Transcatheter closure of a huge iatrogenic atrial septal defect

RATIONALE Iatrogenic atrial septal defects caused by cardiac surgery are rare complications that are traditionally repaired through reoperations; unfortunately, reoperations are accompanied by high risk and trauma. PATIENT CONCERNS Herein, we report a rare case of a huge atrial septal defect after mitral and aortic mechanical valve replacement. DIAGNOSES Transesophageal echocardiography revealed a 20 × 33 mm atrial septal defect with a mainly left-to-right shunt and bidirectional shunt. INTERVENTIONS The defect was successfully occluded using a Shape Memory septal occlude with a waist diameter of 42 mm. OUTCOMES At follow-up 6 months after, the patient's symptoms were remarkably relieved and chest radiograph showed obvious improvement of the pulmonary congestion. LESSONS Percutaneous device treatment can be used as an alternative to surgery in iatrogenic atrial septal defects if the anatomical condition of the septal defect is appropriate for transcatheter closure.