Recurrent Right Atrial Thrombus After Percutaneous ASD Closure.

Abstract

<h4>Background</h4>Percutaneous device closure is the preferred approach for closing secundum atrial septal defects (ASDs), offering a minimally invasive alternative to surgery. Although generally safe, device-related thrombus formation is a rare but serious complication, with limited evidence guiding diagnosis and management.<h4>Case summary</h4>We present a case of a 35-year-old woman who underwent percutaneous device closure of a secundum ASD. She developed intermittent fevers within 48 hours postprocedure, though initial work-up was negative. Three months later, a routine transthoracic echocardiogram revealed a mobile mass attached to the ASD device. She underwent AngioVac thrombectomy, but recurrence of thrombus required surgical removal of the device and ASD patch closure.<h4>Discussion</h4>This case highlights a rare but serious complication of ASD device closure, underscoring the importance of vigilant follow-up and individualized antithrombotic strategies.<h4>Take-home messages</h4>Recurrent thrombus formation after ASD device closure is rare but may necessitate surgical intervention in high-risk patients. Individualized risk assessment, including prothrombotic states and residual shunting, should guide postprocedural antithrombotic strategies.