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Comment

Indications and Complications

An atrial septal occluder device can be used for transcatheter closure of a secundum atrial septal defect (ASD). Contraindications include a mild shunt (pulmonary-to-systemic flow ratio <1.5 : 1), an ASD that is larger than the device, a defect other than a secundum ASD, and severe pulmonary hypertension. Complications include unsatisfactory placement, migration, pericardial effusion, and thrombus formation. The device can be used to close a patent foramen ovale, but there is some controversy related to this issue.

Imaging

Chest radiographs are capable of identifying the device (Figs. A and B) and assessing the possibility of migration. Other complications are more difficult to ascertain with radiographs. CT (Fig. C) can be performed to identify complications, but it has not been extensively studied for this indication. As of 2012, MRI can be performed safely, but metallic artifact can limit evaluation of the area of the device.