CTICasesIatrogenic Atrial Septal Defect (ASD) Post-Cryoablation
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
A woman presented with platypnea-orthodeoxia (though suspected postural hypotension) after cryoablation for atrial fibrillation. CT to rule out pulmonary embolism showed a small, persistent atrial septal defect (ASD) of about 1 cm, later verified by echocardiography. This defect was created during the ablation procedure where the septum is intentionally perforated, but it failed to close spontaneously. The patient also has hypertensive cardiomyopathy with left ventricular diastolic dysfunction and left atrial enlargement.
Key takeaways
Ablation procedures for atrial fibrillation involve intentional perforation of the interatrial septum, typically at the fossa ovalis, to access the left atrium. While these defects usually close quickly, persistent iatrogenic ASDs can occur. In this case, with coexisting diastolic dysfunction, it led to left-to-right shunting, potentially contributing to postural hypotension. The defect will require percutaneous closure.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Lymphatic Pearls in Catastrophic Antiphospholipid Antibody Syndrome with Renal FailureAutoimmune
- Pseudolesion: Convex Posterior Margin of the IVCArtifact
- Acute Dislodgment of Atrial Appendage LeadIatrogenic
- Anterior Dislocation of the Sternoclavicular JointTrauma
- Iatrogenic Tracheal-Esophageal Fistula / Diaphragmatic Perforation (Malpositioned Feeding Tube)Iatrogenic
- Follow-up: Hepatopulmonary SyndromeVascular
- Pleomorphic Undifferentiated Sarcoma of the Left AtriumNeoplastic
- Cervical Aortic Arch with Separate Arch Origins of Left Carotid ArteriesCongenital
See all cases from April 10, 2016 →