Transcatheter Closure of an Atrial Septal Defect in a Patient With Noonan Syndrome After Pericardial Patch Resorption

Introduction. Transcatheter closure of an atrial septal defect (ASD) is considered to be a gold standard for patients with suitable anatomy as compared to cardiac surgery. Patch resorption after surgical closure of an ASD is a very rare late complication which can be successfully managed with transcatheter procedure. Case report. In this case report we present a female patient with Noonan syndrome who presented with hemodinamically significant ASD 37 years after the corrective cardiac surgery. Due to numerous comorbidities which included severe kyphoscoliosis, pectus excavatum and multiple surgeries we decided to perform a transcatheter closure of the ASD. The procedure itself was very challenging in terms of the patient’s short stature and heart’s orientation in the chest, but was performed successfully. Subsequent follow-up was uneventful and patient reported improvement in her symptoms. Conclusion. Transcatheter closure of an ASD in a patient with Noonan syndrome with a history of surgically corrected ASD can be performed successfully, despite challenging chest anatomy.