A failed case of percutaneous septal closure of fenestrated atrial septal defect

A patient presenting with a history of palpitation and exertional dyspnea was initially diagnosed with two separate secundum-type atrial septal defects by transesophageal echocardiography. Subsequent transesophageal echocardiography, after failure of closure with two separate closure devices, showed another defect and an ongoing left to right shunt. During surgery, more defects were observed. The defects were successfully repaired using pericardial patch without incident.