This case highlights the risk of clinically silent femoral deep venous thrombosis and subsequent paradoxical embolism leading to ischemic stroke after unsuccessful transcatheter ASD closure in pediatric patients.
May signal paradoxical embolism from silent femoral DVT after failed pediatric ASD closure; leaves open whether routine screening improves outcomes.
Transcatheter device closure of atrial septal defect (ASD) has become a well-accepted alternative to surgical repair. Serious complications of transcatheter ASD closure are rare, but when they occur, devastating consequences may result. Herein, we present the case of a 4-year-old girl who had an ischemic stroke caused by a presumptive paradoxical embolism after an unsuccessful transcatheter ASD procedure and in whom subsequent venous color Doppler showed deep venous thrombosis (DVT) of the right lower extremity. The risk factors that predisposed to paradoxical cerebral embolism and DVT in this patient are discussed, and the literature is reviewed.
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Fang et al. (2011) studied this question.
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