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Updated: Jun 13, 2026
07:41
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Pulmonary oedema after percutaneous ASD-closure.
Dries Viaene1, Paul Vermeersch, Frank Van den Branden
1Department of Cardiology, ZNA Campus Middelheim, Lindendreef 12020 Antwerpen, Belgium. sdv-s@live.be
Acta Cardiologica
|May 13, 2010
Summary
Percutaneous closure of atrial septal defects (ASD) can cause pulmonary edema in patients with undiagnosed hypertrophic cardiomyopathy. Closing the ASD removes a crucial "escape mechanism," leading to acute heart failure.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Percutaneous closure of atrial septal defects (ASD) is an increasingly common alternative to surgery.
- Device closure is limited to secundum defects with specific anatomical features.
Observation:
- A 27-year-old man with a symptomatic secundum ASD underwent percutaneous closure.
- Immediately post-procedure, he developed severe pulmonary edema.
Findings:
- The patient had undiagnosed hypertrophic cardiomyopathy, which was the cause of the adverse event.
- Occlusion of the left-to-right shunt acutely volume-loaded the poorly compliant left ventricle.
Implications:
- This case highlights the potential hemodynamic complications of ASD closure in hypertrophic cardiomyopathy.
- Careful pre-procedural screening is crucial to identify patients at risk for diastolic dysfunction post-closure.
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