Background
In adult congenital heart defects, atrial septal defect (ASD) accounts
for more than one-fourth of all cases, out of which secundum ASD
accounts for almost 75% of cases. Often Secundum ASD is diagnosed when
a patient is an adult as its detection is difficult due to delayed
symptomatic presentation. Currently, there is a class IIa recommendation
that any asymptomatic patient with an isolated Secundum ASD with
evidence of right atrium (RA) enlargement, right ventricle (RV)
enlargement, and net left-to-right shunt with physiological sequelae but
without cyanosis is a candidate for transcatheter or surgical closure.
However, when ASD closure is difficult as indicated by morphological
features of large size(≥30 mm), wide rim(≥15 mm) deficiency, and
multiple defects surgical closure is preferred compared to transcatheter
closure. The surgical approach to Secundum ASD repair is a safe and
effective operation with little to no morbidity and mortality.
Many congenital heart defects including ASD require a pericardium patch
repair. Recently, CardioCel® a tissue engineered ADAPT™ bovine
pericardial patch known to have a good outcome in terms of preventing
calcification and inflammation reactions has been commonly used in
cardiovascular surgery since 2014. Here we present a novel case of a
patient who underwent Secundum ASD repair with CardioCel patch that
failed within a with presumed degeneration of the patch.