# Delayed cardiac tamponade caused by erosion 5 years after percutaneous closure of atrial septal defect with Figulla Flex II: a case report

## TL;DR

A patient experienced delayed heart damage five years after a minimally invasive heart defect closure procedure, requiring emergency surgery.

## Contribution

Reports a rare case of delayed cardiac erosion caused by a Figulla Flex II device five years post-implantation.

## Key findings

- Cardiac tamponade occurred 5 years after ASD closure with Figulla Flex II device.
- Device penetration through the aortic and right atrial walls was confirmed during surgery.
- Successful removal and repair of the device were performed.

## Abstract

Percutaneous closure of atrial septal defect (ASD) is less invasive than surgical closure and yields good results; however, cardiac erosion is a serious complication. It usually occurs within 72 h after implantation and rarely after months to years. Cardiac erosion has been rarely reported using Figulla Flex II (FFII; Occlutech, Schaffhausen, Switzerland). In this case, we encountered a case of delayed cardiac erosion after FFII implantation. An 81-year-old woman, who underwent percutaneous ASD closure elsewhere 5 years previously, presented to our hospital with sudden chest pain and was diagnosed with cardiac tamponade. She underwent emergency surgery and was diagnosed with cardiac erosion caused by FFII. The device had penetrated the aortic wall through the right atrial wall. Removal and repair were successful. Cardiac erosion can occur long after implantation; therefore, patients require careful follow-up.