Percutaneous device closure of atrial septal defect in HIV-positive patient: a challenge for interventionist

Atrial septal defect (ASD) is one of the most common congenital heart defects. Intracardiac repair via midline sternotomy or right thoracotomy and cardiopulmonary bypass have been considered the standard treatment for the closure of atrial septal defects, but transcatheter closure with Amplatzer septal occluder has recently become an alternative option. Transcatheter device closure of secundum ASD is a more than a decade old technology. This has become an alternative to surgical therapy, and has been regarded as generally safe and effective device closure. Device embolization is a potential complication of every attempted ASD closure, and the causative factors include undersized device, floppy rim, and operator-related technical issues, such as malposition during a “push-pull” maneuver. In this paper, we report a 32-year-old HIV positive female patient who presented with gradual onsite of dyspnea, NYHA class II, and successfully underwent a device closure of large atrial septal defect.