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Updated: Mar 29, 2026
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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Unrecognized Atrial Septal Defect Presenting with Postoperative Occipital Infarction
Jasper Lin1, Vinicius Carraro do Nascimento2, Jeremy Hefford1
1Department of Cardiology, Division of Specialist Medical Services, Gold Coast Hospital and Health Services, Southport, QLD 4215, Australia.
Diagnostics (Basel, Switzerland)
|March 28, 2026
Summary
A patient experienced vision loss after surgery due to a stroke caused by a hidden heart defect. Prompt imaging and closure of the atrial septal defect resolved the issue, preventing further strokes.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Postoperative stroke is a rare but serious complication.
- Occult cardiac shunts can lead to paradoxical embolism.
- Homonymous hemianopia can be a symptom of occipital lobe stroke.
Purpose of the Study:
- To report a case of acute homonymous hemianopia following surgery.
- To investigate the underlying cause of embolic stroke in this patient.
- To highlight the role of multimodality imaging in diagnosing interatrial shunts.
Main Methods:
- Neuroimaging (MRI/CT) to identify stroke.
- Transthoracic echocardiography to screen for shunts.
- Transesophageal echocardiography for detailed cardiac imaging.
- Percutaneous closure of atrial septal defect.
Main Results:
- A 49-year-old woman developed right occipital infarction leading to homonymous hemianopia.
- Echocardiography revealed an ostium secundum atrial septal defect.
- Percutaneous closure of the defect was successful with complete shunt resolution.
Conclusions:
- Multimodality imaging is crucial for detecting occult interatrial shunts.
- Paradoxical embolism is a likely cause of this postoperative stroke.
- Early diagnosis and intervention can prevent recurrent embolic events.
