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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.