Related Experiment Video
Updated: Jun 13, 2026
07:41
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Progressive Enlargement of a Coronary Artery Communication With an Atrial Septal Defect Closure Device
Soichiro Kobayashi1, Akihiro Takasaki1, Yoshito Ogihara1
1Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
JACC. Case Reports
|June 12, 2026
Summary
A rare case of progressive coronary artery enlargement into a closure device after atrial septal defect repair was observed. This finding suggests incomplete healing and potential for late complications, highlighting the need for long-term monitoring.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Imaging
Background:
- Transcatheter atrial septal defect (ASD) closure is a common procedure.
- Late complications after device closure are uncommon but can occur.
- Coronary artery anomalies adjacent to closure devices require careful evaluation.
Purpose of the Study:
- To report a unique case of progressive coronary artery communication into an ASD closure device.
- To investigate the imaging findings and potential mechanisms of this late complication.
Main Methods:
- Coronary angiography was performed 8 years post-transcatheter ASD closure.
- Serial imaging was utilized to assess changes in the coronary artery communication.
- Computed tomography (CT) was used to evaluate device integrity and contrast leakage.
Main Results:
- No coronary stenosis was detected.
- A progressively enlarged coronary artery communication from the left circumflex artery into the device was identified.
- CT revealed contrast opacification within the device and left-to-right leakage, indicating incomplete neoendothelialization and peridevice leak.
Conclusions:
- Progressive enlargement of a preexisting vascular connection associated with the device may occur.
- This phenomenon can impede endothelialization and lead to late complications.
- Long-term surveillance imaging may be warranted in select cases following transcatheter ASD closure.
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