Embolization of an Atrial Septal Defect Occluder Device Into the Left Ventricle

Abstract

Amplatzer Atrial Septal Occluder device has been routinely and successfully used as a percutaneous alternative to cardiac surgery for closure of atrial septal defects. It has shown to the safe with a low complication profile. Complications that most commonly occur with atrial septal defect (ASD) closure devices include malposition or embolization, residual shunt, atrial arrhythmias, thrombosis over the vena cava or atrium, erosion and perforation of the heart, and infective endocarditis. The most common complications associated with an ASD occluder device appear to be embolization and malposition with embolization usually occurring in the main pulmonary artery. We present a case in which the ASO device, Amplatzer TM (Abbott, USA), embolized into the left ventricle.

Three‐dimensional transesophageal echocardiography measurements of ASD sizing parameters in comparison to balloon sizing method in percutaneous ASD closure

“…12 The transcatheter closure of secundum atrial septal defects is increasingly favored over surgical approaches for treating ASDs due to its minimally invasive nature, reduced morbidity and mortality rates, and decreased duration of hospitalization and convalescence. 16 Potential complications associated with ASD device closure include device malposition or embolization, persistent shunting, atrial arrhythmias, thrombosis in the vena cava or atrium, cardiac erosion and perforation, and infective endocarditis. 4,16 A precise determination of ASD dimensions, shape, and morphology ensures an appropriate selection of the occluder device, leading to improved procedural outcomes and reduced complications.…”

“…16 Potential complications associated with ASD device closure include device malposition or embolization, persistent shunting, atrial arrhythmias, thrombosis in the vena cava or atrium, cardiac erosion and perforation, and infective endocarditis. 4,16 A precise determination of ASD dimensions, shape, and morphology ensures an appropriate selection of the occluder device, leading to improved procedural outcomes and reduced complications. 14,17 While underestimation may result in residual shunting due to inadequate closure or device embolization risk, overestimating the defect can cause device mispositioning or erosional effects on adjacent cardiac structures in the long term 18 especially in patients with a deficient aortic rim.…”

Procedural and Short-Term Results of Percutaneous Atrial Septal Defect Closure in Adolescents and Adults

“…Percutaneous ASD closure devices can intracardiacally embolise the right atrium, right ventricle, left atrium or left ventricle, as well as embolise the arcus aorta or abdominal aorta by passing into systemic circulation. [14][15][16][17][18] In a previous study of a series of 15 patients in which the devices were embolised or misplaced, five of the embolised devices were retrieved using catheter techniques, while 10 of them were surgically removed. 8 In a study conducted by Levi et al, 21 of 3821 patients had device embolism, and 15 of the devices were retrieved by transcatheter approach and six by surgical method.…”