Percutaneous Retrieval of a Large Amplatzer Atrial Septal Occluder Device After Embolization to the Main Pulmonary Artery

Abstract

Transcatheter closure of secundum atrial septal defects (sASDs) has become the first choice for treatment when morphology is feasible. However, transcatheter closure may be associated with rare early and late complications. Embolization of the Amplatzer atrial septal occluder (ASO) is one major complication of percutaneous device closure. Although surgical retrieval of an embolized device is widely accepted, percutaneous retrieval of the embolized device is gaining ground as an acceptable alternative method. In this paper, we present a case of embolization of a 38 mm ASO to the main pulmonary artery (MPA) shortly after it was used to close a large complex ASD, and its successful retrieval using a biopsy catheter and an endovascular snare system. To the best of our knowledge, the 38-mm embolized ASO device was the largest one retrieved from the PA with a percutaneous approach.

Keywords

• Atrial septal defect
• atrial septal occluder
• device embolization

Pulmoner Artere Embolize Geniş Amplatzer Septal Oklüder Cihazının Perkütan Yolla Geri Alınması

Abstract

Sekundum atriyal septal defektlerin (sASD) tedavisinde transkateter cihaz ile kapatma morfoloji uygun olduğunda ilk tercih haline gelmiştir. Bununla birlikte transkateter kapatma, nadir görülen erken ve geç komplikasyonlarla ilişkili olabilir. Perkütan cihazla kapatmanın majör komplikasyonlarından biri atriyal septal oklüder (ASO) cihazının embolizasyonudur. Embolize cihazın, cerrahi yolla alınması geniş ölçüde kabul görmesine rağmen perkütan yolla geri alınması kabul edilebilir bir metot olarak gelişmektedir. Bu raporda, 38 mm çapındaki ASO cihazı ile kapatılan, kısa süre sonra cihazın ana pulmoner artere embolize olduğu ve biyopsi kateteri ve endovasküler snare sistemi yardımıyla başarılı bir şekilde geri alındığı geniş, kompleks sASD olgusunu sunuyoruz. Bilgilerimize göre bu 38 mm'lik ASO cihazı pulmoner arterden perkütan yolla geri alınabilen en büyük cihazdır.

Keywords

• Atriyal septal defekt
• atriyal septal oklüder
• cihaz embolizasyonu

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