903d-fd2bd25ad697
                Copyright © © 2023 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 13 February 2023
                Date revision received : 17 May 2023
                Date accepted : 25 May 2023
                Categories
                Subject: Case Report
                Subject: Clinical Case

                Keywords: atrial septal defect,echocardiography,occluder,pregnancy,three-dimensional imaging
                Data availability:
                Keywords: atrial septal defect, echocardiography, occluder, pregnancy, three-dimensional imaging

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