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Correspondence: *Nader D. Nader E-mail: nadernd@gmail.com Available online: 09-08-2019 Arch Cardiol Mex (Eng). 2019;89(1):70-71 www.archivoscardiologia.com Date of reception: 02-10-2018 Date of acceptance: 12-11-2018 DOI: 10.24875/ACME.M19000011 A 25-year-old woman presented to our echocardiography laboratory for a follow-up imaging study. She had a history of muscular ventricular septal defect (VSD) closure by Amplatzer Muscular VSD Occluder (St. Jude Medical, USA) 4 years before this visit. Since this repair, she has remained asymptomatic and was on no medication. In transthoracic echocardiography, the double disc device was visualized in apical four-chamber view (Fig. 1) with no residual VSD flow. Interestingly, in off-axis view of parasternal long-axis imaging, the device was visualized in the form of two side-by-side figure of 8 “Clover-leaf” appearances (Figs. 2 and 3). Percutaneous disc occluders due to their specific “epitrochoidal” mesh configuration and the interaction with ultrasound waves; form this image artifact when viewed from a coronal imaging position1. Transthoracic echocardiography is the main method of follow-up for post-procedural device position, and accurate interpretation of views is of utmost importance2. By increasing utilization of percutaneous closure devices for various indications including atrial and VSD, left atrial appendage, patent foramen ovale, recognition of this particular pattern as a normal imaging artifact of a deployed double-disc device when visualized from a

Artefacto de hoja de trébol después del cierre percutáneo exitoso del defecto del tabique ventricular muscular