Key result
Tuberculosis, not device erosion, causes late hemorrhagic pericardial effusion after ASD closure.
Why the study?
Pericardial effusion occurring late after ASD device closure is extremely rare and device-related erosion is the most likely possibility, but other causes need evaluation.
Case Report (n=1)
Not all hemorrhagic pericardial effusions following ASD device closure are due to erosion; other etiologies like tuberculosis should be considered in endemic areas.
Answers are grounded in this paper and cite their sources.
Consider tuberculosis in hemorrhagic effusion after ASD closure in endemic areas; this case leaves open non-erosion etiologies.
Transcatheter closure of atrial septal defect (ASD) is the preferred modality of treatment. Pericardial effusion occurring late after ASD device closure is extremely rare, and device-related erosion is the most likely possibility. We describe a 41-year-old male who underwent ASD device closure with a 32-mm Amplatzer Septal Occluder device and who developed cardiac tamponade 6 months after the procedure. Extensive investigations did not reveal any evidence of erosion. Given the endemicity of tuberculosis in India, exudative pericardial effusion, a positive tuberculin skin test, and the presence of a few matted mediastinal lymph nodes, the patient was started on antitubercular therapy. There was no reaccumulation of pericardial fluid at subsequent follow-ups. To conclude, not all hemorrhagic pericardial effusions following device closure of ASD are secondary to erosions. After ruling out device erosion, other etiologies for pericardial effusion should be carefully searched for.
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Zameer et al. (2025) conducted a case report in Hemorrhagic pericardial effusion following atrial septal defect device closure (n=1). Atrial septal defect device closure (Amplatzer Septal Occluder) was evaluated on Etiology of pericardial effusion. Hemorrhagic pericardial effusion occurring 6 months after ASD device closure in a 41-year-old male was found to be secondary to tuberculosis rather than device erosion.
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