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

Year 2020, Volume: 23 Issue: 1, 69 - 72, 01.04.2020

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.

References

  • 1. Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, et al. Task force on the management of grown-up congenital heart disease of the European Society of Cardiology (ESC); Association for European Paediatric Cardiology (AEPC); ESC Committee for Practice Guidelines (CPG). ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 2010;31:2915-57.
  • 2. Chessa M, Carminati M, Butera G, Bini RM, Drago M, Rosti L, et al. Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol 2002;39:1061-5.
  • 3. Moore J, Hegde S, El-Said H, Beekman R 3rd, Benson L, Bergersen L, et al.; ACC IMPACT Steering Committee. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv 2013;6:433-42.
  • 4. Misra M, Sadiq A, Namboodiri N, Karunakaran J. The ‘aortic rim’ recount: embolization of interatrial septal occluder into the main pulmonary artery bifurcation after atrial septal defect closure. Interact Cardiovasc Thorac Surg 2007;6:384-6.
  • 5. Sahin DY, Koc M, Cakır H, Arık OZ, Elbasan Z, Caylı M. A silent and late embolization of atrial septal defect occluder device into the right pulmonary artery: a case report. Korean Circ J 2012;42:781-3.
  • 6. Her AY, Lim KH, Shin ES. Transcatheter retrieval of embolized atrial septal defect occluder device by waist capture technique. Int Heart J 2018;59:226-8.
  • 7. Nagre SW. Surgical removal of embolized atrial septal defect device from pulmonary artery. J Thorac Cardiovasc Surg 2015;150:55-7.
  • 8. Goel PK, Kapoor A, Batra A, Khanna R.Transcatheter retrieval of embolized AMPLATZER Septal Occluder.Tex Heart Inst J 2012;39:653-6.
  • 9. Boysan E, Cicek OF, Cicek MC, Hamurcu Z, Gurkahraman S. Surgical removal of an atrial septal occluder device embolized to the main pulmonary artery. Tex Heart Inst J 2014;41:91-3.
  • 10. Manolis AS. Percutaneous retrieval of a dislodged Amplatzer septal occluder device from the pulmonary artery with sole use of a snare and device lassoing. Hellenic J Cardiol 2018;59:57-9.

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

Year 2020, Volume: 23 Issue: 1, 69 - 72, 01.04.2020

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.

References

  • 1. Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, et al. Task force on the management of grown-up congenital heart disease of the European Society of Cardiology (ESC); Association for European Paediatric Cardiology (AEPC); ESC Committee for Practice Guidelines (CPG). ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 2010;31:2915-57.
  • 2. Chessa M, Carminati M, Butera G, Bini RM, Drago M, Rosti L, et al. Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol 2002;39:1061-5.
  • 3. Moore J, Hegde S, El-Said H, Beekman R 3rd, Benson L, Bergersen L, et al.; ACC IMPACT Steering Committee. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv 2013;6:433-42.
  • 4. Misra M, Sadiq A, Namboodiri N, Karunakaran J. The ‘aortic rim’ recount: embolization of interatrial septal occluder into the main pulmonary artery bifurcation after atrial septal defect closure. Interact Cardiovasc Thorac Surg 2007;6:384-6.
  • 5. Sahin DY, Koc M, Cakır H, Arık OZ, Elbasan Z, Caylı M. A silent and late embolization of atrial septal defect occluder device into the right pulmonary artery: a case report. Korean Circ J 2012;42:781-3.
  • 6. Her AY, Lim KH, Shin ES. Transcatheter retrieval of embolized atrial septal defect occluder device by waist capture technique. Int Heart J 2018;59:226-8.
  • 7. Nagre SW. Surgical removal of embolized atrial septal defect device from pulmonary artery. J Thorac Cardiovasc Surg 2015;150:55-7.
  • 8. Goel PK, Kapoor A, Batra A, Khanna R.Transcatheter retrieval of embolized AMPLATZER Septal Occluder.Tex Heart Inst J 2012;39:653-6.
  • 9. Boysan E, Cicek OF, Cicek MC, Hamurcu Z, Gurkahraman S. Surgical removal of an atrial septal occluder device embolized to the main pulmonary artery. Tex Heart Inst J 2014;41:91-3.
  • 10. Manolis AS. Percutaneous retrieval of a dislodged Amplatzer septal occluder device from the pulmonary artery with sole use of a snare and device lassoing. Hellenic J Cardiol 2018;59:57-9.
There are 10 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Reports
Authors

Filiz Akyıldız This is me 0000-0002-0898-0264

Sadık Emren This is me 0000-0002-7652-1123

Emre Özdemir This is me 0000-0003-0034-3022

Tuncay Kırış This is me 0000-0001-9793-718X

Cem Nazlı This is me 0000-0003-2231-3780

Publication Date April 1, 2020
Published in Issue Year 2020 Volume: 23 Issue: 1

Cite

Vancouver Akyıldız F, Emren S, Özdemir E, Kırış T, Nazlı C. Percutaneous Retrieval of a Large Amplatzer Atrial Septal Occluder Device After Embolization to the Main Pulmonary Artery. Koşuyolu Heart Journal. 2020;23(1):69-72.