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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

Aortic wall erosion after percutaneous closure of atrial septal defect

Teresa López-Fernández1, José Juan Gómez de Diego, María Carmen Monedero

  • 1Hospital Universitario La Paz. Servicio de Cardiología, Servicio de Cirugía cardiaca. tlfernandez8@gmail.com

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|August 3, 2010
PubMed

Insights

A rare complication of atrial septal defect closure, aortic fistula, occurred in a young woman. Urgent surgery was needed to correct this potentially lethal issue caused by device erosion.

Area of Science:

  • Cardiology
  • Medical Devices
  • Surgical Technology

Background:

  • Percutaneous closure of atrial septal defects (ASDs) is a common and effective alternative to surgical repair.
  • While generally safe, complications such as cardiac perforation and device erosion can occur.
  • Device erosion, though infrequent, poses a significant risk to patients.

Observation:

  • A 26-year-old woman developed acute hemolysis one month post-percutaneous ASD closure.
  • Three-dimensional transesophageal echocardiography revealed an aortoatrial fistula involving the closure device.
  • The patient presented with symptoms necessitating urgent surgical intervention.

Findings:

  • The fistula was presumed to result from erosion of the aortic wall by the left atrial disk of the occluder device.
  • Factors contributing to device erosion include improper rim assessment and device oversizing or malposition.
  • This case highlights a rare but severe complication of transcatheter ASD closure.

Implications:

  • Prompt diagnosis and surgical correction are crucial for managing aortoatrial fistulas post-device closure.
  • Careful patient selection and pre-procedural imaging are essential to minimize risks.
  • This case underscores the importance of vigilance for rare complications in interventional cardiology procedures.

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