Responce to hemorrhagic pericardial effusion 6 months following atrial septal defect device closure: Has it eroded?

Dear Sir, I am writing regarding the article titled “Hemorrhagic pericardial effusion 6 months following atrial septal defect device closure: Has it eroded?” published in the January 2025–February 2025 issue of Anals of Pediatric Cardiology.[1] I found the manuscript to be of great interest, providing significant insights into the possible complications of transcatheter atrial septal defect (ASD) closure. While the paper is valuable, I wish to elaborate on certain aspects that could benefit from additional investigation. A 41-year-old male patient underwent closure of an ASD and subsequently developed cardiac tamponade 6 months postprocedure. This complication is documented in the medical literature, particularly when using the Amplatzer septal occluder. The presence of pericardial effusion during the follow-up necessitates the consideration of potential aortic erosion by the implanted device. Venczelova et al. described a helpful diagnostic finding on transthoracic echocardiography in their case report: a dilated transverse sinus in the parasternal short-axis view, which is pathognomonic for aortic wall erosion by an ASD occluder and should be considered in the diagnostic workup.[2] I hope this detailed description may be helpful in future for the suspicion of aortic wall erosion after transcatheter ASD closure. Sincerely, Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.