European heart journal. Case reports · 2026
When time flies by: very long-term complication of percutaneous occlusion of a large atrial septal defect-a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Giaj Levra Alessandro, Iaccarino Alessandra, Fumero Andrea D, Torracca Lucia, Presbitero Patrizia
Аннотация
BACKGROUND: Very late complications of percutaneous closure of atrial septal defects (ASD) are rare and poorly described in literature.
CASE SUMMARY: A 53-year-old woman presented with acute-onset diplopia and aphasia. She was diagnosed with ischaemic stroke and underwent thrombolysis. Brain magnetic resonance imaging showed bilateral thalamic infarcts. Workup revealed a residual shunt through a previously implanted Amplatzer occluder placed 21 years earlier for a large, fenestrated ASD. Transoesophageal echocardiography demonstrated device-associated thrombus and significant right-to-left shunting on Valsalva. Percutaneous reclosure was unsuccessful due to a serpiginous intracardiac tract. Surgical removal of the device, septal reconstruction, and tricuspid valvuloplasty were performed via right minithoracotomy. Post-operative recovery was uneventful, and the patient remained asymptomatic at 6-month follow-up.
DISCUSSION: Very late device-related complications, even decades after percutaneous ASD closure, may occur. Lifelong follow-up in patients with complex ASD is needed. Surgical closure may be considered in anatomically challenging cases to reduce long-term risk.
CASE SUMMARY: A 53-year-old woman presented with acute-onset diplopia and aphasia. She was diagnosed with ischaemic stroke and underwent thrombolysis. Brain magnetic resonance imaging showed bilateral thalamic infarcts. Workup revealed a residual shunt through a previously implanted Amplatzer occluder placed 21 years earlier for a large, fenestrated ASD. Transoesophageal echocardiography demonstrated device-associated thrombus and significant right-to-left shunting on Valsalva. Percutaneous reclosure was unsuccessful due to a serpiginous intracardiac tract. Surgical removal of the device, septal reconstruction, and tricuspid valvuloplasty were performed via right minithoracotomy. Post-operative recovery was uneventful, and the patient remained asymptomatic at 6-month follow-up.
DISCUSSION: Very late device-related complications, even decades after percutaneous ASD closure, may occur. Lifelong follow-up in patients with complex ASD is needed. Surgical closure may be considered in anatomically challenging cases to reduce long-term risk.