Related Experiment Video
Updated: Aug 8, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Early cardiac perforation after atrial septal defect closure with the Amplatzer septal occluder
Hans-Henning Sauer1, Kalliopi Ntalakoura, Christoph Haun
1Department of Pediatric Cardiac Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany. h.sauer@uke.uni-hamburg.de
Insights
Transcatheter closure of atrial septal defects can risk aortic perforation, especially with a short anterosuperior rim. This case highlights the need for careful consideration of anatomical factors during device implantation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Transcatheter closure is a common method for treating atrial septal defects (ASDs).
- Amplatzer septal occluders are frequently used devices for ASD closure.
- Potential complications, though rare, require thorough understanding and vigilance.
Observation:
- A case of aortic perforation occurred post-transcatheter closure of an ASD using an Amplatzer septal occluder.
- Emergency surgery was required to address perforations in the right atrium and the aorta's noncoronary sinus of Valsalva.
- The primary closure of the atrial septal defect was successfully achieved during surgery.
Findings:
- A short anterosuperior rim is identified as a potential risk factor for aortic perforation during transcatheter ASD closure.
- This anatomical feature may predispose patients to device-related aortic injury.
Implications:
- Clinicians should carefully assess the anterosuperior rim during pre-procedural planning for transcatheter ASD closure.
- Awareness of this risk factor can guide procedural technique and device selection.
- Further research may be warranted to define the precise threshold for this risk factor and optimize patient selection.
Abstract:
We report a case of aortic perforation after transcatheter closure of an atrial septal defect by an Amplatzer septal occluder. During emergency surgery, perforations of the dome of the right atrium and the noncoronary sinus of Valsalva of the aorta were repaired. Atrial septal defect was primarily closed. A short anterosuperior rim should be considered a risk factor for aortic perforation in transcatheter atrial septal defect closure.
