Late aortic perforation with a fractured ATRIASEPT II device resulting in life-threatening tamponade

Pérez, Francisco José Hernández; Díaz, José; Montero, Carlos; Touchard, Arturo García; Oteo-Domínguez, Juan Francisco; Puente, José Ramón Domínguez; Ruigómez, Javier Goicolea

doi:10.4244/eijv9i4a86

Cited by 9 publications

(6 citation statements)

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“…The partial endothelization of the device certainly contributed to the fact that the strut was able to unfold freely. Remarkably, all ATRIASEPT device fractures reported in the literature occurred late between 3 months and 4 years after implantation, similar to the case reported here, rather than directly after intervention [5,6].…”

Section: Accepted Manuscriptsupporting

confidence: 86%

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Fracture of a Transcatheter Atrial Septal Defect Occluder Device Causing Mitral Valve Perforation

Werner

Prêtre²,

Wilhelm

2019

The Annals of Thoracic Surgery

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Transcatheter atrial septal defect (ASD) device closure has gained increasing popularity over the past decades due to shorter hospital stay and the absence of skin scars. However, concern about the seriousness of device-related complications is accumulating. We report a case of device fracture in a young asymptomatic woman almost 4 years after percutaneous secundum ASD closure, resulting in mitral valve perforation. Subsequently, elective surgical removal of the device and mitral valve reconstruction was performed. This case demonstrates that complications from transcatheter ASD closure may even occur late after implantation.

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Section: Accepted Manuscriptsupporting

confidence: 86%

“…The septum was closed using an autologous pericardial patch. [5,6]. In contrast to its precursors, the ATRIASEPT II device presents an improved left atrial sail.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Fracture of a Transcatheter Atrial Septal Defect Occluder Device Causing Mitral Valve Perforation

Werner

Prêtre²,

Wilhelm

2019

The Annals of Thoracic Surgery

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“…Cardiac erosions and perforations leading to pericardial effusions, tamponade, and even death have been observed in conjunction with several atrial septal occlusion devices . Various patch‐like devices have been used in the past and are utilized in contemporary clinical practice, such as the Starflex/Biostar family, the Solysafe Septal Occluder, and the Cardia device.…”

Section: Discussionmentioning

confidence: 99%

Wire‐frame integrity of patch‐like Gore devices following atrial septal defect closure

Kubicki

Fingerhut

Uhl

et al. 2019

Cathet Cardio Intervent

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Objectives To assess the structural integrity of the patch‐like Gore Septal Occluder (GSO) used for device closure of secundum‐type atrial septal defects (ASD II) in pediatric patients. Background GSO has shown to be effective and safe for ASD device closure in children and adolescents. Methods Single‐center, retrospective mid‐ to long‐term follow‐up of all children and adolescents with a GSO in situ (≥12 months). Periprocedural data and follow‐up data were evaluated, including chest X‐rays to assess the GSO's wire‐frame morphology. Results Ninety‐one consecutive patients were enrolled with a median age and weight of 5 years (range 2–18) and 20 kg (range 11–95) at implantation. ASD anatomy included 64 single and 27 multi‐fenestrated defects, with 39 patients having small retro‐aortic rims (≤4 mm). Median follow‐up period was 42.5 months (range 12–74). Chest X‐rays were available in 80 children: in 74 of them, the GSO's visualization on X‐ray enabled us to reliably assess the wire‐frame structure. Wire‐frame fracture (WFF) was ultimately detected in five of the 74 patients (6.8%); however, those occluders appeared stably anchored and well aligned to both sides of the septum, and no free wire fragments had escaped the GSO matrix. Thus, no further treatment was required. Conclusions Our data confirm that the GSO is safe and effective for ASD closure. Despite its lightweight construction, the GSO seems to offer reliable mechanical durability. Wire‐frame fractures occur, but the free wire‐ends appear to have remained stable within the GSO matrix without any clinical sequelae so far.

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“…The 64 patients who completed 6-month follow-up showed no device migration, perforation, or thrombi [65]. The Atriasept II was improved using a round left disk and no wire arm, but aortic perforations and PVA coating malfunctions continued to be reported [66,67].…”

Section: Cardia Atriasept I/ii and Ultracept I/iimentioning

confidence: 96%

Historical developments of atrial septal defect closure devices: what we learn from the past

Nassif

Abdelghani

Bouma

et al. 2016

Expert Review of Medical Devices

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Introduction: Since King and Mills' pioneering work in percutaneous closure devices of secundum atrial septal defects (ASD) four decades ago, developments in device shape, material and implantation technique led to adoption of percutaneous ASD closure as current treatment of choice. Not only was the feasibility of such a percutaneous procedure tested altogether, but pursuing the ideal device in terms of safety and efficacy became priority. Areas covered: In this review we present the historical development of ASD devices in design, material and technique with clinical data, and provide the future perspectives in percutaneous ASD closures. Expert opinion: An 'ideal device' requires complete defect closure with negligible risk of complications using a safe, straightforward delivery technique with repositioning and retrieving properties. Some of the devices currently at hand come close to fulfilling these criteria, however none seem to provide those prerequisites completely. By understanding how challenges in device development were overcome in the past, new insights into future improvements are given. ARTICLE HISTORY

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Late aortic perforation with a fractured ATRIASEPT II device resulting in life-threatening tamponade

Cited by 9 publications

References 0 publications

Fracture of a Transcatheter Atrial Septal Defect Occluder Device Causing Mitral Valve Perforation

Fracture of a Transcatheter Atrial Septal Defect Occluder Device Causing Mitral Valve Perforation

Wire‐frame integrity of patch‐like Gore devices following atrial septal defect closure

Historical developments of atrial septal defect closure devices: what we learn from the past

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