Key result
Surgical device removal resolves severe late-onset infective endocarditis 19 months after transcatheter ASD closure.
Why the study?
Infective endocarditis after transcatheter atrial septal defect closure is rare.
Case Report (n=1)
This case highlights that infective endocarditis can occur well beyond 6 months after transcatheter ASD closure, questioning current guidelines that restrict prophylaxis to the early postimplant period.
Late IE after pediatric ASD device closure warrants vigilance; leaves open optimal long-term surveillance and prophylaxis needs.
BACKGROUND: Infective endocarditis (IE) after transcatheter atrial septal defect (ASD) closure is rare. CASE SUMMARY: We report the case of a 6-year-old girl who developed methicillin-resistant Staphylococcus aureus IE 19 months after ASD closure with an Amplatzer device. She presented with severe sepsis, a large vegetation on the right atrial side of the occluder, and moderate tricuspid regurgitation. Despite empirical antibiotic therapy, persistent bacteremia mandated surgical removal of the device, ASD closure with a pericardial patch, and tricuspid valve repair. Six weeks of targeted antibiotics led to a favorable 1-year outcome. DISCUSSION: This case, alongside other reports of late-onset IE after transcatheter ASD closure, highlights that although rare, such infections can occur well beyond 6 months postprocedure. This observation questions current guidelines restricting prophylactic measures to the early postimplant period. TAKE-HOME MESSAGE: Patients with septal occluders may require prolonged vigilance and reinforced education on skin and dental hygiene to minimize the risk of late IE.
No takes yet. Share an insight, caveat, or question.
Gery et al. (2025) conducted a case report in Infective endocarditis after transcatheter atrial septal defect closure (n=1). Transcatheter ASD closure with an Amplatzer device was evaluated on Clinical outcome after surgical device removal and antibiotic therapy. A 6-year-old girl developed severe late-onset infective endocarditis 19 months after transcatheter ASD closure, requiring surgical device removal and targeted antibiotics for a favorable outcome.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: