Transcatheter closure of a huge iatrogenic atrial septal defect: A case report

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Rationale:Iatrogenic atrial septal defects caused by cardiac surgery are rare complications that are traditionally repaired through reoperations; unfortunately, reoperations are accompanied by high risk and trauma.Patient concerns:Herein, we report a rare case of a huge atrial septal defect after mitral and aortic mechanical valve replacement.Diagnoses:Transesophageal echocardiography revealed a 20 × 33 mm atrial septal defect with a mainly left-to-right shunt and bidirectional shunt.Interventions:The defect was successfully occluded using a Shape Memory septal occlude with a waist diameter of 42 mm.Outcomes:At follow-up 6 months after, the patient's symptoms were remarkably relieved and chest radiograph showed obvious improvement of the pulmonary congestion.Lessons:Percutaneous device treatment can be used as an alternative to surgery in iatrogenic atrial septal defects if the anatomical condition of the septal defect is appropriate for transcatheter closure.

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