With the accumulation of a large number of cases of atrial septal defect blocker interventions and longer follow-up, a late postoperative complication, cardiac abrasion, is gradually coming into focus. At the China Heart Congress, Professor Jiang Shiliang from Fu Wai Cardiovascular Hospital gave an insight into this issue. Cardiac abrasion is mainly due to the sharp edges of the septal blocker, which damage adjacent tissues or structures as the heart beats, eventually leading to aorto-left atrial fistula, aorto-right atrial fistula, aorto-right and left atrial fistula (both atria are perforated), pericardial effusion due to atrial rupture and perforation or cardiac compression and mitral valve perforation. This complication occurs mainly when the defect is located anteroseptally, individually in those with 2 blockers implanted, 90％ the aortic side of the defect has poor margins; if the sharp edges of the blockers are adjacent to or convex to the aortic root, atrial wall and anterior mitral valve after blocking, there is a potential risk of abrasive perforation in these areas. According to foreign data, the incidence of cardiac abrasion after intervention with atrial septal defect blockers is 0.05％ to 0.28％. In China, more than 50,000 atrial septal defect occlusion procedures have been performed so far, and 21 cases (0.04%) of cardiac abrasion have occurred, of which 18 cases were confirmed, and 3 cases of sudden death were suspected to be caused by postoperative cardiac compression, of which 16 and 5 cases were with imported and domestic occluders, respectively. Most of the cardiac abrasions occurred within 1 year after the operation, while foreign reports reported that it could occur within 72 hours after the blocking operation, or several days and years after the operation. In China, the shortest incidence is 20 hours after surgery and the longest is 6 months after surgery. Patients may have shortness of breath, chest pain, and other symptoms after cardiac erosion occurs, and some may have a strong tea-colored urine and hemoglobinuria. In addition, for those with sudden onset of severe chest tightness, shortness of breath, chest pain or even syncope, they should be alerted to the possibility of cardiac tamponade. In addition, it is worth noting that there are also those without any symptoms. Echocardiography helps to clarify the assessment of aorto-atrial fistula, mitral valve perforation/regurgitation and the presence and amount of pericardial effusion. Treatment of cardiac erosion is usually surgical, but interventional techniques to occlude the aorto-atrial fistula are also an option, with successful cases at Toronto Children’s Hospital in Canada and Fu Wai Cardiovascular Hospital in Beijing. However, because of the presence of two blockers near the aortic root, strict long-term follow-up is required after the intervention. Those with no clinical symptoms and no enlargement of the atria can also be followed up and observed. There are no ideal measures to prevent the complication of cardiac abrasion after septal defect blocking, but usually for anterosuperior septal defects with poor marginal conditions, the anterosuperior side of the blocker is “Y” or “V” shaped as much as possible, and part of it “However, the blocker should not be too large, and the maximum diameter of the left atrial lateral disc should be strictly controlled to be smaller than the maximum diameter of the atrial septum to avoid postoperative cardiac abrasion. He also pointed out that preoperative interventionalists should inform patients and their relatives or guardians about the advantages and disadvantages of atrial septal defect blocker intervention, and that they should be instructed to come to the hospital for regular (1, 3, 6, and 12 months or more) review after surgery. If there is any significant and persistent discomfort, patients should be seen at any hospital.