Successful Percutaneous Device Closure of a Large Secundum Atrial Septal Defect in an Elderly Female with COPD and Atrial Fibrillation: A Case Report

We describe a 72-year-old female with chronic obstructive pulmonary disease (COPD), atrial fibrillation, and a large ostium secundum atrial septal defect (ASD), who presented with progressive dyspnea, hypoxemia, and acute COPD exacerbation. Despite advanced age, lung disease, arrhythmia, and a high surgical risk score, the defect was successfully closed percutaneously using a 46 mm Lifetech CERA device. ASD and COPD both have synergistic effect on Right heart volume overload leading to Right heart failure. This case demonstrates that transcatheter ASD closure can be safely and effectively performed in carefully selected elderly patients with significant left-to-right shunting and without Eisenmenger physiology, even in the presence of multiple comorbidities (1–3). Transcatheter ASD closure has less adverse events and faster recovery rates with reduction in duration of Hospital stay as compared to surgical closure.