%0 Journal Article
%T Asymptomatic Embolization After Percutaneous Ostium Primum Atrial Septal Defect Closure: A Rare Complication - Asymptomatic Embolization After Percutaneous Ostium Primum Atrial Septal Defect Closure: A Rare Complication - Open Access Pub
%A Eric Eeckhout
%A Gr¨¦goire Girod
%A Sergiu Vijiala
%J OAP | Home | Journal of Clinical Case reports and Images | Open Access Pub
%D 2019
%X Percutaneous device closure of atrial septal defects (ASD) has proven to be safe and it is nowadays the standard treatment for ASDs. Immediate or late device embolization is a rare but potential complication of every attempted ASD device closure. We report a case of asymptomatic Amplatzer Septal Occluder into the left ventricular outflow tract (LVOT) detected by routine transthoracic echocardiography 3 months after successful implantation in a stable patient. DOI10.14302/issn.2641-5518.jcci-19-2692 Atrial septal defect (ASD) is the fourth most common congenital heart defect, with an incidence of 2.78 per 10,000 live births. 1 The gold standard treatment of ASD since 1960s was surgery with good postoperative results on the long-term follow-up. In 1975 King&Mills performed the first application of ASD closure in the human population using a transvenous umbrella during cardiac catheterization.2 Percutaneous atrial septal defect closure using the Amplatzer septal occluder (ABBOTT) or many other devices is an established alternative treatment to the classical surgery with excellent safety, clinical outcome, being an effective procedure. In the last 2 decades, this technique replaced surgical closure of ASDs in most centres, becoming a widely accepted and practiced procedure. With the accelerated growth in transcatheter device closure, many centres started to report outcome data for this procedure with a general interest focused on its complications. Late complications are more common with the advances in the procedure and the rate of immediate complication is very low. The need for immediate surgery following the implantation is rare (<1%) as reported by Godart et al. in 2015. 5 Procedure Related Complications As in any interventional cardiac catheterisation procedure, percutaneous transcatheter ASD closure is associated with all the general risks, the most common and frequent immediate complications related to the transcatheter itself being vessel or cardiac perforation, the introduction of an infectious pathogen and the risk of contrast agent reactions. Spence and col. reported in 2005 in Heart that the complications of femoral vein access like haematomas rarely need blood transfusions and less frequently surgical repair when retroperitoneal haematomas developed. 6 The most common reported complication in literature are device embolisation or malposition (3.5%), followed (not in the frequency order, but rather randomly because the rate and type of complications depend on the experience of the centres and patients particularities) by arrhythmia such as
%U https://www.openaccesspub.org/jcci/article/1037