# Upsizing of GORE® Cardioform ASD Occluder for Atrial Septal Defect With Atrial Septal Aneurysm

## TL;DR

This paper describes a successful treatment of a complex heart defect using an upsized device to close an atrial septal defect complicated by an atrial septal aneurysm.

## Contribution

The novel approach of upsizing the GORE® Cardioform ASD Occluder device to address edge leakage caused by an atrial septal aneurysm is presented.

## Key findings

- A two-size-up GORE® Cardioform ASD Occluder device successfully closed the defect.
- Controlled movement of the atrial septal aneurysm enabled effective device implantation.

## Abstract

Atrial septal defects (ASDs) often present with multiple foramina, including a patent foramen ovale (PFO) and atrial septal aneurysms (ASAs). Transcatheter device closure of an ASD may require additional supportive techniques in complex cases. Here, we report a case of a secundum ASD complicated by an ASA and a PFO in a man in his 50s. A GORE® Cardioform ASD Occluder (GCA) device of the optimal size for balloon sizing was implanted. However, edge leakage occurred from the front of the device because of a large, moving ASA. Implantation of a two-size-up GCA device successfully closed the ASD under controlled ASA movement.