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Image challenge
Device closure of an atrial septal defect: is seeing always believing?
  1. Chinmay Parale,
  2. Saurav Banerjee,
  3. A Shaheer Ahmed
  1. Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Chinmay Parale, Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India; chinmayparale{at}gmail.com

https://doi.org/10.1136/heartjnl-2022-321617

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    Clinical introduction

    A young woman presented to us with complaints of mild exertional breathlessness. Clinical examination was suggestive of a wide and fixed split second heart sound, and transthoracic echocardiography was notable for the presence of an ostium secundum atrial septal defect measuring 22 mm. There was also dilatation of the right atrium and ventricle along with mild pulmonary hypertension (mean pulmonary artery pressure—28 mm Hg). A percutaneous device closure with a double disk occluder (24/26 mm Cocoon Septal Occluder, Vascular Innovations) was planned under echocardiographic and fluoroscopic guidance. After deployment of the left atrial disc of the device, an interesting development was …

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    Footnotes

    • Twitter @chinmayparale

    • Contributors CP conceptualised and wrote the manuscript and involved in patient management; SB involved in data collection and patient management; ASA edited the manuscript and involved in patient managment.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.