Hypoxia after Atrial Septal Defect (ASD) closure

Closure of atrial septal defect was the first open cardiac surgical procedure performed successfully using cardiopulmonary bypass support and remains, in theory, one of the most straightforward open cardiac surgical procedures. This does not, however, imply that it is trivial. Accurate diagnosis of the type of ASD and the presence of anomalous venous return are essential. Critical errors can still be made and are made by surgeons inexperienced in the management of congenital defects. This is amplified by the pressure to perform more procedures through minimal access incisions. This case demonstrates a potential error in the closure of a secundum ASD when the intracardiac anatomy is not clearly identified.