Late Management of An Atrial Septal Defect Closure Device Embolized to Left Ventricle Outflow Tract
DOI:
https://doi.org/10.63623/kpmrwk83Keywords:
Atrial septal defect, Closure device, Embolization, Left ventricle outflow, Eustachian valvAbstract
Atrial septal defect (ASD) which is among most common congenital heart disease diagnosed in adults. It is commonly managed with percutaneous closure successfully. However, percutaneous closure procedure has been associated with some rare complications including embolization. Embolization of the device into to the main pulmonary artery, left atrium, right ventricle, aortic arch, descending aorta, abdominal aorta, iliac bifurcation, and iliac arteries have been reported. Embolizations usually occur during procedure and rarely several hours or a few days after intervention. However, as far as we know, a silent embolization to left ventricle outflow (LVOT) for 13 years has not been reported previously. Here, we report a case of atrial septal defect closure device which is embolized to left ventricle outflow having index procedure 13 years before. The device was successfully retrieved surgically and ASD was repaired.
References
[1]Menillo AM, Alahmadi MH, Pearson-Shaver AL. Atrial septal defect. StatPearls Publishing, 2025 Jan.
[2]Baumgartner H, De Backer J, Babu-Narayan SV, Budts W, Chessa M, Diller GP, et al. 2020 ESC Guidelines for the management of adult congenital heart disease. European Heart Journal, 2021, 42(6), 563-645. DOI: 10.1093/eurheartj/ehaa554
[3]Oster M, Bhatt AB, Zaragoza-Macias E, Dendukuri N, Marelli A. Interventional therapy versus medical therapy for secundum atrial septal defect: A systematic review (part 2) for the 2018 AHA/ACC guideline for the management of adults with congenital heart disease: A report of the American college of cardiology/American heart association task force on clinical practice guidelines. Journal of the American College of Cardiology, 2019, 73(12), 1579-1595. DOI: 10.1016/j.jacc.2018.08.1032
[4]Faletra FF, Ho SY, Auricchio A. Anatomy of right atrial structures by real-time 3D transesophageal echocardiography. JACC Cardiovascular Imaging, 2010, 3(9), 966-975. DOI: 10.1016/j.jcmg.2010.03.014
[5]Silvestry FE, Cohen MS, Armsby LB, Burkule NJ, Fleishman CE, Hijazi ZM, et al. American society of echocardiography; Society for cardiac angiography and interventions. Guidelines for the echocardiographic assessment of atrial septal defect and patent foramen ovale: From the American society of echocardiography and society for cardiac angiography and interventions. Journal of the American Society of Echocardiography, 2015, 28(8), 910-958. DOI: 10.1016/j.echo.2015.05.015
[6]Konstantinov IE, Kotani Y, Buratto E, Schulz A, Ivanov Y. Minimally invasive approaches to atrial septal defect closure. JTCVS Techniques, 2022, 14, 184-190. DOI: 10.1016/j.xjtc.2022.02.037
[7]Hierlmeier BJ, Ostrovsky G, Zarth M. Embolization of an atrial septal defect occluder device into the left ventricle. Cureus, 2020, 12(11), e11417. DOI: 10.7759/cureus.11417
[8]Garre S, Gadhinglajkar S, Sreedhar R, Krishnamoorthy KM, Pillai VV. Atrial septal defect occluder device embolization: experience of a tertiary care cardiac center. Annals of Cardiac Anaesthesia, 2023, 26(2), 149-154. DOI: 10.4103/aca.aca_28_22
[9]Chessa M, Carminati M, Butera G, Bini RM, Drago M, Rosti L, et al. Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. Journal of the American College of Cardiology, 2002, 39(6), 1061-1065. DOI: 10.1016/s0735-1097(02)01711-4
[10]Onorato EM. Large eustachian valve fostering paradoxical thromboembolism: passive bystander or serial partner in crime? World Journal of Cardiology, 2021, 13(7), 204-210. DOI: 10.4330/wjc.v13.i7.204
[11]Nazi NNM, Raja Shariff ER, Yusoff MR, Ibrahim KS, Kasim S. Giant eustachian valve mimicking an inter-atrial septal defect. Journal of Asian Pacific Society of Cardiology, 2024;3:e29. DOI: 10.15420/japsc.2023.53
[12]Wang AT, Kim U. Prominent eustachian valve mimicking inferior rim of atrial septum causing iatrogenic inferior vena cava type sinus venosus atrial septal defect. Cureus, 2021, 13(6), e15387. DOI: 10.7759/cureus.15387
[13]Krishnamoorthy KM, Gopalakrishnan A, Kumar DS, Sivasankaran SS. Eustachian valve-masquerading ASD rim. Indian Heart Journal, 2017, 69(3), 422-423. DOI: 10.1016/j.ihj.2017.04.011
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Copyright (c) 2025 Yilmaz Gunes, İsa Sincer, Kemallettin Erdem, Ayşenur Özcan, Ahmet Emre Akbaba (Author)
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