Transcatheter techniques for closure of patent ductus arteriosus (PDA) have been used for almost 40 years. We report a case of a 24-year-old female with a 22 mm PDA, congestive heart failure, and atrial fibrillation. She underwent transcatheter PDA closure with an Amplatzer atrial septal occluder (ASO). Following the procedure, she developed hemolysis due to a large residual shunt. However, the shunt gradually resolved until complete closure was achieved within 8 months. An attempt to restore sinus rhythm with electrical cardioversion was successful and the patient is now, 2 years after procedure, in New York Heart Association functional class I. Off-label use of an ASO for closure of a very large PDA yielded an excellent clinical result.

Post-operative ventricular septal defect (VSD) following septal myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM) is a rare complication which may warrant closure. Repeat early sternotomy for surgical closure of the VSD seems undesirable and transcatheter VSD closure may be a valid alternative. We report the case of successful closure of a 10-mm VSD following surgical therapy for HOCM using an Amplatzer Muscular VSD Occluder.