Never drop your guard down after atrial septal defect closure: a case report

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Percutaneous atrial septal defect (ASD) closure can lead to rare but serious complications, including erosion of surrounding cardiac structures.
• Erosion-related complications typically manifest within the first six months post-implantation.

Purpose of the Study:

• To emphasize the necessity of long-term, staged imaging surveillance following percutaneous ASD closure.
• To identify risk factors contributing to device-induced erosion and atrial septal erosion.
• To discuss the implications of a deficient aortic rim and compare different procedural approaches.

Main Methods:

• A case report detailing a 40-year-old female patient who underwent percutaneous ASD closure in 2006.
• Follow-up revealed device dislodgement and atrial shunting 12 years post-procedure, attributed to device-induced erosion.
• The patient underwent successful surgical device removal and interatrial defect correction.

Main Results:

• A rare complication of device-induced atrial septal erosion occurred 12 years after percutaneous ASD closure.
• The erosion led to device dislodgement and subsequent atrial shunting.
• Surgical intervention was required for device removal and defect repair.

Conclusions:

• Long-term imaging follow-up is essential, extending well beyond the initial post-procedural period.
• Deficient aortic rim may be a risk factor for device erosion.
• Prompt diagnosis and intervention are critical for managing such late complications.