title: Surgical repair after ineffective device closure of an inferior sinus venosus defect.
abstract: A young woman presented with severe heart failure symptoms 4 years after percutaneous device closure of an atrial septal defect (ASD). There was residual left-to-right shunting, and the device was obstructing the inferior caval vein and tricuspid valve flow. Intraoperatively, the ASD was shown to be an inferior sinus venosus defect, and reconstruction of the mitral valve and the posterior wall of the left atrium was required. This case emphasizes the importance of appropriate patient selection for interventional ASD closure and demonstrates that patients with less-than-optimal results should be referred for surgical correction early, before the device produces secondary damage to atrial structures and atrioventricular valves.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery,  German Heart Institute Berlin, Berlin,  Germany.
authors.forename: Kadir
authors.initials: K
authors.lastname: Yilmaz
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Christof
authors.initials: C
authors.lastname: Stamm
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D006348:Cardiac Surgical Procedures; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D018579:Patient Selection; D010690:Phlebography; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D055989:Septal Occluder Device; D017211:Treatment Failure; D055815:Young Adult