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

ABSTRACT: 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.).

SUBMITTER: Sunder V

PROVIDER: S-EPMC9434646 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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

Sunder Vikas V Sabir Sajjad S Mark George G Kaddissi George G Peters Priscilla P Ragupathi Loheetha L

JACC. Case reports 20220817 16

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. (<b>Level of Difficulty: Intermediate.</b>). ...[more]

PMID: 36062052

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Left Atrial Appendage Closure in a Patient With a Patent Foramen Ovale Septal Occluder Device.

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Complications caused by iatrogenic right-to-left shunt after surgical closure of atrial septal defect: a case report.

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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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| S-EPMC10267617 | biostudies-literature

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

Project description: Not available

| S-EPMC8311455 | biostudies-literature

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

Project description: Not available

| S-EPMC9831926 | biostudies-literature

Novel technique to reduce prolapsed device in atrial septal defect closure.

Project description:ObjectiveTranscatheter closure of atrial septal defect (ASD) has become an alternative treatment to surgical repair. One of the challenges is the prolapse of the left atrial disc during the procedure. Many techniques have been developed to prevent the prolapse but not reduce it. In this study, we present a novel technique, termed push back technique, that help reduce the prolapsed device.MethodsWe enrolled 24 patients (8 males, 16 females) between May 2008 and January 2023 who underwent the push back technique during transcatheter closure of ASD in Taichung Veterans General Hospital. We recorded the hemodynamic data, success rate and complications including device embolization/migration, valvular regurgitation, pericardial effusion, and residual shunt.ResultsThe median age was 6.3 years (1.2-70.5 years) and the median weight was 19.1 kg (7.8-90 kg). Fifteen (62.5%) patients had mild pulmonary hypertension. The median Qp/Qs was 2.54 (1.5-8.8). The median ASD stretched size was 21.2 mm (7.7-35.3 mm). The median device size was 22 mm (8-40 mm). The median fluoroscopy time was 14 min (5-23 min) and median procedure time was 47 min (25-78 min). The push back technique successfully reduced the prolapsed device in 21 (87.5%) patients. There was no complication in all patients.ConclusionWe present a novel push back technique that can successfully reduce the prolapsed device in 87.5% (21/24) patients without complications. It is feasible, safe and effective.

| S-EPMC10227603 | biostudies-literature

Late-onset aortic regurgitation after device closure of atrial septal defect.

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| S-EPMC11651406 | biostudies-literature

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