Percutaneous Closure of a Giant Secundum Atrial Septal Defect Using 2 Sutured Occluders

Authors

• Arturo Giacaman Saavedra, Henry Ford HealthFollow
• Georgi Fram, Henry Ford HealthFollow
• Pedro Engel Gonzalez, Henry Ford HealthFollow
• Tiberio M. Frisoli, Henry Ford HealthFollow
• Rommel Yap, Henry Ford HealthFollow
• James Lee, Henry Ford HealthFollow
• Bryan Zweig, Henry Ford HealthFollow
• John Dawdy, Henry Ford HealthFollow
• Brian O’Neill, Henry Ford HealthFollow
• Pedro Villablanca, Henry Ford HealthFollow

Recommended Citation

Giacaman A, Fram G, Engel P, Frisoli T, Yap R, Lee J, Zwieg B, Dawdy J, O’Neill B, Villablanca P. Percutaneous Closure of a Giant Secundum Atrial Septal Defect Using 2 Sutured Occluders. JACC Case Rep. 2026;31(34):109006.

Document Type

Article

Publication Date

8-26-2026

Publication Title

JACC Case Rep

Abstract

BACKGROUND: Giant 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.

PubMed ID

42347721

ePublication

ePub ahead of print

Volume

31

Issue

34

First Page

109006

Last Page

109006