Khajali Zahra, Firouzi Ata, Pouraliakbar Hamidreza, Hosseini Zahra, Jorfi Fateme
Shaheed Rajaei Cardiovascular Medical and Research Center, Tehran, Iran.
Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Egypt Heart J. 2021 Jun 5;73(1):50. doi: 10.1186/s43044-021-00171-8.
Secundum-type atrial septal defects (ASD) constitute 8% to 10% of congenital heart defect. Secundum ASDs can be closed either percutaneously or surgically. However, ASD device closure has proven to be technically safe and feasible; it is not free of complications. These complications include device embolization/malposition which have been reported in 3.5% of cases, arrhythmia, and pericardial effusion in 2.6% and 0.5-1.5% respectively, device thrombus, residual shunting, and impingement of the device on the adjacent structures.
We introduce three patients with secundum ASD who had preexisting pericardial effusion, device closure was performed for them, and after the procedure, the effusion size progressed significantly. We used multimodality imaging to diagnose the cause of pericardial effusion (PE). Cardiac erosion was diagnosed in one of the patients that managed surgically. We did not found any specific procedure-related cause for worsening the pericardial effusion in the other two patients.
Several reasons include procedure-related complication and other systemic causes should be considered in patients who develop pericardial effusion after trans catheter closure of ASDs.
继发孔型房间隔缺损（ASD）占先天性心脏病的8%至10%。继发孔型ASD可通过经皮或手术方式闭合。然而，ASD封堵器闭合术已被证明在技术上是安全可行的；但并非没有并发症。这些并发症包括封堵器栓塞/位置异常（报道发生率为3.5%）、心律失常，心包积液分别为2.6%和0.5 - 1.5%，封堵器血栓形成、残余分流以及封堵器对相邻结构的压迫。
我们介绍3例继发孔型ASD患者，他们术前即存在心包积液，对其进行了封堵器闭合术，术后积液量显著增加。我们采用多种影像学检查来诊断心包积液（PE）的原因。其中1例患者经手术治疗后诊断为心脏侵蚀。另外2例患者，我们未发现导致心包积液加重的任何与手术相关的特定原因。
对于经导管闭合ASD后出现心包积液的患者，应考虑多种原因，包括与手术相关的并发症以及其他全身因素。
