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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

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Aortic sinus-left atrial fistula after interventional closure of atrial septal defect

Walter Knirsch1, Ali Dodge-Khatami, Christian Balmer

  • 1Division of Pediatric Cardiology, University Children's Hospital, Zurich, Switzerland. walter.knirsch@kispi.unizh.ch

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|June 25, 2005
PubMed

Insights

Interventional closure of atrial septal defects using an Amplatzer septal occluder can rarely lead to aortic sinus-to-left atrial fistula. Surgical explantation successfully treated the complication in an asymptomatic child.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pediatric Cardiology

Background:

  • Atrial septal defects (ASDs) are commonly closed using percutaneous devices.
  • The Amplatzer septal occluder is a frequently used device for ASD closure.
  • Complications, though rare, require careful monitoring and management.

Observation:

  • A 3-year-old boy received an Amplatzer septal occluder for an ASD.
  • Four weeks post-procedure, an aortic sinus-to-left atrial fistula was identified via echocardiography.
  • The child remained asymptomatic despite the fistula.

Findings:

  • The development of an aortic sinus-to-left atrial fistula is a rare complication of Amplatzer septal occluder placement.
  • Echocardiography is effective in detecting such post-procedural fistulas.
  • Surgical intervention successfully addressed both the fistula and the residual ASD.

Implications:

  • This case highlights the importance of vigilant echocardiographic surveillance after device closure of ASDs.
  • Early detection and surgical management are crucial for resolving rare complications like aortopulmonary fistulas.
  • Understanding potential device-related complications informs procedural safety and patient selection.

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