Atrial Septal Defect Closure Complications

Atrial Septal Defect (ASD) closure is primarily indicated for central-type defects, where at least 2 mm of rim tissue remains on both the superior and inferior vena cava sides of the septum. This ensures proper placement and stability of the closure device. While the procedure is generally safe, several potential complications can arise.

Common Complications of ASD Closure

1. Device Embolization

One of the most serious complications is device dislodgement or embolization. If the closure device becomes dislodged, it can often be retrieved using a catheter-based (interventional) approach. In more complex cases, surgical intervention may be required to remove the device and perform a traditional repair.

2. Atrioventricular Block

Complete atrioventricular (AV) block can occur if the closure device applies pressure or causes irritation to the AV node. This risk is higher when the inferior vena cava rim is short, increasing the likelihood of mechanical trauma to the conduction system. Close monitoring is essential during and after the procedure to detect any conduction abnormalities.

3. Aortic-to-Left/Right Atrial Fistula

In some cases, the closure device may erode into the aortic root or sinus, leading to the formation of an abnormal connection (fistula) between the aorta and either the left or right atrium. This rare but serious complication may require surgical correction to prevent further cardiovascular complications.

4. Valve Regurgitation

Tricuspid valve regurgitation is another potential issue following ASD closure. The presence of the closure device may interfere with normal valve function, leading to incomplete closure of the tricuspid leaflets. Mild regurgitation is often well-tolerated, but significant cases may require further evaluation and management.

Overall, while complications are relatively uncommon, patients undergoing ASD closure should be closely followed post-procedure to monitor for any signs of device-related issues or cardiac rhythm disturbances. Early detection and intervention can significantly improve outcomes.