Transcatheter Amplatzer duct occluder closure of direct right pulmonary to left atrium communication.

Although rare, a congenital direct communication between pulmonary artery and left atrium can present a paradoxical embolism in adults. In our case, diagnosis was first made on contrast transcranial Doppler with Valsalva maneuver and subsequently confirmed by intracardiac echocardiography and selective pulmonary angiography. Successful catheter-based closure using Amplatzer duct occluder device resulted in definitive exclusion of the source of paradoxical embolism.