scholarly journals Emergent surgical removal of a migrated atrial septal defect occluder: case report

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Bi Wen ◽  
Juan He
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Major Complication ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Percutaneous Closure ◽  
Surgical Removal ◽  
Device Implantation ◽  
Occluder Device ◽  
Asd Closure

Abstract Background Atrial septal defect (ASD) closure has been widely accepted and is now routinely performed using a percutaneous approach under especially echocardiographic guidance Transesophageal echocardiography (TEE). One major complication is dislocation of occluder device during or after the device implantation. Surgical removal may be required, especially when the device stuck in the left ventricular outflow tract (LVOT). Case introduction A 21-year-old female was admitted to our department for percutaneous closure of secundum ASD. Percutaneous closure under the guidance of TEE was recommended for the patients. During device implantation, the TEE showed dislocation of the 22 mm ASD occluder device, stucked into the LVOT and behind the anterior mitral leaflet, producing severe LVOT obstruction Fig. 1). We herein present a safe and quick technique for surgical removal of an ASD occlude device located in the LVOT. Conclusion This technique provides a safe method for surgical removal of malposition and migration ASD occluder device.

Acute Changes in Left Ventricular End Diastolic Pressure following the Transcatheter Closure of an Atrial Septal Defect in Adults

2016 ◽  
Vol 19 (3) ◽  
pp. 145 ◽  
Author(s):  
Young Hwa Kong ◽  
Jinyoung Song ◽  
Kyung Hee Kim ◽  
June Huh ◽  
I-Seok Kang
Keyword(s):  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Device Closure ◽  
Acute Changes ◽  
Asd Closure

<strong>Background:</strong> Acute changes in left ventricular diastolic function shortly after ASD closure in elderly patients have not been well known. We aimed to investigate acute changes in left ventricular end diastolic pressure (LVEDP) in elderly patients following transcatheter closure of atrial septal defect (ASD). <br /><strong>Methods:</strong> All 19 adults with ASDs who underwent transcatheter closure between June 2013 and December 2014 were enrolled. LVEDP was measured prior to device closure and compared with that immediately following device closure and 15 minutes after device closure. <br /><strong>Results:</strong> The median age of the patients was 48 years old. The baseline E/e’ and LVEDP values were 8.3 ± 2.8 and 13 ± 3 mmHg. The LVEDP value immediately following closure was 19 ± 4 mmHg, and 15 minutes after closure was 16 ± 4 mmHg. The median increase in the LVEDP value immediately following closure was 6 mmHg, which significantly differed from that prior to closure. The LVEDP 15 minutes after closure decreased but remained significantly higher than the value observed immediately after closure. No significant changes were observed with regard to E/e’ at either 1 day or 3 months following closure. The LVEDP value <br />15 minutes after device closure was significantly correlated with those observed before closure and immediately following closure; however, no significant correlations were observed with regard to patient age, Qp/Qs, E/e’ before closure, or E/e’ 3 months after device closure.<br /><strong>Conclusion:</strong> LVEDP in adults with ASDs significantly increases following device closure. LVEDP before closure predicts LVEDP following device closure.

scholarly journals Cryoballoon Atrial Fibrillation Ablation in a Patient with an Atrial Septal Defect Closure Device

2021 ◽  
Author(s):  
Meisam Mokhtari ◽  
Zahra Khajali ◽  
Mona Heidarali ◽  
Majid Haghjoo
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Septal Defect ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Septal Defect ◽  
Closure Device ◽  
Atrial Septal Defect Closure ◽  
Occluder Device ◽  
Asd Closure

Atrial fibrillation (AF) is the most commonly treated arrhythmia in clinical practice and is often found in association with an atrial septal defect (ASD). However, ASD closure rarely confers complete arrhythmia control. A 23-year-old man presented to our center with frequent episodes of palpitations. AF was documented in 12-lead electrocardiography, and echocardiography showed a secundum-type ASD, 14 mm in size, with a significant left-to-right shunt. ASD closure was performed successfully with an ASD occluder device with no residual shunting. During follow-up, the patient experienced several episodes of AF. Thirteen months after the ASD closure, cryoballoon pulmonary vein isolation was done successfully with no complications. During a 12-month follow-up, he had no symptoms or AF recurrences, and echocardiography showed no residual shunting. This study showed that cryoballoon pulmonary vein isolation could be performed successfully without residual shunts in patients with ASD closure devices.

Migraine Symptoms Related to the Percutaneous Closure of An Ostium Secundum Atrial Septal Defect: Report of Four Paediatric Cases and Review of the Literature

Cephalalgia ◽  
2007 ◽  
Vol 27 (6) ◽  
pp. 550-556 ◽  
Author(s):  
DM Fernández-Mayoralas ◽  
A Fernández-Jaén ◽  
N Muñoz-Jareño ◽  
F Gutiérrez-Larraya ◽  
B Calleja-Pérez ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Migraine Headache ◽  
Septal Defect ◽  
Review Of The Literature ◽  
Secundum Atrial Septal Defect ◽  
Device Implantation ◽  
Paediatric Patients ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
Benign Course

Several publications have recently suggested that atrial septal defect may be associated with the physiopathology of headache with migraine-type characteristics. We describe four previously asymptomatic paediatric patients with atrial septal defect who underwent percutaneous Amplatzer septal occluder device implantation and who subsequently developed symptoms compatible with migraine headache. The cases had normal echocardiograms after the intervention and a benign course with headache improvement after several weeks or months. There are paediatric patients with atrial septal defect who may dramatically develop migraine symptoms with or without aura following percutaneous correction of their defect. Large paediatric studies are needed to offer accurate prognoses for children and their families. The possibility of using clopidogrel to treat this type of headache is subject to debate.

Response to fluid challenge in patients with atrial septal defect

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M D'Alto ◽  
M Chessa ◽  
G Gaio ◽  
G Santoro ◽  
M Giordano ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Vascular Resistance ◽  
Pulmonary Circulation ◽  
Septal Defect ◽  
Fluid Challenge ◽  
Left Ventricular ◽  
Percutaneous Closure ◽  
Right Atrial ◽  
Pulmonary Vascular Disease ◽  
Pulmonary Arterial

Abstract Background A fluid challenge test (FCT) with a rapid infusion of saline allows for discrimination between pre- and post-capillary pulmonary hypertension (PH) and may unmask hidden post-capillary PH. Patients with atrial septal defect (ASD) may develop pre- or post-capillary PH after shunt closure respectively in case of pulmonary vascular disease or left ventricular disease. Aim To evaluate the haemodynamic changes of the pulmonary circulation in ASD patients undergoing percutaneous closure with indicated according to the current ESC guidelines. Methods Twenty-three patients (mean age 42.9±12.4 years; 15 female) underwent right heart catheterization in basal conditions and after FCT (volume loading with rapid saline infusion of 7 ml/kg in 10 min) before percutaneous closure of the ASD. Right atrial pressure (RAP), systolic, mean and diastolic pulmonary arterial pressure (sPAP, mPAP and dPAP), pulmonary arterial wedge pressure (PAWP), cardiac output (CO), pulmonary vascular resistance (PVR), systemic vascular resistance (SVR) and the ratio between pulmonary and systemic flow (QP/QS) were calculated four times: before and after inflating the sizing balloon both at baseline and immediately after FCT (Fig. 1). Results The patients had an increase in pressures and flows after FCT with open ASD: mPAP (18.7±4.4 vs 16.7±4.6 mmHg, p&lt;0.001), PAWP (11.3±3.1 vs 9.2±3.0 mmHg, p&lt;0.001), QP (12.5±2.3 vs 10.3±2.0 l/min, p&lt;0.001), and QS (6.6±1.4 vs 5.9±1.2 l/min, p&lt;0.001) but RAP remained unchanged (8.7±3.0 vs 8.3±2.4 mmHg, p=0.35). PVR (0.2±0.4 vs 0.8±0.3 Wood Units, p&lt;0.001) and SVR (11.2±3.2 vs 12.5±3.2 Wood Units, p=0.02) decreased, and PVR/SVR (0.06±0.02 vs 0.06±0.3, p=0.25) remained unchanged. QP/QS increased in all patients after FCT (mean±SD: 2.0±0.4 vs 1.8±0.4, p&lt;0.001). During a temporary ASD closure by sizing balloon, the patients had increases of RAP (9.0±2.6 vs 7.6±2.6 mmHg, p&lt;0.001) mPAP (19.5±4.0 vs 17.4±3.7 mmHg, p&lt;0.001), PAWP (13.2±2.1 vs 11.2±2.9 mmHg, p&lt;0.001), and CO (7.7±2.7 vs 6.8±2.3 l/min, p&lt;0.001) after FCT. PVR remained unchanged (0.9±0.4 vs 1.1±0.6, p=0.12) and SVR reduced (9.8±2.7 vs 11.3±2.9, p&lt;0.001) after FCT. Conclusions None of the reported ASD patients presented with FCT criteria of post-capillary PH (that is a PAWP &gt;18 mmHg). The FCT was associated with an increase in QP/QS suggesting that the patients still had a distensible pulmonary circulation. Further studies are needed to explore the relevance of a FCT in ASD patients, particularly those with higher PVR values. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Using Medtronic AP360 Mechanical Prosthesis in Mitral Valve Replacement for Patients with Mitral Insufficiency After Primum Atrial Septal Defect Repair to Reduce Left Ventricular Outflow Tract Obstruction Risk

2021 ◽  
Author(s):  
Lei Guo ◽  
Qiqi Yang ◽  
Yu Han ◽  
Junnan Zheng ◽  
Yiming Ni
Keyword(s):  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Mitral Insufficiency ◽  
Severe Mitral Regurgitation ◽  
Left Ventricular Outflow

Abstract Background: Atrial septal defect is one of the most common congenital heart diseases in adults. Primum atrial septal defect (PASD) accounts for 4% to 5% of congenital heart defects. Patients with PASD frequently suffer mitral insufficiency, and thus, mitral valvuloplasty (MVP) or mitral valve replacement (MVR) is often required at the time of PASD repair. Unfortunately, recurrent unrepairable severe mitral regurgitation can develop in many patients undergoing PASD repair plus MVP in either short- or long-term after the repair surgery, requiring a re-do MVR. In those patients, risk of left ventricular outflow tract obstruction (LVOTO) has increased.Case presentation: We present 5 such cases who were aged from 24 to 47 years and had a PASD repair plus MVP or MVR for 14 to 40 years, suffering moderate to severe mitral regurgitation. Using Medtronic AP360 mechanical mitral prostheses, only one patient occurred mild LVOTO. Conclusions: Usage of Medtronic AP360 mechanical mitral prostheses to perform MVR in patients with MI who had a PASD repair history can potentially reduce the risk of LVOTO. Long-term follow-up is required to further confirm this clinical benefit associated with AP360 implantation in patients with PASD.

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