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Quiz of the Week - 2 August 2023

A 55-year-old hypertensive female patient underwent ASD device closure. TEE images after three weeks showed the following. What’s happening?
 
 
 
 
Shunting across small residual and missed atrial septal defect
Shunting across a patent foramen ovale
Residual shunt across the fenestration in the ASD device
Faulty design in ASD device at manufacturer
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