{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:00Z","timestamp":1753876260224,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background\u2003<\/jats:title>\n                  <jats:p>Inappropriate shocks have been reported in \u223c1\/3 of patients with implantable cardiac defibrillators (ICDs). We report an unusual case of inappropriate ICD shocks due to atrial fibrillation (AF) caused by a missed atrial septal defect (ASD) in a patient with a modified Bentall procedure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary\u2003<\/jats:title>\n                  <jats:p>A 67-year-old Caucasian male, with an ICD and a history of a modified Bentall procedure 24 years ago, reported to our outpatient clinic with recurrent inappropriate ICD shocks due to episodes of fast AF. The transthoracic echocardiographic exam revealed two large aneurysms at the ostia of the coronary arteries. We performed further evaluation with transoesophageal echocardiogram and computed tomography (CT) angiography. The aneurysms measured on CT were 3.14 cm \u00d7 2.29 cm on the right ostium and 1.9 cm \u00d7 0.99 cm on the left. A large secundum type ASD of 1.5 cm, missed in all previous echocardiographic studies, was revealed. The therapeutic options of surgical closure of the ASD and repair of the aneurysms or a more conservative approach with percutaneous closure of the ASD and closer follow-up were discussed with the patient. The patient declined the surgical option due to high complication risk, and closure of the ASD with an Amplatzer device was performed 3 months later. A 3-year follow-up was uneventful.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion\u2003<\/jats:title>\n                  <jats:p>It is of major importance to comprehensively and thoroughly assess patients before and after a surgical intervention to not miss other treatable conditions preoperatively and complications in the postoperative period.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab412","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T15:49:37Z","timestamp":1633621777000},"source":"Crossref","is-referenced-by-count":0,"title":["Inappropriate shocks from a transvenous implantable defibrillator caused by atrial fibrillation and a missed atrial septal defect in a patient with a modified Bentall procedure"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-2729","authenticated-orcid":false,"given":"Anna","family":"Kostopoulou","sequence":"first","affiliation":[{"name":"Department of Electrophysiology and Pacing, Onassis Cardiac Surgery Center, Syngrou 356, 17674 Kallithea, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4884-7684","authenticated-orcid":false,"given":"Epameinontas","family":"Fountas","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Onassis Cardiac Surgery Center, Syngrou 356, 17674 Kallithea, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Karapanagiotou","sequence":"additional","affiliation":[{"name":"Laboratory of Imaging, Onassis Cardiac Surgery Center, Syngrou 356, 17674 Kallithea, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stamatis","family":"Kyrzopoulos","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Onassis Cardiac Surgery Center, Syngrou 356, 17674 Kallithea, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"2021111719383176700_ytab412-B1","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.1016\/j.athoracsur.2015.10.090","article-title":"Bentall procedure: a systematic review and meta-analysis","volume":"101","author":"Mookhoek","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2021111719383176700_ytab412-B2","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1016\/S0003-4975(03)00015-8","article-title":"Fate of coronary ostial anastomoses after the modified Bentall procedure","volume":"75","author":"Milano","year":"2003","journal-title":"Ann Thorac 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dilemma: saccular aneurysm or pseudoaneurysm of the ascending aorta with dissection above level of leaflets","volume":"8","author":"Mehrpooya","year":"2012","journal-title":"ARYA Atheroscler"},{"key":"2021111719383176700_ytab412-B7","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/j.1540-8191.2011.01319.x","article-title":"Right coronary ostial aneurysm following a Bentall procedure","volume":"26","author":"Lusini","year":"2011","journal-title":"J Card Surg"},{"key":"2021111719383176700_ytab412-B8","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/jocs.13086","article-title":"A \u201cfloppy hat\u201d-shaped reconstruction for giant coronary ostial-aneurysms after a Bentall operation","volume":"32","author":"Lee","year":"2017","journal-title":"J Card Surg"},{"key":"2021111719383176700_ytab412-B9","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1016\/S0002-9149(02)02290-7","article-title":"Frequency of coronary ostial aneurysms after aortic root surgery in patients with the Marfan syndrome","volume":"89","author":"Meijboom","year":"2002","journal-title":"Am J Cardiol"},{"key":"2021111719383176700_ytab412-B10","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1510\/icvts.2008.183103","article-title":"Giant left coronary ostial aneurysm after modified Bentall procedure in a Marfan patient","volume":"7","author":"Okamoto","year":"2008","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2021111719383176700_ytab412-B11","first-page":"45","article-title":"Atrial septal defect and atrial fibrillation: the known and unknown","volume":"1","author":"Blake","year":"2008","journal-title":"J Atr Fibrillation"},{"key":"2021111719383176700_ytab412-B12","doi-asserted-by":"crossref","first-page":"S2874","DOI":"10.21037\/jtd.2018.08.111","article-title":"Atrial septal defect closure: indications and contra-indications","volume":"10","author":"Fraisse","year":"2018","journal-title":"J Thorac 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