Atrial septal defects (ASD) are one of the most common acyanotic congenital heart lesions. Clinical presentations, complications, and appropriate device sizing are challenging for percutaneous approach. We report a successful percutaneous closure of extreme large secundum ASD with mild pulmonary hypertension, using amplatzer septal occluder (ASO) with fluoroscopic and transesophageal echocardiography guidance (TEE) in a 26-year-old female. Implantation was successful, and no complications were observed during the one month of follow-up.
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