Key result
Percutaneous ASD closure complicated by recurrent device-related thrombus requires surgical removal and patch closure.
Why the study?
Device-related thrombus formation following percutaneous secundum ASD closure is a rare but serious complication, with limited evidence guiding its diagnosis and management.
Case Report (n=1)
Recurrent thrombus formation after ASD device closure is a rare but serious complication that may necessitate surgical intervention and individualized antithrombotic strategies.
Recurrent device thrombus after ASD closure may necessitate surgery; single case leaves open optimal antithrombotic strategies.
BACKGROUND: Percutaneous device closure is the preferred approach for closing secundum atrial septal defects (ASDs), offering a minimally invasive alternative to surgery. Although generally safe, device-related thrombus formation is a rare but serious complication, with limited evidence guiding diagnosis and management. CASE SUMMARY: We present a case of a 35-year-old woman who underwent percutaneous device closure of a secundum ASD. She developed intermittent fevers within 48 hours postprocedure, though initial work-up was negative. Three months later, a routine transthoracic echocardiogram revealed a mobile mass attached to the ASD device. She underwent AngioVac thrombectomy, but recurrence of thrombus required surgical removal of the device and ASD patch closure. DISCUSSION: This case highlights a rare but serious complication of ASD device closure, underscoring the importance of vigilant follow-up and individualized antithrombotic strategies. TAKE-HOME MESSAGES: Recurrent thrombus formation after ASD device closure is rare but may necessitate surgical intervention in high-risk patients. Individualized risk assessment, including prothrombotic states and residual shunting, should guide postprocedural antithrombotic strategies.
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Kajimoto et al. (2025) conducted a case report in Secundum atrial septal defect (n=1). Percutaneous device closure of secundum ASD was evaluated on Recurrent thrombus formation requiring surgical removal. Percutaneous device closure of a secundum ASD in a 35-year-old woman was complicated by recurrent device-related thrombus requiring surgical removal of the device and ASD patch closure.
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