Percutaneous atrial Septal Occluder devices and cardiac erosion: A review of the literature

Crawford, Geoffrey B.; Brindis, Ralph G.; Krucoff, Mitchell W.; Mansalis, Benjamin P.; Carroll, John D.

doi:10.1002/ccd.24347

Cited by 124 publications

(109 citation statements)

References 46 publications

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“…3 Additionally, little information is available regarding the presence of coronary artery anomalies in patients undergoing ASD device closure. To our knowledge, this is the first reported case providing e62…”

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confidence: 99%

Coronary Anomaly Preventing Transcatheter Closure of an Atrial Septal Defect

Williams

Ootaki

Quartermain

2012

Circ: Cardiovascular Interventions

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A 4-year-old asymptomatic girl presented for elective transcatheter closure of her ostium secundum atrial septal defect (ASD). Her examination revealed a fixed split second heart sound with a 2/6 systolic ejection murmur at the left upper sternal border and a right ventricular lift. Transthoracic echocardiogram demonstrated a 15-mm secundum ASD with a mildly dilated right ventricle. The left coronary artery (LCA) could not be readily identified on the study. The patient was referred for percutaneous device closure when a preprocedural transesophageal echocardiogram revealed a moderatesized secundum ASD with left to right shunting, moderate right ventricle dilation, and an anomalous origin of the LCA from the right sinus of Valsalva was identified ( Figure 1A). The origin and distribution of the right coronary artery was normal. Cardiac catheterization revealed a Qp:Qs ratio of 2:1. Aortography confirmed the anomalous origin of the LCA from the right sinus of Valsalva with a course posterior to the aorta ( Figure 2A).With balloon sizing using the stop flow technique, the ASD measured 12 mm in diameter. A 12-mm Amplatzer septal occluder was then positioned but not released in the defect and was evaluated by transesophageal echocardiogram. The Amplatzer septal occluder was well seated but concern arose secondary to the device's proximity to the anomalous LCA as it coursed posterior and adjacent to the atrial septum ( Figure 1B). A repeat aortography revealed systolic compression of the LCA ( Figure 2B and online-only Data Supplement Video). No electrocardiogram abnormalities suggesting ischemia or hemodynamic changes occurred. The device was successfully removed and a repeat aortogram demonstrated no further distortion of the LCA ( Figure 2C). The patient recovered well and has been recommended for surgical ASD closure.In the current era, there exist very few contraindications to transcatheter closure of secundum ASDs 1 and very few periand postprocedural complications.2 Known device-related complications of percutaneous ASD closure, particularly with the Amplatzer septal occluder, include worsening of aortic regurgitation and cardiac erosion.3 Additionally, little information is available regarding the presence of coronary artery anomalies in patients undergoing ASD device closure. To our knowledge, this is the first reported case providing

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mentioning

confidence: 99%

Coronary Anomaly Preventing Transcatheter Closure of an Atrial Septal Defect

Williams

Ootaki

Quartermain

2012

Circ: Cardiovascular Interventions

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“…However, there is a risk for these rigid devices inside a vessel to erode their wall and cause esophageal fistula. Multiple reports have documented erosive complications with septal Amplatzer occluders in the heart, even years after their placement, with dire consequences (9). Only long term follow-up can determine the safety of these devices.…”

Section: Discussionmentioning

confidence: 99%

Hybrid treatment of dysphagia lusoria: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug

Cobos-González¹,

Aragón-López²,

García-Buen-Abad³

et al. 2016

Rev Esp Enferm Dig

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Compression of the esophagus by a retroesophageal aberrant right subclavian artery (ARSA) is a rare cause of dysphagia. We present the case of a 47-year-old female with symptoms of progressive dysphagia diagnosed with dysphagia lusoria using barium swallow and contrast computed tomography and successfully treated with a hybrid procedure: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug through the right superficial femoral artery. We consider this approach safer, less invasive and more complete to avoid recurrent dysphagia.

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“…33, 34 Cardiac erosion is a rare, but serious complication with an incidence of 0.1-0.3%. 35 The majority of erosions occur within 5 days of the procedure. Therefore, we keep patients in hospital during this period.…”

Section: Specific Complications In the 2 Groupsmentioning

confidence: 99%

Comparison of Clinical Outcomes After Transcatheter vs. Minimally Invasive Cardiac Surgery Closure for Atrial Septal Defect

Kodaira

Kawamura

Okamoto

et al. 2017

Circ J

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nickel allergy. 6, 7 Technological advances have made contemporary surgery less invasive than classical surgery using full sternotomy. Cardiac surgery performed without full sternotomy is called minimally invasive cardiac surgery (MICS). 8 Advantages of MICS are swift recovery and reduction of pain and sternal wound infection. Furthermore, it is cosmetically appealing, considering the higher prevalence of women and the relatively young population of patients with ASD compared with the typical surgical population. 9 MICS for ASD has been shown to be a safe procedure with satisfactory long-term outcomes. 10,11 More recently, MICS has used endoscopy through a small skin incision in the right chest wall, and is called a right mini-thoracotomy MICS. 12 The aim of this study was to compare percutaneous closure with right mini-thoracotomy MICS for secundum ASD because to date, no direct comparison has been made in terms of efficacy and safety. We also report data on the S ecundum atrial septal defect (ASD) is one of the most common congenital cardiac malformations. 1 Guidelines recommend closure of ASD in patients with right ventricular enlargement, regardless of symptoms. 2 Surgical closure was performed for the first time in 1953 and has been the gold standard for decades. Percutaneous ASD closure, on the other hand, was introduced in 1975. 3 In 2002, a non-randomized multicenter study compared percutaneous closure with surgery, and demonstrated comparable success rates. Notably, minor complication rates were significantly higher with surgery than with percutaneous closure, and the hospital stay was shorter with percutaneous closure. 4 Percutaneous closure has been widely performed and has replaced surgery, except in cases of large defects, insufficient rims, or a left atrium too small to accommodate a device. 2,5 However, concern remains regarding the requirement for prosthetic device implantation, which could eventually lead to delayed complications such as cardiac erosion, device thromboembolic events and Conclusions: Percutaneous closure and MICS had high success rates without deaths. For ASD patients with a suitable anatomy, percutaneous closure can be considered as the first therapeutic option.

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Percutaneous atrial Septal Occluder devices and cardiac erosion: A review of the literature

Cited by 124 publications

References 46 publications

Coronary Anomaly Preventing Transcatheter Closure of an Atrial Septal Defect

Coronary Anomaly Preventing Transcatheter Closure of an Atrial Septal Defect

Hybrid treatment of dysphagia lusoria: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug

Comparison of Clinical Outcomes After Transcatheter vs. Minimally Invasive Cardiac Surgery Closure for Atrial Septal Defect

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