Atrial septal defect percutaneous closure complications


 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Overview
As with any invasive treatment, percutaneous closure could be associated with potential complications. Common complications include issues with device functional integrity such as embolization around the device or erosion of the materials and malpositioning. Other complications include potential for development of serious circulatory conditions such as atrial fibrillation, heart block, and thrombus formation.The disadvantages are a thick profile of the device and concerns related to a large amount of nitinol (a nickel-titanium compound) in the device and consequent potential for nickel toxicity.

Complications
Frequency of complications with percutaneous closure is low, manifesting in under 9% of all cases. With experienced, skilled clinicians, the rate of complication may be as low as 1%. . Complications associated with percutaneous closure include:

Device related


 * Device embolization
 * Malposition of device
 * Device erosion

Medical complications


 * Atrial fibrillation or supraventricular tachycardia
 * Transient antrioventricular block/heart block
 * Pericardial effusion
 * Thrombus formation (on the left atrial appendage)
 * Iliac vein dissection
 * Groin hematoma
 * Cardiac perforation
 * Increased levels of cardiac tropnin I
 * Residual shunts
 * There can be migration or erosion of the device so follow-up is warranted.