Cardiac perforation 6 years following the implantation of an Amplatzer septal occluder

Cardiac perforation 6 years following the implantation of an Amplatzer septal occluder Amplatzer vascular occluders have been used to close atrial septal defects (ASDs), ventricular septal defects, aorto‐pulmonary fistulas and defects, aorto‐atrial fistulas following aortic valve replacement, and left ventricular aneurysms. However, they can result in device migration resulting in cardiogenic shock and leaks resulting in perforation and pseudoaneurysm formation. We present images of an Amplatzer device which resulted in cardiac erosion and tamponade 6 years after implantation for an ASD.A 14‐year‐old female was admitted to an outside hospital with chest pain 6 years following repair of an ASD with an Amplatzer occluder. An echocardiogram now revealed a significant pericardial effusion with signs of tamponade. A bloody effusion was drained and she was transferred to our hospital where a repeat echocardiogram showed flow around the occluder which had also been seen on a routine follow‐up study 1 year previously (Figure ). At the time of surgery following institution of cardiopulmonary bypass and cardioplegic arrest, there was erosion of the device at the roof of the right atrium adjacent to the aortic root (Figure A). The right atrium was opened, and the device was noted to be partially detached from the atrial septum (Figure B). The device was explanted and the ASD http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Cardiac Surgery Wiley

Cardiac perforation 6 years following the implantation of an Amplatzer septal occluder

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Publisher
Wiley
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
0886-0440
eISSN
1540-8191
D.O.I.
10.1111/jocs.13540
Publisher site
See Article on Publisher Site

Abstract

Amplatzer vascular occluders have been used to close atrial septal defects (ASDs), ventricular septal defects, aorto‐pulmonary fistulas and defects, aorto‐atrial fistulas following aortic valve replacement, and left ventricular aneurysms. However, they can result in device migration resulting in cardiogenic shock and leaks resulting in perforation and pseudoaneurysm formation. We present images of an Amplatzer device which resulted in cardiac erosion and tamponade 6 years after implantation for an ASD.A 14‐year‐old female was admitted to an outside hospital with chest pain 6 years following repair of an ASD with an Amplatzer occluder. An echocardiogram now revealed a significant pericardial effusion with signs of tamponade. A bloody effusion was drained and she was transferred to our hospital where a repeat echocardiogram showed flow around the occluder which had also been seen on a routine follow‐up study 1 year previously (Figure ). At the time of surgery following institution of cardiopulmonary bypass and cardioplegic arrest, there was erosion of the device at the roof of the right atrium adjacent to the aortic root (Figure A). The right atrium was opened, and the device was noted to be partially detached from the atrial septum (Figure B). The device was explanted and the ASD

Journal

Journal of Cardiac SurgeryWiley

Published: Jan 1, 2018

References

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