Transhepatic Approach for Device Closure of Secundum Atrial Septal Defect in Patient with Interrupted Inferior Vena Cava

Transcatheter device closure of secundum atrial septal defect is a well known option since 1974. The procedure is routinely performed through femoral vein approach but rarely inferior venacava (IVC) may be interrupted or blocked so transfemoral approach cannot be an option in these patients. In such rare cases surgical closure can be performed but in cases of percutaneous closure of secundum atrial septal defect the viable options are transjugular and transhepatic routes. We used transhepatic approach in this patient for device closure of secundum atrial septal defect. A 27mm occluder was used for the defect and two flipper free coils were used to seal the tract and there were no major complications. The patient was discharged home after 36 hours of the procedure with normal liver functions and ultrasonography.