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Case Reports

Highly Fenestrated Septum Primum Leads to Failure of Amplatzer Septal Defect Closure

^a Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
^b Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
^c Department of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Accepted for publication February 25, 2008.

^_* Address correspondence to Dr Zenati, Division of Cardiac Surgery, University of Pittsburgh, C700 PUH, 200 Lothrop St, Pittsburgh, PA 15213 (Email: zenatim{at}upmc.edu).

A patient presenting with a history of transient ischemic attacks was initially diagnosed with a large secundum-type atrial septal defect by transesophageal echocardiography. Subsequent attempts to percutaneously repair the defect using an Amplatzer septal occlude device (AGA Medical, Plymouth, MN) failed to position correctly on multiple attempts. At the time of surgery, a largely deficient and highly fenestrated septum primum was found, which was likely the cause of the Amplatzer device (AGA Medical) failure. The defect was then definitively repaired using a bovine pericardial patch without incident.