Unexpected difficulty during transcatheter device closure of atrial septal defect associated with right aortic arch

Abstract

Right aortic arch (RAA) associated with isolated atrial septal defect (ASD) is very rare. We report successful closure of ASD associated with RAA using a 26-mm atrial septal occluder in a 30-year-old male patient. The impingement of right descending aorta in RAA caused malposition of the device in the left atrium. Deployment of the device through the right upper pulmonary vein successfully closed the defect. Follow-up evaluation by computerized tomography scan and echocardiogram showed no pulmonary venous obstruction.

Keywords

• Atrial septal defect
• atrial septal occluder
• congenital heart disease in adults
• right aortic arch