Background: Secundum atrial septal defect (ASD) is a common congenital heart defect in
adults. Patients with ASDs at high risk of cardiovascular complications undergo either surgical
repair or percutaneous device closure.
Case Report: We report the case of an 85-year-old male with unusual recurrent cerebral
infarctions. The patient has undergone repair of secundum ASD 12 years ago. Evaluation by
transesophageal echocardiography revealed a mobile mass at the patch repair site in the left
atrium. The mass was surgically removed due to recurrent stroke during the anticoagulation.
Conclusion: This case emphasizes the importance of regular cardiac checkup and the need to
consider cardioembolic source as being part of the etiology of stroke recurrence, even if the
event occurs many years after intracardiac shunt closures.