Percutaneous closure of atrial septal defects in adults has emerged as an alternative to surgery. We report a sequela of such closure in a 16-year-old boy: embolization of the atrial septal defect occluder into the main pulmonary artery when the patient experienced an episode of intense coughing immediately after device deployment. We removed the device surgically and closed the atrial septal defect in a standard manner, with an autologous pericardial patch.

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Brachial artery cannulation is technically simple and less time consuming, thus suitable even for emergency cases. With an acceptable risk of local complications, we recommend routine use of upper brachial cannulation for antegrade cerebral perfusion.

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