Progressive Enlargement of a Coronary Artery Communication With an Atrial Septal Defect Closure Device.

A 70-year-old man underwent coronary angiography 8 years after transcatheter atrial septal defect closure. Although no coronary stenosis was observed, a progressively enlarged coronary artery communication originating from the atrial branch of the left circumflex artery and extending into the device was identified. Serial imaging demonstrated progressive enlargement and elongation of this vascular structure over time. Computed tomography showed contrast opacification within the device and left-to-right leakage, suggesting incomplete neoendothelialization and peridevice leak. These findings may reflect progressive enlargement of a preexisting vascular connection associated with the device, which may interfere with endothelialization and contribute to late complications.