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Updated: Sep 11, 2025

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Hemorrhagic pericardial effusion 6 months following atrial septal defect device closure: Has it eroded?
Alaina Zameer1, Chetan Patel2, Lamk Kadiyani1
1Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
Insights
Late pericardial effusion after transcatheter atrial septal defect (ASD) closure is rare. This case highlights tuberculosis as a cause, not device erosion, emphasizing the need to explore other etiologies.
Area of Science:
- Cardiology
- Interventional Cardiology
- Infectious Diseases
Background:
- Transcatheter closure is the preferred treatment for atrial septal defects (ASDs).
- Late pericardial effusion after device closure is rare, often attributed to device erosion.
- Cardiac tamponade is a potential complication.
Abstract:
Transcatheter closure of atrial septal defect (ASD) is the preferred modality of treatment. Pericardial effusion occurring late after ASD device closure is extremely rare, and device-related erosion is the most likely possibility. We describe a 41-year-old male who underwent ASD device closure with a 32-mm Amplatzer Septal Occluder device and who developed cardiac tamponade 6 months after the procedure. Extensive investigations did not reveal any evidence of erosion. Given the endemicity of tuberculosis in India, exudative pericardial effusion, a positive tuberculin skin test, and the presence of a few matted mediastinal lymph nodes, the patient was started on antitubercular therapy. There was no reaccumulation of pericardial fluid at subsequent follow-ups. To conclude, not all hemorrhagic pericardial effusions following device closure of ASD are secondary to erosions. After ruling out device erosion, other etiologies for pericardial effusion should be carefully searched for.
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