Avoiding and Solving Complications During Percutaneous Closure of ASD

We present 11 cases of percutaneous transcatheter occlusion of atrial septal defects (ASD`s) in adults. These select cases represent an educational approach to special dilemmas, complications, and challenges which may occur during such a common procedure. The cases include:

1. Multi-fenestrated ASD
2. Balloon-assisted deployment of ASD occlude
3. Dilator-assisted deployment of ASD occlude
4. Cobra-shape disfiguration of the left-sided disc
5. ASD with deficient rim - aortic rim
6. Partial deployment in pulmonary vein
7. High (adjacent to superior vena cava) ASD
8. Large Chiari network
9. Double interatrial septum
10. Snaring a runaway occluder
11. Closure of ASD in the elderly

The interventional team is expected to be resourceful in the preparation for and performance of the procedure. Learning from others` experience may be of benefit when coping with complex cases of ASD closure, as well as the prudent use of imaging modalities, personal experience and proper selection of equipment.