Case report of worsening of preexisting pericardial effusion after ASD device closure: is it calamitous?

Abstract Background Secundum-type atrial septal defects (ASD) constitute 8% to 10% of congenital heart defect. Secundum ASDs can be closed either percutaneously or surgically. However, ASD device closure has proven to be technically safe and feasible; it is not free of complications. These complications include device embolization/malposition which have been reported in 3.5% of cases, arrhythmia, and pericardial effusion in 2.6% and 0.5–1.5% respectively, device thrombus, residual shunting, and impingement of the device on the adjacent structures. Case presentation We introduce three patients with secundum ASD who had preexisting pericardial effusion, device closure was performed for them, and after the procedure, the effusion size progressed significantly. We used multimodality imaging to diagnose the cause of pericardial effusion (PE). Cardiac erosion was diagnosed in one of the patients that managed surgically. We did not found any specific procedure-related cause for worsening the pericardial effusion in the other two patients. Conclusion Several reasons include procedure-related complication and other systemic causes should be considered in patients who develop pericardial effusion after trans catheter closure of ASDs.

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Asymptomatic Embolization After Percutaneous Ostium Primum Atrial Septal Defect Closure: a Rare Complication

Journal of Clinical Case reports and Images ◽

10.14302/issn.2641-5518.jcci-19-2692 ◽

2019 ◽

Vol 1 (2) ◽

pp. 8-13

Author(s):

Sergiu Vijiala ◽

Eric Eeckhout ◽

Grégoire Girod ◽

Grégoire Girod

Keyword(s):

Rare Complication ◽

Ventricular Outflow Tract ◽

Left Ventricular ◽

Device Closure ◽

Atrial Septal Defect Closure ◽

Septal Defects ◽

Percutaneous Device ◽

Left Ventricular Outflow ◽

Device Embolization ◽

Percutaneous Device Closure

Percutaneous device closure of atrial septal defects (ASD) has proven to be safe and it is nowadays the standard treatment for ASDs. Immediate or late device embolization is a rare but potential complication of every attempted ASD device closure. We report a case of asymptomatic Amplatzer Septal Occluder into the left ventricular outflow tract (LVOT) detected by routine transthoracic echocardiography 3 months after successful implantation in a stable patient.

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Very large Atrial Septal Defect Device Closure: Feasibility and safety

Indonesian Journal of Cardiology ◽

10.30701/ijc.1121 ◽

2021 ◽

Vol 42 (2) ◽

Author(s):

Goutam Datta

Keyword(s):

Pericardial Effusion ◽

Atrial Septal Defect ◽

Septal Defect ◽

Volume Overload ◽

Ventricular Volume ◽

Percutaneous Closure ◽

Device Closure ◽

Device Embolization ◽

Male Patients ◽

Device Size

Objectives: There is limited data regarding feasibility and safety of very large ASD devices deployment. Percutaneous closure of very large atrial septal defect (ASD) is a valid alternative to surgical approach. But complications like erosion, cardiac perforation, atrioventricular block, pericardial effusion, infective endocarditis, or cardiac arrhythmias may occur following ASD device closure. Methods: Forty four patients with very large ostium secundum ASD were studied in a tertiary medical centre. Adult patients with defect size of 38 mm or more and device size of 40 mm or more were selected for device closure. Patients having suitable anatomy, significant left to right shunt(>1.5:1) ,right ventricular volume overload and without significant pulmonary arterial hypertension were chosen for device closure. Results : There were thirty six female patients and eight male patients in our study. Majority of our patients (twenty four) were in forty to fifty years age group. Device could be deployed successfully in forty two (95.5%). Twelve patients had device size of 46 mm (27%). Eight patients had 44 mm devices(18%). Forty two millimeter devices were used in sixteen patients (36%). Eight patients had device size of 40 mm(18%).Device embolization occurred in two patients. There were two cases of pericardial effusion and pericardiocentesis was needed in one patients. Transient complete heart block was seen in one patient. Four patients had suffered from transient and self terminating atrial arrhythmias. There was no mortality or erosion in our study. Conclusion: Percutaneous closure of very large ASD is feasible and associated with low complication rate

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