title: Iatrogenic erosion of the septum primum resulting in an atrial septal defect with left-to-right shunt: a rare pitfall of patent foramen ovale percutaneous closure.
abstract: Iatrogenic erosion of the septum primum after foramen ovale closure is an anecdotal event. We report the case of a 39-year-old woman admitted to our institution for multifocal cryptogenic cerebral ischemia and a patent foramen ovale (PFO) associated with an aneurysm of the septum primum. The patient underwent percutaneous closure of the PFO with an Amplatzer PFO Occluder device. At the 6-months follow up, the device was in the right position, but a jagged defect of the septum primum and evidence of significant left-to-right shunting was detected. The atrial septal defect was then repaired by a surgical approach. Although this event is not life-threatening, it should be considered as a therapeutic pitfall, resulting in a risk of paradoxical embolism recurrences and long-term hemodynamic impairment. © 2013 Wiley Periodicals, Inc.
authors.affiliation: Cardiovascular and Thoracic Diseases Department, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Scacciatella
authors.forename: Lorenza Michela
authors.initials: LM
authors.lastname: Biava
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Marra
mesh_terms: D000328:Adult; D054087:Atrial Septum; D006328:Cardiac Catheterization / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005260:Female; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007049:Iatrogenic Disease; D055989:Septal Occluder Device / Q000009:adverse effects*
keywords: cerebrovascular disease; complications adult cath/intervention (COMP); congenital heart disease in adults (CHDA); patent foramen ovale (PFO)/atrial septal defect