The 'aortic rim' recount: embolization of interatrial septal occluder into the main pulmonary artery bifurcation after atrial septal defect closure

Misra, Manoranjan; Sadiq, Adil; Namboodiri, Narayanan; Karunakaran, Jayakumar

doi:10.1510/icvts.2006.141044

Cited by 42 publications

(43 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, 2 reports have shown that an anterior margin of less than 5 mm may predispose to early and late device embolization. 29,47 Hypermobility of the interatrial septum was hypothesized to be a risk factor for unsuccessful percutaneous device closure of ASD and PFO. 48 However, an evaluation of 69 device placements at our institution revealed no significant correlation between exaggerated septal mobility and the success of device closure of interatrial communications.…”

Section: Device Embolizationmentioning

confidence: 99%

Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications

Yared

Baggish

Solı́s

et al. 2009

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

Section: Device Embolizationmentioning

confidence: 99%

Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications

Yared

Baggish

Solı́s

et al. 2009

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

“…1,7,8) Our patient had an aortic rim measuring 2 mm, and margins of < 5 mm may predispose the patient to early and late device embolization. 9) Surgery for retrieval of the device is a proposed treatment, but it carries additional risks including bleeding secondary to antiplatelet therapy. Several transcatheter retrieval techniques of embolized devices have been described using gooseneck snares, pig tail catheters, and bioptomes.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Retrieval of Embolized Atrial Septal Defect Occluder Device by Waist Capture Technique

2018

View full text Add to dashboard Cite

SummaryThis case study describes the successful percutaneous transcatheter retrieval of an embolized Amplatzer occluder device using the "waist capture technique" in a patient with an atrial septal defect. This technique allowed for stability of the Amplatzer device, compression of the atrial discs for easier removal, prevention of further embolization, and minimal injury to vasculature during device retrieval. This novel and effective technique can be used safely for the retrieval of Amplatzer devices in the venous system.(Int Heart J 2018; 59: 226-228) Key words: Amplatzer occlusion device, Percutaneous transcatheter occlusion T he percutaneous transcatheter occlusion technique is an effective, successful alternative to surgery for the treatment of atrial septal defects (ASD). The Amplatzer septal occlusion device is efficient, safe, and easy to use and has a high success rate.1,2) However, a common complication occurring in 0.55% of cases is device embolization.3) Transcatheter retrieval of the embolized device is possible in about half of cases, and several techniques have been described, including the use of gooseneck snares, pig tail catheters, and bioptomes. [3][4][5] In this case study, we report the successful transcatheter retrieval of an embolized ASD occluder device using the "waist capture technique." Case ReportA 51-year-old man presented with dyspnea on exertion (NYHA class II), with physical examination revealing a split second heart sound and a left sternal systolic murmur. Electrocardiography showed incomplete right bundle branch block. Transthoracic echocardiography (TTE) showed a secundum type ASD with a left to right shunt and a moderate pulmonary/systemic flow ratio (Qp/Qs) of 2.2 and transesophageal echocardiography (TEE) confirmed the presence of a round shaped ASD, measuring 20 mm by 18 mm. The aortic rim was the shortest measuring 2 mm, while all other surrounding rims had adequate margins. Preparation was made for percutaneous ASD closure with the patient's informed consent. The procedure was performed under general anesthesia with TEE guidance. The stretched maximal diameter of the defect with sizing balloon was 22 mm, and a 22 mm Amplatzer septal occluder device was selected for use.The device was loaded into the delivery system and introduced into a 9-French long sheath that had already been placed over the exchange wire. After the device was advanced into the left atrium (LA), the delivery system was withdrawn into the right atrium (RA) until the LA sided disc opened and aligned with the interatrial septum. When continuous TEE confirmed adequate device positioning, the RA sided disc was opened, and to assure stability and appropriate apposition to the rims, gentle push/pull (The Minnesota Wiggle) was performed prior to releasing the device. In view of the complete obliteration of color flow across the defect on TEE as well as the stable position of the device, it was left in place.The next day, routine chest x-rays and TTE were performed. The x-rays revealed the Amplatzer device sh...

show abstract

“…Klinikte öksürük, göğüs kafesinde sıkışma gibi nonspesifik semptomlar görülebilmekle birlikte literatürdeki bir çok olgu sunumunda hastaların asemptomatik oldukları bildirilmiştir (2,3,7) . Embolize olan cihazın potansiyel olarak pulmoner arterde erozyon oluşturarak ölümcül kanamaya yol açma riski bulunmaktadır ve vakit geçirilmeden çıkar-tılması önerilmektedir (8) .…”

Section: Discussionunclassified

Retrieval of the Atrial Septal Defect Closure Device Embolized to Pulmonary Artery

Durmaz¹,

Kurtoğlu²,

Güngör³

et al. 2017

Kosuyolu Heart Journal

View full text Add to dashboard Cite

GİRİŞOstium sekundum tip atriyal septal defekt (ASD) erişkinlerde en sık karşılaşılan konjenital kalp anomalileri arasında yer almaktadır. Bu defektlerin cerrahi olarak kapatılması uzun süreden bu yana uygulanan altın standart tedavi yöntemidir (1). ASD'lerin cihaz kullanılarak perkütan girişim yoluyla kapatılması cerrahiye alternatif bir tedavi olarak ortaya çıkmıştır.Perkütan ASD kapatılmasında kullanılan cihazlara ait parçalar ya da cihazın tamamı embolize olabilmekte ve bu durum acil cerrahi müdahale gerektirebilmektedir. Bu makalede Cardia Ultrasept ASD kapatma cihazı kullanılarak gerçekleştirilen başarılı perkütan kapatma sonrası erken dönemde cihazın pulmoner artere embolize olduğu ve cerrahi yöntemle çıkartıldığı bir olgu sunulmakta ve literatür bilgileri eşliğinde bu tip komplikasyonlarda uygulanan tedavi yaklaşımları tartışılmaktadır. OlGu sunumuOtuz dokuz yaşındaki erkek hasta egzersizle oluşan nefes darlığı şikayeti ile başvurduğu başka bir hastanede yapılan transtorasik ekokardiyografi (EKO) incelemesinde ASD tespit edilmesi üzerine merkezimize sevk edildi. Tanıyı doğrulamak için yapılan transözefageal EKO'da ostium sekundum tipteki defektin çapının 24 mm olduğu ve süperior, inferior ve aortik kenarlarda sırasıyla 23 mm, 11 mm ve 14 mm uzunluğunda rim bulunduğu tespit edilerek defektin perkütan kapatmaya uygun olduğuna karar verildi. CARDIA Ultrasept (Cardia Inc., Eagan, MN, USA) ASD kapatma cihazı (28 mm) kullanılarak defekt kapatıldı.İşlem sonrası asemptomatik olan ve klinikte takip edilen hastaya kontrol amaçlı yapı-lan rutin transtorasik EKO'da kapatma cihazının yerinde olmadığı ve septal defektin açık olduğu görüldü. Bunun üzerine hasta yeniden anjiyografi laboratuvarına alındı. Flourosko- ÖZETAtriyal septal defekt (ASD) erişkinlerde en sık karşılaşılan konjenital kalp anomalileri arasında yer almaktadır. Perkütan girişimle ASD kapatılması cerrahiye alternatif olarak ortaya çıkmıştır ve cerrahi ile karşılaş-tırılabilir sonuçlar elde edilmiştir. Cihaz embolizasyonu bu tekniğin nadir görülen ancak potansiyel olarak ölümle sonuçlanabilecek bir komplikasyonudur. Bu olgu sunumunda pulmoner artere embolize olan CARDIA Ultrasept cihazın cerrahi olarak çıkartılması sunulmakta ve bu komplikasyonun tedavisinde uygulanabilecek yaklaşımlar literatür bilgisi eşliğinde tartışılmaktadır.Anahtar Kelimeler: Atriyal septal defekt; embolizasyon; pulmoner arter Retrieval of the Atrial Septal Defect Closure Device Embolized to Pulmonary Artery ABSTRACTAtrial septal defect (ASD) is among the most common congenital heart defects in adults. Percutaneous closure of ASD has emerged as an alternative to surgery and has comparable results with those of surgery. Device embolization is a rare but potentially fatal complication of this technique. In this case report, we present the embolization of CARDIA Ultrasept ASD Occluder Device to pulmonary artery which was retrieved surgically and discuss the management of this complication in the light of literature.

show abstract

The 'aortic rim' recount: embolization of interatrial septal occluder into the main pulmonary artery bifurcation after atrial septal defect closure

Cited by 42 publications

References 9 publications

Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications

Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications

Transcatheter Retrieval of Embolized Atrial Septal Defect Occluder Device by Waist Capture Technique

Retrieval of the Atrial Septal Defect Closure Device Embolized to Pulmonary Artery

Contact Info

Product

Resources

About