``Cobra-Like'' Deformation of an Amplatzer Septal Occluder

Abstract

Transcatheter occlusion of secundum atrial septal defects using Amplatzer septal occluders (ASOs) is a safe, simple, and effective alternative to surgical closure. We present the first report of a "cobra-like" shape deformation of the device encountered during inappropriate positioning. The complication is reversible and is easily avoidable.

Incidence of thrombus formation on the CardioSEAL and the Amplatzer interatrial closure devices

“…11 However, there were 2 CardioSEAL devices with abnormal positions of the arms. On these devices, 1 of the 4 spring arms was in an abnormal position, perpendicular to the plane of the cloth sheet.…”

Tulip Deformity with Cera Atrial Septal Defect Devices: A Report of 3 Cases

“…Regards to the single reported tulip deformity, the authors in that case have contemplated about opening the device against LA roof or wall [2]. The same hypothesis has been postulated for the cobra head malformation of the Amplatzer Septal Occluder (ASO) [1,3]. We feel that may not be the case since we have voluntarily avoided opening the device close to the LA wall or roof.…”

“…Cobra head malformation of ASD device is one such which has been reported in literature [2]. Tulip deformity has recently been reported as a case report [3]. We report 3 cases with tulip deformity during percutaneous closure of ASD using Lifetech Cera ASD devices.…”

Challenges in Atrial Septal Defect Occlusion

“…The dilator was used to retain the left disc in the LA as the right disc was uncovered and pulled gently toward the RA, allowing engagement of the IAS from the right aspect (Videos 10 and 11). This technique has also been shown to aid the closure of large ASDs and quickly redeploying the distal disc [12], repeating the procedure several times [13], and loading the device into the sheath while making back-and forth movements in the sheath [14]. Such attempts were at least partially effective in regaining normal device configuration.…”