ABSTRACT

Although many of the ostium secundum atrial septal defects can be successfully closed by percutaneous transvenous approach, surgical method as well is preferred in some cases due to vascular reasons or due to the anatomical characteristics of the defect. Detecting ostium secundum atrial septal defect in a 26-year-old female patient, who presented with shortness of breath, percutaneous closure procedure was planned. During percuta- neous closure, it was observed that guidewire and catheter persistently went towards patent foramen ovale because of quite flaccid structure of interatrial septum. For this reason, occluder could not be placed in the defect area. Before using the option of surgery for the patient, guidewire and simmons 1 diagnostic catheter were pushed forward towards to the left ventricle and then left atrium by transarterial approach through the femoral artery. Guidewire and the catheter were easily passed through atrial septal defect without passing through patent foramen ovale benefiting from the left atrial pressure. Occluder was retrogradely carried via transarterial route and successfully implanted in the defect area. Transarterial approach may be an alternative before surgery in se- lected cases in which percutaneous closure of atrial septal defect has failed.