Transcatheter Intervention Treatment Secondary Septal Pouch and Patent Foramen Ovale With an Atrial Septal Defect Occluder

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J INVASIVE CARDIOL 2024. doi:10.25270/jic/24.00278. Epub October 18, 2024.

Patent foramen ovale (PFO) is an embryonic defect in the interatrial septum that has been associated with an increased risk of transient ischemic attacks (TIA) in patients aged 18 to 65 years. A secondary septal pouch, a rare dysplasia structure, provides an environment favorable for blood stasis and thrombus formation. Here, we report a patient experiencing TIA who was found to have PFO and secondary septal pouch and who was treated successfully with an atrial septal defect (ASD) occluder.

A 48-year-old man was admitted to our hospital with typical symptoms of TIA. Preoperative transesophageal echocardiography demonstrated PFO (Figure 1) and secondary septal pouch on the right (Figure 2, Video 1). Contrast transthoracic echocardiography (TEE) showed a moderate right-to-left shunt (Video 2). To close the secondary septal pouch and the PFO at the same time, successful atrial septal puncture was confirmed under the guide of TEE (Figure 3A). Subsequently, a 25/25mm ASD occluder (LifeTech Scientific) was implanted (Figure 4). Post-implantation, the occluder was stable at the implant location (Figure 3B-D). Furthermore, the right-to-left shunt disappeared immediately (Video 3). Thus, ASD occluder implantation may be an effective simultaneous treatment of PFO and secondary septal pouch.

Affiliations and Disclosures

Kun Wang, MB¹; Hao-nan Liu, MB²; Xiao-mei Gao, MB¹; Xiao-fei Jiang, MD^1,2

From the ¹Zhuhai People's Hospital, Zhuhai Hospital, Jinan University, Zhuhai, Guangdong, China; ²Zhuhai People's Hospital, Zhuhai Clinical Medical College of Jinan University, Zhuhai, Guangdong, China.

Dr Wang and Dr Liu contributed equally to the manuscript.

Disclosures: The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Consent statement: The authors confirm that informed consent was obtained from the patient for the study described in the manuscript and to the publication of their data

Address for correspondence: Xiao-fei Jiang, MD, Zhuhai People's Hospital, Zhuhai hospital affiliated with Jinan University, Zhuhai, Guangdong. Email: zhcardiology@126.com