• Yong Yang, Xi Li, Mao Chen, and Yuan Feng.
• Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
• Medicine (Baltimore). 2017 Dec 1; 96 (50): e9216.

RationaleIatrogenic atrial septal defects caused by cardiac surgery are rare complications that are traditionally repaired through reoperations; unfortunately, reoperations are accompanied by high risk and trauma.Patient ConcernsHerein, we report a rare case of a huge atrial septal defect after mitral and aortic mechanical valve replacement.DiagnosesTransesophageal echocardiography revealed a 20 × 33 mm atrial septal defect with a mainly left-to-right shunt and bidirectional shunt.InterventionsThe defect was successfully occluded using a Shape Memory septal occlude with a waist diameter of 42 mm.OutcomesAt follow-up 6 months after, the patient's symptoms were remarkably relieved and chest radiograph showed obvious improvement of the pulmonary congestion.LessonsPercutaneous device treatment can be used as an alternative to surgery in iatrogenic atrial septal defects if the anatomical condition of the septal defect is appropriate for transcatheter closure.Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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