Device erosion

Percutaneous atrial Septal Occluder devices and cardiac erosion: A review of the literature

“…Erosion is assumed to be related to an abrasive mechanical force between the device and human tissue rather than an inflammatory mediated weakening of the wall [47]. The abrasive potential of the ASO device appears related to the nitinol thread.…”

“…This simplistic model must give way to scientifically valid models of the complex issues of in vivo device‐tissue interaction as devices are placed in unique intracardiac locations. The role of medical imaging to better characterize device‐tissue interactions is one avenue to better understand the underlying mechanism of erosion [47]. It is also noteworthy that less rigid devices such as the HSO device may not cause erosion but they have a propensity for strut fracture which again illustrates the complexity of device–heart interactions in the era of structural heart disease interventions.…”

“…Descriptive epidemiologic data of erosion cases associated with ASO devices were presented at Transcatheter Cardiovascular Therapeutics 2011 (data provided by AGA Medical Corporation; case adjudication using source data was performed by an independent panel of physicians) [48]. Cases were identified from field events, literature search, and a post approval study.…”

Erosions, erosions, and erosions! Device closure of atrial septal defects: How safe is safe?

“…It would be interesting to look at the change of shape of the ASO in cases with deficient anterior‐superior rim and in those who receive an “oversized” device. Additional imaging techniques such as CTA may also help assess the 3‐D geometry and how the device will fit in cases deemed at risk for erosion [23].…”

Late tissue erosion after transcatheter closure of an atrial septal defect

“…It has been suggested that tissue erosion results from the mechanical force exerted by the device on to the atrial wall, with the nitinol thread of the ASO device providing the abrasive potential. Moreover, tissue susceptibility to erosion is thought to derive from underlying structural defects, age‐related changes in cardiac tissue, and spatial variations in tissue strength . The site of erosion is critical for the development of hemopericardium and cardiac tamponade.…”