ArticleJACC. Case reports2026
Percutaneous Closure of a Giant Secundum Atrial Septal Defect Using 2 Sutured Occluders.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundGiant secundum atrial septal defects (ASDs) are generally considered unsuitable for transcatheter closure and often require surgical repair. Innovative percutaneous strategies may provide an alternative in prohibitive-risk patients. CASE SUMMARY: A 75-year-old man with a giant secundum ASD (64.5 × 38.8 mm), severe mitral and tricuspid regurgitation, pulmonary hypertension, atrial fibrillation, cirrhosis, and chronic kidney disease was deemed inoperable. After staged mitral and tricuspid transcatheter edge-to-edge repair, the ASD was successfully closed using two 38-mm septal occluder devices sutured together ex vivo and simultaneously deployed, resulting in stable device position without residual shunt. DISCUSSION: This case demonstrates a novel percutaneous strategy for closure of exceptionally large ASDs exceeding currently available occluder size limits. TAKE-HOME MESSAGE: Percutaneous closure of giant ASDs may be feasible in selected prohibitive-risk patients using coupled occluder devices.
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