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A 15-year-old girl was diagnosed as having secundum atrial septal defect (ASD) at infancy. Transcatheter closure of the ASD was performed at 4 years of age, using a StarFlex 33 mm device (NMT Medical, Boston, Massachusetts). One week following implantation, a small residual shunt was noted. Within the first year following the procedure, a protrusion of one of the right-sided nitinol centring springs developed, and the left-to-right shunt had increased (figure 1).
After 10 years of clinical follow-up, the girl was asymptomatic, but the residual shunt increased, and closure was indicated.
A transcatheter closure of the residual shunt was successfully performed by implanting a second 12 mm Amplatzer Septal Occluder (ASO) (AGA Medical Corporation, Plymouth, Minnesota) (figure 2).
The second device embraced and grabbed the StarFlex, straightening the protruding spring (figure 3). A surgical approach could be the treatment of choice for a protruding spring of the StarFlex device and closure of the residual shunt. We present the transcatheter approach as an attractive alternative to surgery.
Competing interests: None.
Patient consent: Obtained.
Provenance and peer review: Not commissioned; not externally peer reviewed.