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It was reported that on (b)(6) 2026, a 19mm amplatzer septal occluder was chosen for an atrial septal defect using a 9f amplatzer trevisio intravascular delivery system.During procedure, it was noted that the rims were thin, and balloon sizing showed a maximum measurable diameter of 19¿20 mm.Therefore, a 19mm device was selected initially.During the attempt to implant inside the body, continuous contact with the aorta was observed, and the device was determined to be oversized.Additionally, because the defect morphology was elliptical, it was considered that downsizing the device would not increase the risk of device embolization.There were no bends or kinks been observed in the delivery sheath.The device was therefore changed to a new 18mm amplatzer septal occluder and transesophageal echocardiogram (tee) imaging confirmed that there were no issues following device replacement.The patient remained hemodynamically stable throughout the procedure.There was no clinically significant delay in procedure and no adverse patient effects.The patient was reported stable.
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