{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:37:55Z","timestamp":1786649875970,"version":"build-2736575974"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Multisystem inflammatory syndrome in children (MIS-C), a postinfectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is characterized by hyperinflammation and a prothrombotic state. Thrombosis involving intracardiac devices is rare but potentially life-threatening. We report a 16-year-old girl who had transcatheter closure of a fossa ovalis atrial septal defect using an Amplatzer septal occluder at 4 years of age. During the ongoing coronavirus disease 2019 pandemic, she presented with fever, rash, elevated inflammatory markers, and positive SARS-CoV-2 antibody testing. Transthoracic echocardiography revealed a large mobile thrombus attached to the interatrial septum near the device. She was diagnosed with MIS-C and managed with intravenous immunoglobulin, corticosteroids, and unfractionated heparin. Serial echocardiography showed resolution of the thrombus within 5 days, and she was discharged on low-dose aspirin. This case highlights late thrombus formation on an atrial septal occluder in the context of MIS-C, emphasizing the need for echocardiographic surveillance and anticoagulation in children with prior cardiac interventions who present with hyperinflammatory syndromes.<\/jats:p>","DOI":"10.4103\/apc.apc_229_25","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T07:00:10Z","timestamp":1776236410000},"page":"96-99","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Late thrombosis after an Amplatzer septal occluder in a child with multisystem inflammatory syndrome during the coronavirus disease 2019 pandemic"],"prefix":"10.4103","volume":"19","author":[{"given":"Virupaksh","family":"Koneti","sequence":"first","affiliation":[{"name":"MBBS, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veda","family":"Vallala","sequence":"additional","affiliation":[{"name":"Pediatric Cardiologist, Rainbow Children\u2019s Heart Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keerthan Reddy","family":"Thanam","sequence":"additional","affiliation":[{"name":"MBBS, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri Krishna","family":"Surampudi","sequence":"additional","affiliation":[{"name":"MBBS, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Sinha","sequence":"additional","affiliation":[{"name":"Pediatric Cardiologist, Rainbow Children\u2019s Heart Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1056\/NEJMoa2021680","article-title":"Multisystem inflammatory syndrome in U.S. Children and adolescents","volume":"383","author":"Feldstein","year":"2020","journal-title":"N Engl J Med"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1001\/jama.2020.10369","article-title":"Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2","volume":"324","author":"Whittaker","year":"2020","journal-title":"JAMA"},{"key":"R3-20260420","article-title":"Multisystem Inflammatory Syndrome in Children and Adolescents with COVID-19","year":"2020","journal-title":"Scientific brief: World Health 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Cardiol"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"127","DOI":"10.4103\/apc.apc_105_22","article-title":"Unexpected stormy course after uneventful device closure of atrial septal defect \u2013 Possibly due to post-COVID-19 inflammatory state","volume":"16","author":"Singhi","year":"2023","journal-title":"Ann Pediatr Cardiol"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1002\/art.41454","article-title":"American College of Rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS-CoV-2 and hyperinflammation in pediatric COVID-19: Version 1","volume":"72","author":"Henderson","year":"2020","journal-title":"Arthritis Rheumatol"}],"container-title":["Annals of Pediatric 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