Successful percutaneous closure of a residual atrial septal defect due to device failure

Rosa, Sílvia Aguiar; Ferreira, Filipa; Sousa, Lídia de; Fiarresga, António; Martins, José Diogo Ferreira; Galrinho, A; Agapito, Ana; Fazendas, Paula; Pinto, Fátima F.; Ferreira, Rui Cruz

doi:10.1016/j.repc.2016.09.020

Cited by 5 publications

(7 citation statements)

References 4 publications

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“…ASD closure-related thrombosis is more frequently seen in delayed than in early stage after the occluder release ( 5 , 9 , 12 , 17 , 18 ). However, thrombosis can occur during device implantation and any stage after occluder release ( 13 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, the child of our case received an Amplatzer occluder and had no pre-existing risk factors. Fiarresga et al ( 5 ) and Eren et al ( 22 ) speculated that the thrombus was already formed in the delivery sheath when the left disc was first released. With the retraction of the occluder, a portion of the thrombus can attach to the left disc and thus be taken to the heart.…”

Section: Discussionmentioning

confidence: 99%

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Case report: Early thrombosis in left atrial during transcatheter closure of ASD in a child with favorable outcome after use of GPIIb/IIIa receptor antagonist and heparin

et al. 2023

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BackgroundAcute thrombus in atrial septal defect occluders is a rare complication that requires aggressive, effective, and safe management. Tirofiban, a platelet glycoprotein IIb/IIIa receptor antagonist, is widely used for the management of thromboembolic diseases, such as coronary heart disease and stroke. To date, there is no report using the GPIIb/IIIa receptor antagonist tirofiban for the management of ASD closure-related thrombosis in children.Case presentationHerein, we reported a case of a 5-year-old girl with ASD who presented with acute thrombus on the left disc of the occluder device immediately after transcatheter closure of ASD. The thrombus was successfully dissolved 24 h after a combined infusion of heparin and tirofiban, followed by 1 months of aspirin and clopidogrel and 5 months of aspirin alone. No thromboembolism or hemorrhage events occurred during follow-up for more than 2 years.ConclusionThe continuous infusion of GPIIb/IIIa receptor antagonist tirofiban combined with heparin may have beneficial effects for the management of thrombosis during ASD closure procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case report: Early thrombosis in left atrial during transcatheter closure of ASD in a child with favorable outcome after use of GPIIb/IIIa receptor antagonist and heparin

et al. 2023

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“…Mortality and morbidity are low in the treatment of this condition, regardless of which approach is chosen [ 15 , 16 ]. Some publications have reported a second device closure for residual shunt following initial transcatheter closure [ 10 , 17 , 18 ] or surgical treatment for residual shunt after transcatheter closure [ 19 ]. However, reports of cath-lab procedure to close a residual shunt following initial surgical closure of ASD are rare [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…The alternative to transcatheter treatment is surgical repair with an antilogous pericardial or synthetic patch. Reports have been published with regard to residual shunts after surgical or interventional therapy and their treatment [ 9 , 10 ]. Most residual shunts have sufficient rims to be closed with an occluder and few reports device closure of residual shunts following initial surgical closure of an atrial septal defect (ASD).…”

Section: Introductionmentioning

confidence: 99%

Transcatheter closure of a residual shunt with posteroinferior deficient rim after surgical closure of an ASD: a case report

Deng

Yao

Wang

et al. 2020

BMC Cardiovasc Disord

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Background: There are few reports in the literature of device closure of residual shunts following initial surgical closure of an atrial septal defect (ASD). This case study reports one such case. We describe here a case of secundum type ASD that was initially closed surgically, followed by device closure of a residual shunt with a posteroinferior deficient rim. Case presentation: A 7-month-old boy was admitted to our hospital for elective surgery to surgically correct a secundum type ASD. Unfortunately, a residual shunt 3.5 mm in diameter appeared before discharge and was enlarged at1-year follow-up. The cause of this residual shunt was dehiscence at the posteroinferior aspect, and the posteroinferior rim was 3.7 mm. After careful discussion and preparation, we proceeded with an interventional procedure. A 16 mm ASD occluder (AGA Medical Corp, Plymouth, Minnesota) was deployed successfully with no residual shunt. In some cases of ASD, interventional therapy is not considered due to the size and position of the defect, but we show here, a successful case of interventional therapy for a residual shunt with a deficient rim. Conclusion: We have presented a case in which a postoperative residual shunt with a deficient rim was successfully closed with interventional therapy.

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“…Similar to the Cardia ASD prosthesis, having the same low profile metal frame could help the second device achieve better apposition to the first. 13 However, since the mechanism of PVA membrane disappearance is unknown, a second device with a different structure should be chosen to avoid recurrent inadequate endothelialization response 8,11,14 ASD device sizes utilized in reported cases range from 14 mm to 30 mm, so the complication seems to be independent from size. There was no evidence of infection or any failure mechanism.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Perforation of Polyvinyl Alcohol Membrane: A Rare Cause of Atrial Septal Occluder Failure

Parlar

Bozyel

2019

Kocaeli Üniversitesi Sağlık Bilimleri Dergisi

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Objective: Percutaneous closure of atrial septal defect is a well-established procedure and has evolved to become the standard of care due to its many advantages. However, atrial septal defect closure devices covered with polyvinyl alcohol membrane could cause recurrent significant shunts due to a spontaneous polyvinyl alcohol membrane perforation. To investigate whether spontaneous polyvinyl alcohol membrane perforation developed in our patients who had implanted with CARDIA Ultrasept atrial septal defect occluder (Eagan, Minnesota, USA) that covered with Polyvinyl Alcohol membrane. Methods: We retrospectively rewieved all patients with a diagnosis of secundum type atrial septal defect who underwent percutanoues closure with CARDIA Ultrasept prosthesis. Results: Ten patients aged 4 to 56 years who underwent atrial septal defect closure with UItrasept device were included. During a median 26 months follow up period, we detected a four cases of polyvinyl alcohol membrane failure. In 3 patients, perforation of polyvinyl alcohol membrane caused significant left to right shunt that required re-intervention, while in one patient it caused minimal residual shunt. The devices were used were 14 mm (two patients), 16 mm (one patient) and 30 mm (one patient). Two patients underwent surgical device removal and pericardial patch closure. One patient underwent device in device procedure. Residual shunts were not occured in after reinterventions. Conclusion: Polyvinyl alcohol membrane perforation is rare and can require reintervention. Operators have to be aware of this malfunction.

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Successful percutaneous closure of a residual atrial septal defect due to device failure

Cited by 5 publications

References 4 publications

Case report: Early thrombosis in left atrial during transcatheter closure of ASD in a child with favorable outcome after use of GPIIb/IIIa receptor antagonist and heparin

Case report: Early thrombosis in left atrial during transcatheter closure of ASD in a child with favorable outcome after use of GPIIb/IIIa receptor antagonist and heparin

Transcatheter closure of a residual shunt with posteroinferior deficient rim after surgical closure of an ASD: a case report

Spontaneous Perforation of Polyvinyl Alcohol Membrane: A Rare Cause of Atrial Septal Occluder Failure

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