Katherine, I wanted to thank you for your post. My brother found this forum and had read your story and called me, saying “you have to read this - this is exactly like what you’re going through”. Your experience with your surgeon sounds almost identical to mine, and I was so struck by some very specific parallels that I had to write. I was diagnosed with an ASD early this year at the age of 50, with no specific cardiac symptoms having manifested (except for potentially the extreme insomnia I’ve had for past 4 years w/3 subsequent years of various unsuccessful attempts at treating the severe sleep apnea that was diagnosed, eventually progressing to right heart enlargement which lead to the ASD finding). Because the intravenous ASD closure was “minimally invasive”, and because I had so many preliminary workups (starting w/the basic echo that found the shunt, then a T.E.E., then a transcranial doppler, then a heart cath), I stupidly let the young surgeon’s overabundance of self confidence prevent me from having my lifelong hypersensitivity/allergy to metal jewelry keep me from holding everything until I had my allergy medically confirmed. At every preliminary workup I mentioned, “I keep reading about two frequent complications after closure with the Amplatzer Septal Occluder: chronic A-fib, and allergic reactions. I’ve never been able to wear metal jewelry - I’m pretty sure I’m allergic to several metals.” EVERY TIME, without fail, the surgeon just dismissively said, “You wear jeans don’t you? If you can wear jeans, you’re not allergic to metal.” I always responded with, “But I wear underwear - in fact I wear boxer briefs that cover everywhere the various rivets and buttons on jeans could make contact with my skin.” Well, fast forward to after the ASD closure . I immediately had complications. I went into A-fib (for the first time in my life) during the surgery, and two days later developed a huge swollen lymph node in my left armpit (the size of half a tennis ball). 2nd day home it was back to the E.R. in the middle of the night. The surgeon eventually agrees to see me again and says, “You must’ve been predisposed to A-fib. As for the lymph node, that could be anything…”. Fourteen days after surgery I developed severe giant hives from head to toe, which grew into welts, and the ones in the palms of my hands itched so badly I couldn’t stand it. Back to the E.R. at 3am one Sunday, subsequently back to the cardiologist later that week. After 9 solid days of debilitating hives/welts that became only moderately more bearable while continuing high does Prednisone for them, I pushed to the cardiologist’s office to get him to see me again to discuss the complications (after he’d dismissively insisted I go see my primary care dr, and I had done so, only to have my primary dr tell me “this clearly is the result of something related to your surgery”). Upon entering the room, before I can speak the surgeon blurts out, “I’m going to talk, and you’re going to listen.” He then immediately proceeded to berate me for being a “difficult patient” (perhaps because he’s unequipped to deal appropriately with any indication of anxiety coming from his patients who are experiencing debilitating complications which he is directly responsible for - complications that he’d repeatedly insisted were “statistically insignificant” before they actually were happening in front of him?) and he immediately proceeded to completely flip out and angrily quit my case, even canceling an outpatient surgery that I was scheduled to have with him just two weeks later (to implant a subcutaneous LINQ monitor to track this new Afib - which he’d concluded was absolutely necessary the day after my ASD closure and my second day in Afib). This is the same surgeon who had claimed to have gone out of his way to push the insurance company to cover the procedure (in the absence of a prior stroke) during all the preliminary workups, who now - at the first sign of complications - put on a big show of angrily quitting my case and distancing himself from it as aggressively as possible. I had been struck by the fact that the cath lab nurses had commented to me (while prepping me in the procedure room the day of my closure) that the device company rep had come all the way there to observe the procedure. I remember asking, “If they’ve implanted over 200,000 of these things, why would they send a company rep to observe my procedure several states away from where they’re located?”. The answer I was given was, “Oh they come to every ASO device procedure to observe.” That had struck me as really strange. Then when I read about your cardiologist - who had been so helpful prior to any post-surgical complications - pulling the same exact routine of quitting your case at the first signs of trouble - I couldn’t help but think there’s something more going on here. Perhaps the device company advises high volume implant surgeons to distance themselves from the cases where certain complications show up, or perhaps this surgeon is just a really arrogant asshole who has no business being a surgeon. Either way, I’m now in the process (thanks to reading everything you wrote) of documenting the metal allergy (I just had the patch test done last week which indicated a strong allergy to titanium and vanadium; I was unable to find a source for the MELISA test, but probably it’s unnecessary at this point with a strong positive on the patch test). I saw a new cardiologist (unfortunately one in the same office/practice as the surgeon who did my closure but one who is older and more experienced, although he does not claim any experience with doing ASO implants or explants) two weeks ago, and he immediately outfitted me with a Zio surface-adhering A-fib monitor for two weeks to try to determine the next steps for the A-fib, and he indicated if explant is required he would refer me to a minimally invasive thoracic surgeon in the region, outside of their hospital system, who could handle my case for the explant and surgical closure…). So, I only wish I had found this forum before I had allowed this surgeon to pressure me to ignore all my concerns and listen to his boasts of having done “over 300 of these procedures without complications” and that I had trusted my gut instinct and researched the Amplatzer Septal Occluder even more thoroughly and over more time. The Netflix documentary, “The Bleeding Edge” recently came out and so much was brought to light in that which I can obviously attest to now but had no idea was the case beforehand regarding the medical device implant industry. One thing worth noting is that the makers of that documentary did a good job of discussing the DaVinci robotically assisted surgery’s very serious issues, and in light of what they showed, if (when) I have to have an explant procedure and conventional surgical correction of my ASD, I would work very hard to find an experienced minimally invasive thoracic surgeon who could do the surgery without using the DaVinci, or one who has done so many of them that their proficiency wouldn’t be in question. Thank you for all the info you shared - I just want to get my life and my health back, and to caution anyone who’s been told they need to have percutaneous ASD closure via an implanted device to BE CERTAIN YOU ARE NOT ALLERGIC TO METALS before undergoing the procedure. Incidentally, I reached out to St. Jude’s/Abbott (the device manufacturer), referencing my device’s specific serial number, hoping to learn EXACTLY what the metal makeup of my device is (in light of the positive test results for titanium allergy AFTER implantation had been completed), and their response was “Speak with a cardiologist. No detailed information regarding the composition of the Amplatzer device can be sent out externally.” THIS is their response even when given the exact serial number of my device and the information that I’ve just confirmed a strong titanium allergy following post-implantation complications and was simply seeking any info to help best guide my medical decisions moving forward. They wouldn’t even provide any basic info/data regarding incidence of allergic adaptation vs. need for explantation. Isn’t it great to know that the device manufacturers are so concerned for patients’ well-being once they’ve sold their devices? I’ve had better customer service from basic household appliance manufacturers… - Sky C.