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Atrial Septal Defect Closure Device-Related Infective Endocarditis in a 20-Week Pregnant Woman.

ABSTRACT: With increasing atrial septal defect (ASD) repairs, more women of childbearing age will have ASD closure devices. Current ASD closure trials have excluded women planning pregnancy, making their management challenging. We present a pregnant woman, with a repaired ASD, who presented with device-related infective endocarditis. (Level of Difficulty: Beginner.).

SUBMITTER: Sharma N

PROVIDER: S-EPMC8310939 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Infective endocarditis-induced complete closure of a ventricular septal defect and complete heart block in a child.

Project description:We hereby report rare occurrence of irreversible complete heart block in a child with tricuspid valve infective endocarditis. The tricuspid valve vegetation also caused complete closure of perimembranous ventricular septal defect, which was later discovered during surgery.

| S-EPMC9075550 | biostudies-literature

Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo-Endothelialization.

Project description:Background Current guidelines recommend at least 6 months of antithrombotic therapy and antibiotic prophylaxis after septal-occluding device deployment in transcatheter closure of atrial septal defect. It has been estimated that it takes ≈6 months for complete neo-endothelialization; however, neo-endothelialization has not previously been assessed in vivo in humans. Methods and Results The neointimal coverage of septal occluder devices was evaluated 6 months after implantation in 15 patients by angioscopy from the right atrium. Each occluder surface was divided into 9 areas; the levels of endothelialization in each area were semiquantitatively assessed by 4-point grades. Device neo-endothelialization was sufficient in two thirds of patients, but insufficient in one third. In the comparison between patients with sufficiently endothelialized devices of average grade score ≥2 (good endothelialization group, n=10) and those with poorly endothelialized devices of average grade score <2 (poor endothelialization group, n=5), those in the poor endothelialization group had larger devices deployed (27.0 mm [25.0-31.5 mm] versus 17.0 mm [15.6-22.5 mm], respectively) and progressive right heart dilatation. The endothelialization was poorer around the central areas. Moreover, the prevalence of thrombus formation on the devices was higher in the poorly endothelialized areas than in the sufficiently endothelialized areas (Grade 0, 94.1%; Grade 1, 63.2%; Grade 2, 0%; Grade 3, 1.6%). Conclusions Neo-endothelialization on the closure devices varied 6 months after implantation. Notably, poor endothelialization and thrombus attachment were observed around the central areas and on the larger devices.

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Closure of Iatrogenic Atrial Septal Defect After Placement of Left Atrial Appendage Closure Device.

Project description:An 86-year-old woman experienced hypoxia with right-to-left flow across an iatrogenic atrial septal defect after deployment of a left atrial appendage closure device. Emergent closure of the defect was performed with an atrial septal occluder device with resolution of hypoxia. (Level of Difficulty: Intermediate.).

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Mobile vegetations on a poorly endothelialized atrial septal defect closure device.

Project description: Not available

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Atrial Septal Defect Closure With the ReAces Device: Burning No Bridges.

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Transjugular closure of a residual septal device defect: a case report.

Project description:BackgroundSevere residual shunts after percutaneous closure of atrial septal defects are unusual. These patients are usually considered candidates for surgery.Case summaryWe describe the transjugular closure of a residual atrial septal defect with significant left-to-right shunt due to a malpositioned large atrial septal device in a symptomatic 74-year-old female. Transjugular access was chosen first due to the unfavourable position of the device for delivery of a new one from the femoral approach. An overlapping Figulla® Flex II 27/30 mm PFO device was successfully implanted with the guidance of 3D-transoesophageal echocardiography.DiscussionThis case demonstrates the safety and feasibility of transjugular access as an alternative to femoral or transhepatic approaches in patients with difficult atrial septal anatomies, who are usually referred for surgery.

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Project description: Not available

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Partial Tricuspid Valve Stenosis during Device Closure of Perimembranous Ventricular Septal Defect.

Project description: Not available

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Disappearing high velocity severe tricuspid regurgitation following Ventricular septal defect device closure.

Project description:This report describes the disappearance of severe high velocity tricuspid regurgitation following a small ventricular septal defect device closure, in an eight year old girl.

| S-EPMC5485395 | biostudies-literature

Ventricular septal defect and bivalvular endocarditis.

Project description:A 63-year-old man presented with generalized fatigue, chills, malaise, dyspnea, intermittent fevers, and 50-pound weight loss of 4 months' duration. Blood cultures were positive for pan-sensitive Streptococcus anginosus. Transesophageal echocardiography showed an 11 mm × 3 mm mobile mass attached to the mitral valve, a 16 mm × 16 mm mobile mass attached to the pulmonary valve, and a small membranous ventricular septal defect. The patient received 12 weeks of intravenous (IV) antibiotics with eventual resolution of the masses. Multi-valve endocarditis involving both the left and right chambers is rarely reported without prior history of IV drug use or infective endocarditis. Our case emphasizes the importance of careful assessment for ventricular septal defects or extra-cardiac shunts in individuals who present with simultaneous right and left-sided endocarditis.

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