Device Dislocation, Probably Due to Paroxysmal Coughing Early After Percutaneous Closure of Secundum Type Atrial Septal Defect

In a 56-year-old woman with a secundum-type atrial septal defect, a closure device was successfully implanted with primarily adequate positioning of the occluder. Two weeks after discharge, the patient developed paroxysmal coughing that probably led to a device dislocation. Months later, a considerable left-to-right shunt was detected, and the device was found to be ingrown in a defective position and had to be removed surgically. In conclusion, the case demonstrates that recurrent coughing may interfere with closure devices and may lead to dangerous dislocation.