Percutaneous closure of postoperative malaligned residual atrial septal defect was successfully performed from the transjugular approach under transesophageal echocardiography guidance in a 38-year-old symptomatic woman with patent femoral venous access using the usual hardware. This demonstrates the feasibility of transjugular approach as an alternative to femoral or transhepatic approaches in patients with difficult atrial septal anatomy who are usually referred for surgery.
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