Key result
Oversized Amplatzer device successfully closes an ostium secundum ASD with floppy rims without dislodgement.
Why the study?
Floppy rims of ASD often preclude transcatheter closure due to risks of dislodgement and embolization, though adequate length margins might hold an oversized device.
Can an oversized device successfully close an ASD with floppy rims in an adult patient?
Case Report (n=1)
No
Can an oversized device successfully close an ASD with floppy rims in an adult patient?
Oversizing the closure device may allow for successful percutaneous closure of ASDs with floppy rims, potentially avoiding the need for surgical closure.
May support oversized device use for floppy-rim ASD closure in adults; hypothesis-generating and requires prospective validation.
Floppy rims of atrial septal defect (ASD) preclude device closure as those rims do not hold the device with a high risk of device dislodgement and embolization. In spite of the floppiness if the margins have an adequate length (>5 mm), sometimes it may also hold the oversized device obviating the need for surgical closure. We report a successful closure of an adult 30 mm ostium secundum ASD with floppy posterosuperior and inferior vena cava rim with Amplatzer 34 mm device. “Oversize the device in floppy rims” is the only clue to get success in those cases. Sometimes, a fair trial against nature’s negativity can also result in a successful outcome.
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Das et al. (2021) conducted a case report in Atrial septal defect with floppy rims (n=1). Percutaneous device closure with oversized Amplatzer device was evaluated on Successful device closure without dislodgement. Percutaneous closure of a 30 mm ostium secundum atrial septal defect with floppy rims was successfully achieved without dislodgement by using an oversized 34 mm Amplatzer device.
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