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Cardiac perforation 6 weeks after percutaneous atrial septal defect repair using an Amplatzer septal occluder

Michal S Maimon1, Savithiri Ratnapalan, Anh Do

  • 1Division of Emergency Medicine, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8.

Pediatrics
|October 18, 2006
PubMed

Insights

A rare complication of atrial septal defect closure using an Amplatzer septal occluder led to cardiac tamponade. Prompt diagnosis and surgical intervention were crucial for patient survival.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pediatric Cardiology

Background:

  • Percutaneous closure of secundum atrial septal defects (ASDs) is a common procedure.
  • The Amplatzer septal occluder (ASO) is frequently used for ASD closure.
  • Complications, though rare, can be life-threatening.

Observation:

  • A 14-year-old boy presented with syncope, bradycardia, and hypotension 6 weeks post-ASO closure.
  • Echocardiography revealed a significant pericardial effusion.
  • Subxiphoid pericardiocentesis evacuated 320 mL of blood.

Findings:

  • Surgical exploration identified a right atrial perforation at the superior-posterior aspect.
  • The ASO was removed, and the ASD was repaired with a pericardial patch.
  • The perforation was successfully corrected.

Implications:

  • This case highlights a rare but severe complication of percutaneous ASD closure.
  • Timely access to patient records is vital for managing complex presentations.
  • Prompt diagnosis and multidisciplinary management are essential for favorable outcomes in such cases.

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