Stroke and peripheral embolism from an Amplatzer septal occluder 5 years after implantation

Stöllberger, Claudia; Finsterer, Josef; Krexner, E.; Schneider, B.

doi:10.1007/s00415-008-0873-z

Cited by 14 publications

(11 citation statements)

References 13 publications

(2 reference statements)

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“…Whereas in the largest follow-up series dealing with that problem [8], the Amplatzer ASD/PFO occluder was the only type of device with no thrombus formation in the early follow-up, supported also by data from smaller series [22]. In contrast, others have shown early [9] and also late thrombus formation for Amplatzer occluder as well [23], the longest interval being 5 years after implantation [24]. Our patient with an interval of more than 8 years after implantation poses new questions: despite a regular ingrowth of the implant on histology thrombotic formation grew on both sides of the device with symptomatic recurrent coronary, cerebral and ocular embolism.…”

Section: Discussionmentioning

confidence: 79%

Clinical, echocardiographic and histopathologic findings in nine patients with surgically explanted ASD/PFO devices: Do we know enough about the healing process in humans?

Vogt¹,

Kühn²,

Hörer³

et al. 2011

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 79%

Clinical, echocardiographic and histopathologic findings in nine patients with surgically explanted ASD/PFO devices: Do we know enough about the healing process in humans?

Vogt¹,

Kühn²,

Hörer³

et al. 2011

International Journal of Cardiology

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“…8 The most frequent neurological events occur within the first 12 months, and only a few cases of recurrent strokes are reported to have occurred 5 years or longer after device closure of intracardiac shunt. [9][10][11] Currently, most of the intracardiac shunts, regardless of ASD or PFO, are performed using percutaneous devices, as in the above-mentioned cases. The unique feature of the present case is that ASD closure was performed surgically and stroke recurrence occurred three times over a time period that was more prolonged than described in previous reports.…”

Section: Discussionmentioning

confidence: 99%

Stroke Recurrence in a Patient Twelve Years after Repair of a Secundum Atrial Septal Defect

Seo

et al. 2018

J Neurocrit Care

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Background: Secundum atrial septal defect (ASD) is a common congenital heart defect in adults. Patients with ASDs at high risk of cardiovascular complications undergo either surgical repair or percutaneous device closure. Case Report: We report the case of an 85-year-old male with unusual recurrent cerebral infarctions. The patient has undergone repair of secundum ASD 12 years ago. Evaluation by transesophageal echocardiography revealed a mobile mass at the patch repair site in the left atrium. The mass was surgically removed due to recurrent stroke during the anticoagulation. Conclusion: This case emphasizes the importance of regular cardiac checkup and the need to consider cardioembolic source as being part of the etiology of stroke recurrence, even if the event occurs many years after intracardiac shunt closures.

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“…Symptomatic atrial fibrillation was diagnosed 58 months after implantation, and a therapy with bisoprolol and acetylsalicylic acid was started. Between 56 and 59 months after implantation, a left-sided SO thrombosis developed, as demonstrated by computed tomography [6]. The SO thrombosis led to ischemic stroke and peripheral embolism, necessitating surgical embolectomy in all extremities and oral anticoagulation (OAC) with phenprocoumon.…”

Section: Case Presentationmentioning

confidence: 99%

“…Complications of occluders include thrombosis and embolism, dislocation, cardiac perforation, and, rarely, infection [1-5]. We report the fatal course of septicemia in a patient who had already survived an SO-related thromboembolism two years previously [6]. …”

Section: Introductionmentioning

confidence: 99%

Fatal septicemia in a patient with cerebral lymphoma and an Amplatzer septal occluder: a case report

2011

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IntroductionThe Amplatzer septal occluder is frequently used for percutaneous closure of an atrial septal defect. Complications include thrombosis and embolism, dislocation, cardiac perforation, and, rarely, infection. We report the case of a patient who had survived an occluder-related thromboembolism two years previously.Case presentationA 72-year-old Caucasian woman had received a septal occluder because of an atrial septal defect seven years ago. Two years ago, she underwent chemotherapy of a non-Hodgkin lymphoma, developed atrial fibrillation, and experienced a left-sided occluder thrombosis with stroke and peripheral embolism. Now, she presented with cerebral lymphoma, received glucocorticoids, and subsequently developed skin lesions. Swabs from the lesions and blood cultures were positive for methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa. Endocarditis, however, was considered only two months later and echocardiography suggested aortic valve endocarditis. Despite antibiotic therapy, she died three days later because of septicemia, and no post-mortem investigation was carried out. It remains uncertain whether the septal occluder was endothelialized or infected and whether explantation might have changed the outcome.ConclusionsIf infections occur in patients with a septal occluder, endocarditis should be considered and echocardiography should be performed early. To prevent a fatal outcome, explantation of the septal occluder should be considered, especially in patients with problems that suggest delayed endothelialization. Post-mortem investigations, including bacteriologic studies, should be carried out in patients with a septal occluder in order to assess the focal and global long-term effects of these devices.

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Stroke and peripheral embolism from an Amplatzer septal occluder 5 years after implantation

Cited by 14 publications

References 13 publications

Clinical, echocardiographic and histopathologic findings in nine patients with surgically explanted ASD/PFO devices: Do we know enough about the healing process in humans?

Clinical, echocardiographic and histopathologic findings in nine patients with surgically explanted ASD/PFO devices: Do we know enough about the healing process in humans?

Stroke Recurrence in a Patient Twelve Years after Repair of a Secundum Atrial Septal Defect

Fatal septicemia in a patient with cerebral lymphoma and an Amplatzer septal occluder: a case report

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