Tulip malformation of the left atrial disc in the lifetech cera ASD device: A novel complication of percutaneous ASD closure

A previously unreported tulip-like malformation of the left atrial disc was encountered during percutaneous closure of an atrial septal defect (ASD) using the LifeTech Cera ASD device, requiring snare assistance to permit recapture into the delivery sheath. This was likely to be as a result of attempting to recapture the left atrial disc whilst it remained in contact with some part of the atrial septum or left atrial wall. To help avoid this, it is recommended to ensure complete intracavity positioning of the Cera device prior to retrieval into the sheath.