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Devos P, Guedeney P, Montalescot G. Patent Foramen Ovale Percutaneous Closure: Evolution and Ongoing Challenges. J Clin Med 2023; 13:54. [PMID: 38202061 PMCID: PMC10780039 DOI: 10.3390/jcm13010054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/28/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Patent foramen ovale (PFO) concerns nearly a quarter of the general population and incidence may reach up to 50% in patients with cryptogenic stroke. Recent randomized clinical trials confirmed that percutaneous closure of PFO-related stroke reduces the risk of embolic event recurrence. PFO also comes into play in other pathogenic conditions, such as migraine, decompression sickness or platypnea-orthodeoxia syndrome, where the heterogeneity of patients is high and evidence for closure is less well-documented. In this review, we describe the current indications for PFO percutaneous closure and the remaining challenges, and try to provide future directions regarding the technique and its indications.
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Affiliation(s)
- Perrine Devos
- ACTION Study Group, INSERM UMRS_1166 Institut de Cardiologie (AP-HP), Sorbonne Université, 75005 Paris, France; (P.D.); (P.G.)
| | - Paul Guedeney
- ACTION Study Group, INSERM UMRS_1166 Institut de Cardiologie (AP-HP), Sorbonne Université, 75005 Paris, France; (P.D.); (P.G.)
| | - Gilles Montalescot
- ACTION Study Group, INSERM UMRS_1166 Institut de Cardiologie (AP-HP), Sorbonne Université, 75005 Paris, France; (P.D.); (P.G.)
- Institut de Cardiologie, Centre Hospitalier Universitaire, Pitié-Salpêtrière, 47 Boulevard de l’Hôpital, 75013 Paris, France
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Liguori C, Lassandro G, Ferrandino G, Picchi SG, Tamburrini S, Toro G, Tamburro F, Masala S, Scaglione M. ECG-Gated CCTA in the Assessment of Post-Procedural Complications. Diagnostics (Basel) 2023; 13:2500. [PMID: 37568862 PMCID: PMC10417539 DOI: 10.3390/diagnostics13152500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/15/2023] [Accepted: 07/22/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION The aim of our study was to assess the role of ECG-gated coronary CT angiography (CCTA) in the diagnosis, imaging follow-up, and treatment guidance in post-procedural/surgical interventions in the heart and thoracic aorta (PTCA, TAVI, PMK/ICD placement, CABGs). MATERIALS AND METHODS We retrospectively evaluated 294 ECG-gated CCTA studies performed in our center from January 2020 to January 2023. CCTA studies were acquired to detect/exclude possible complications related to the endovascular or surgical procedure. RESULTS There were 27 cases (9.2%) of post-procedural complications. Patients enrolled in the study were 18 males and 9 females (male/female ratio: 2), with age ranging from 47 to 86 years (mean age, 68.3 years). Among percutaneous coronary intervention (PCI) complications, coronary intimal dissection with ascending aorta involvement was found to be the most frequent complication after PTCA (22.2%). Vascular wall pseudoaneurysm formation (11.1%) and coronary stent misalignment or displacement (14.8%) were complications less frequently encountered after PTCA. Right atrial or ventricular perforation with associated hemopericardium were the most common complications (18.5%) after pacemaker implantation. Complications encountered after aortic valve interventions were loosening and dislocation of the prosthesis associated with aortic root pseudoaneurysm (7.4%), para-valvular leak (11.1%), and hemopericardium (7.4%). In one patient who underwent transcatheter repair of patent foramen ovale (3.7%), CTTA detected the dislocation of the Amplatzer septal occluder. CONCLUSIONS ECG-gated CCTA is a fundamental diagnostic tool for the detection of post-procedural endovascular/surgical complications to enable optimal patient management. Radiologists must be familiar with the use of cardiac synchronization in the course of CT and must be aware of all possible complications that can occur in the context of acute settings or routine follow-up studies.
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Affiliation(s)
- Carlo Liguori
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, 80147 Naples, Italy; (G.L.); (S.G.P.); (S.T.)
| | - Giulia Lassandro
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, 80147 Naples, Italy; (G.L.); (S.G.P.); (S.T.)
| | - Giovanni Ferrandino
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, 80147 Naples, Italy; (G.L.); (S.G.P.); (S.T.)
| | - Stefano Giusto Picchi
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, 80147 Naples, Italy; (G.L.); (S.G.P.); (S.T.)
| | - Stefania Tamburrini
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, 80147 Naples, Italy; (G.L.); (S.G.P.); (S.T.)
| | - Gabriella Toro
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, 80147 Naples, Italy; (G.L.); (S.G.P.); (S.T.)
| | - Fabio Tamburro
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, 80147 Naples, Italy; (G.L.); (S.G.P.); (S.T.)
| | - Salvatore Masala
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (S.M.)
| | - Mariano Scaglione
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (S.M.)
- Department of Radiology, James Cook University Hospital, Middlesbrough TS4 3BW, UK
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Bagaria V, Hiremath CS. Late systemic desaturation after transcatheter device closure of atrial septal defect. Cardiol Young 2023; 33:1223-1225. [PMID: 36533532 DOI: 10.1017/s1047951122003833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Transcatheter device closure has emerged as the preferred treatment for ostium secundum atrial septal defects with adequate margins, occasionally requiring surgical intervention to manage complications. We report a case of a young female patient who presented with systemic desaturation and exertional dyspnoea 5 years after device closure. Evaluation demonstrated anterior malposition of the septal occluder, with the right atrial rim of the device diverting the blood from the inferior vena cava to the left atrium. She underwent surgical extraction of the device and pericardial patch closure of the atrial septal defect.
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Affiliation(s)
- Vivek Bagaria
- Department of Cardiothoracic and Vascular Surgery, Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, Bangalore 560066, India
| | - Channabasavaraj S Hiremath
- Department of Cardiothoracic and Vascular Surgery, Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, Bangalore 560066, India
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Prevention of Migrating Atrial Septal Occluder in Large Hole Atrial Septal Defect Intervention by Snare. Cureus 2023; 15:e36904. [PMID: 37012947 PMCID: PMC10066060 DOI: 10.7759/cureus.36904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Migrating Amplatzer Septal Occluder (ASO) is a rare complication due to insufficient margins, especially large-hole Atrial Septal Defect (ASD). After deploying, ASO occasionally exposes the low margins, resulting in dislocated devices and embolization. The majority of embolizations happen right away after release. The embolized device must be removed using extended fluoroscopy and occasionally by open heart surgery. The device is released by unscrewing the cable while the snare holds the screw end. On Transesophageal Echocardiography (TEE), the device position is once again validated. If the device is stable, the snare is then removed.
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Kim S, Min S. Surgical Removal of Migrated Atrial Septal Defect Closure Device: A Case Report. Vasc Specialist Int 2022; 38:24. [PMID: 36172798 PMCID: PMC9520317 DOI: 10.5758/vsi.220033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/20/2022] Open
Abstract
Percutaneous closure of atrial septal defects (ASDs) has emerged as an alternative to surgical treatment; however, several early and late complications have been reported. In this report, we present the case of a patient who underwent surgical removal of a migrated ‘Figulla Flex II’ ASD occlusion device at the aortic bifurcation 2 months after ASD occlusion.
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Affiliation(s)
- Sunjoo Kim
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sangil Min
- Division of Transplantation and Vascular Surgery, Department of Surgery, Seoul National University Hospital, Seoul, Korea
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Liao YQ, Zhang MQ. Acute air embolism caused by autotransfusion during percutaneous atrial septal defect closure: A case report. Clin Case Rep 2022; 10:e05654. [PMID: 35356172 PMCID: PMC8958190 DOI: 10.1002/ccr3.5654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/06/2022] [Accepted: 03/15/2022] [Indexed: 02/05/2023] Open
Abstract
Atrial septal defect is a common congenital heart disease in adults and it is often asymptomatic. Percutaneous device closure is gaining popularity, but percutaneous repair of atrial septal defect leading to left atrial rupture and subsequent autotransfusion under high pressure leading to air embolism has not been reported yet.
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Affiliation(s)
- Yu-Qi Liao
- Department of Anesthesiology The Third People's Hospital of Chengdu Chengdu China
| | - Meng-Qiu Zhang
- Department of Anesthesiology West China Hospital Sichuan University Chengdu China
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Van Praagh R. Interatrial Communications. CONGENIT HEART DIS 2022. [DOI: 10.1016/b978-1-56053-368-9.00009-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Basantwani S, Sultania N, Jambotkar T. A prospective study of various anesthetic techniques in patients with acyanotic congenital heart diseases undergoing device closure. Ann Card Anaesth 2022; 25:441-446. [DOI: 10.4103/aca.aca_59_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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10
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Özdemir E, Nazlı C. Late embolisation of an atrial septal occluder device in the abdominal aorta. Glob Cardiol Sci Pract 2020; 2020:e202037. [PMID: 33598497 PMCID: PMC7868103 DOI: 10.21542/gcsp.2020.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Percutaneous closure of secundum atrial septal defect (sASD) - which is the most common in adult congenital heart disease - is considered to be the first treatment option but can involve early and late complications. We report on the late embolization of a device to the abdominal aorta, 12 months after successful percutaneous closure of sASD. A 63-year-old woman, who suffered from stomach ache, was found to have an ASD occluder device in her abdominal aorta. Although surgical intervention to remove the embolisation may be considered, medical follow-up and re-intervention of percutaneous closure may be feasible for inappropriate cases.
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Affiliation(s)
- Emre Özdemir
- Izmir Katip Çelebi University, Atatürk Training and Research Hospital, Department of Cardiology, Izmir, Turkey
| | - Cem Nazlı
- Izmir Katip Çelebi University, Atatürk Training and Research Hospital, Department of Cardiology, Izmir, Turkey
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Transcatheter closure of a residual shunt with posteroinferior deficient rim after surgical closure of an ASD: a case report. BMC Cardiovasc Disord 2020; 20:343. [PMID: 32698795 PMCID: PMC7374861 DOI: 10.1186/s12872-020-01624-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are few reports in the literature of device closure of residual shunts following initial surgical closure of an atrial septal defect (ASD). This case study reports one such case. We describe here a case of secundum type ASD that was initially closed surgically, followed by device closure of a residual shunt with a posteroinferior deficient rim. CASE PRESENTATION A 7-month-old boy was admitted to our hospital for elective surgery to surgically correct a secundum type ASD. Unfortunately, a residual shunt 3.5 mm in diameter appeared before discharge and was enlarged at1-year follow-up. The cause of this residual shunt was dehiscence at the posteroinferior aspect, and the posteroinferior rim was 3.7 mm. After careful discussion and preparation, we proceeded with an interventional procedure. A 16 mm ASD occluder (AGA Medical Corp, Plymouth, Minnesota) was deployed successfully with no residual shunt. In some cases of ASD, interventional therapy is not considered due to the size and position of the defect, but we show here, a successful case of interventional therapy for a residual shunt with a deficient rim. CONCLUSION We have presented a case in which a postoperative residual shunt with a deficient rim was successfully closed with interventional therapy.
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12
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Sun KP, Xu N, Huang ST, Chen LW, Cao H, Chen Q. Comparison of Short-Term Quality of Life between Percutaneous Device Closure and Surgical Repair via Median Sternotomy for Atrial Septal Defect in Adult Patients. J INVEST SURG 2020; 34:1223-1230. [PMID: 32654541 DOI: 10.1080/08941939.2020.1793037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare the quality of life and psychological state of patients after receiving different closure treatments for atrial septal defect (ASD) and to explore some factors affecting the quality of life of patients after ASD closure. METHODS Fifty-five patients who underwent percutaneous device closure of ASD (group A) and fifty-five patients who underwent surgical repair via median sternotomy of ASD (group B) were followed up from before to one year after surgery to assess their quality of life. We used the Medical Outcomes Study 36-Item Short-Form (SF-36) and the Hospital Anxiety and Depression Scale (HADS) to evaluate the quality of life of patients. RESULTS Both groups had improved HADS scores after operation. In the comparison of the postoperative quality of life between the two groups, group A was superior to group B on some dimensions of the SF-36, and there was a significant difference in HADS scores. Age was negatively correlated with quality of life. CONCLUSIONS In adults over 18 years of age, the quality of life after surgical repair or percutaneous device closure of ASD improved significantly. Compared with surgical repair via median sternotomy, percutaneous device closure has a more significant effect on the improvement in some aspects of people's quality of life.
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Affiliation(s)
- Kai-Peng Sun
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Ning Xu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Shu-Ting Huang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Liang-Wan Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
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13
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Lu W, Ouyang W, Wang S, Liu Y, Zhang F, Wang W, Pan X. A novel totally biodegradable device for effective atrial septal defect closure: A 2-year study in sheep. J Interv Cardiol 2018; 31:841-848. [PMID: 30079559 DOI: 10.1111/joic.12550] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/10/2018] [Accepted: 07/18/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Wenxin Lu
- Structural Heart Disease Center, National Center for Cardiovascular Disease; China and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Wenbin Ouyang
- Structural Heart Disease Center, National Center for Cardiovascular Disease; China and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Shouzheng Wang
- Structural Heart Disease Center, National Center for Cardiovascular Disease; China and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Yao Liu
- Structural Heart Disease Center, National Center for Cardiovascular Disease; China and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Fengwen Zhang
- Structural Heart Disease Center, National Center for Cardiovascular Disease; China and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Weiwei Wang
- Tianjin Key Laboratory of Biomaterial Research, Institute of Biomedical Engineering; Chinese Academy of Medical Sciences and Peking Union Medical College; Tianjin China
| | - Xiangbin Pan
- Structural Heart Disease Center, National Center for Cardiovascular Disease; China and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
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Collado FMS, Poulin MF, Murphy JJ, Jneid H, Kavinsky CJ. Patent Foramen Ovale Closure for Stroke Prevention and Other Disorders. J Am Heart Assoc 2018; 7:e007146. [PMID: 29910192 PMCID: PMC6220531 DOI: 10.1161/jaha.117.007146] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Fareed Moses S Collado
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL
| | - Marie-France Poulin
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL
| | - Joshua J Murphy
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL
| | - Hani Jneid
- Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Clifford J Kavinsky
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL
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Ramalingam R, Patil S, Setty N, Kharge J, Puttegowda B, Rachaiah JM, Manjunath CN. Tough, but not impossible - Retrieval of large atrial septal occluder devices embolized to left atrium. Interv Med Appl Sci 2017; 9:42-46. [PMID: 28932495 PMCID: PMC5598121 DOI: 10.1556/1646.9.2017.1.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Atrial septal defect (ASD) is a congenital heart defect that is being increasingly treated using percutaneous interventions. However, these techniques are not devoid of complications. One such complication is device embolization. Removal of such closure device poses tremendous risk and consequent complications both by percutaneous retrieval and surgical removal. Herein, we present two cases of ASDs that were closed using atrial septal occluder, but the devices were subsequently embolized into left atrium. These devices were then percutaneously retrieved without any further complication or injury.
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Affiliation(s)
- Rangaraj Ramalingam
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bengaluru, Karnataka, India
| | - Shivanand Patil
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bengaluru, Karnataka, India
| | - Natraj Setty
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bengaluru, Karnataka, India
| | - Jayashree Kharge
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bengaluru, Karnataka, India
| | - Beeresha Puttegowda
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bengaluru, Karnataka, India
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Das S, Kumar P, Bhardwaj V, Palleti R. Anesthetic management of Amplatzer atrial septal defect closure device embolization to right ventricular outflow tract. Saudi J Anaesth 2016; 10:335-8. [PMID: 27375392 PMCID: PMC4916821 DOI: 10.4103/1658-354x.174911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Percutaneous device closure of atrial septal defect (ASD) is an alternative treatment to surgery with advantages of avoidance of surgery, short procedure time, early discharge from hospital, and lower rates of complications. However, percutaneous device closure is associated with infrequent life-threatening complications such as device embolization. We report a case device embolization of the ASD occlude device into right ventricular outflow tract resulting progressive hypoxia. The role of anesthesiologist as a team leader in managing such emergency is discussed.
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Affiliation(s)
- S Das
- Department of Cardiac Anesthesia, All India Institute of Medical Sciences, New Delhi, India
| | - P Kumar
- Department of Cardiac Anesthesia, All India Institute of Medical Sciences, New Delhi, India
| | - V Bhardwaj
- Department of Cardiac Anesthesia, All India Institute of Medical Sciences, New Delhi, India
| | - R Palleti
- Department of Cardiothoracic Surgery, All India Institute of Medical Sciences, New Delhi, India
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Finocchi C, Del Sette M. Migraine with aura and patent foramen ovale: myth or reality? Neurol Sci 2016; 36 Suppl 1:61-6. [PMID: 26017514 DOI: 10.1007/s10072-015-2163-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Several observational studies report that subjects with migraine with aura have a higher prevalence of right-to left shunt, commonly due to patent foramen ovale, and that patent foramen ovale is more prevalent in subjects with migraine with aura. Although migraine without aura has been less extensively studied, it does not seem to be associated with an increased prevalence of right-to left shunt. The mechanism that underlies the possible relationship between patent foramen ovale and migraine with aura remains speculative. The proposed mechanisms are migraine-triggering vasoactive chemicals bypassing the pulmonary filter and reaching the cerebral circulation and paradoxical microembolization. However, it is unclear, at this time, if there is a causal or comorbid association between the two conditions. In some families atrial shunts show a dominant inheritance that seems to be linked to inheritance of migraine with aura. Migraine with aura is an independent risk factor for ischemic stroke, and patent foramen ovale is present more frequently in patients with cryptogenic stroke than in controls. At this moment, there is no convincing evidence that excess stroke risk of migraine is simply mediated by patent foramen ovale through paradoxical embolism. Several non-controlled studies suggest that closure of the foramen ovale significantly reduces attack frequency in migraine patient, but the only prospective placebo-controlled trial does not support these results. Patent foramen ovale closure, at present, is not indicated as a treatment for migraine in clinical practice.
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Affiliation(s)
- C Finocchi
- Dipartimento di Neuroscienze, Oftalmologia, Genetica e Scienze Materno-Infantili, Univesità di Genova, Largo Daneo 3, 16132, Genoa, Italy,
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Takagi H, Umemoto T. A meta-analysis of case-control studies of the association of migraine and patent foramen ovale. J Cardiol 2015; 67:493-503. [PMID: 26527111 DOI: 10.1016/j.jjcc.2015.09.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/08/2015] [Accepted: 09/12/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To establish quantitative evidence, we performed the first meta-analysis of case-control studies assessing the relationship between migraine and patent foramen ovale (PFO). METHODS MEDLINE and EMBASE were searched through April 2015 using PubMed and OVID. Eligible studies were case-control studies reporting PFO (or migraine) prevalence in migraine patients versus no-migraine subjects (or PFO patients versus no-PFO subjects). RESULTS Of 395 potentially relevant articles screened initially, 21 eligible studies enrolling a total of 5572 participants were identified and included. Pooled analyses demonstrated statistically significant 3.36-fold migraine-with-aura [odds ratio (OR), 3.36; 95% confidence interval (CI), 2.04-5.55; p<0.00001] and 2.46-fold migraine-with/without-aura prevalence (OR, 2.46; 95% CI, 1.55-3.91; p=0.0001) but statistically non-significant 1.30-fold migraine-without-aura prevalence (OR, 1.30; 95% CI, 0.85-1.99; p=0.22) in PFO patients relative to no-PFO subjects. CONCLUSIONS PFO is associated with 3.4-fold migraine-with-aura and 2.5-fold migraine-with/without-aura prevalence but unassociated with migraine-without-aura prevalence.
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Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
| | - Takuya Umemoto
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan
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Merante A, Gareri P, Castagna A, Marigliano NM, Candigliota M, Ferraro A, Ruotolo G. Transient cerebral ischemia in an elderly patient with patent foramen ovale and atrial septal aneurysm. Clin Interv Aging 2015; 10:1445-9. [PMID: 26379429 PMCID: PMC4567244 DOI: 10.2147/cia.s80190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cerebrovascular disease is one of the most common causes of cerebrovascular morbidity and mortality in developed countries; up to 40% of acute ischemic strokes in young adults are cryptogenic in nature – that is, no cause is determined. However, in more than half of these patients, patent foramen ovale (PFO) is seen along with an increased incidence of atrial septal aneurysm (ASA). The following is a report of an interesting case: a 68-year-old man with ASA and transient cerebral ischemia. Transesophageal echocardiography (TEE) showed the presence of ASA; a test with microbubbles derived from a mixture of air and saline or colloids pointed out a shunt on the foramen ovale following Valsalva’s maneuver. The patient underwent percutaneous transcatheter closure of the interatrial communication by an interventional cardiologist. TEE and transcranial Doppler or TEE with the microbubbles test are the recommended methods for detecting and quantifying intracardiac shunts, both at rest and following Valsalva’s maneuver. In patients following the first event of transient ischemic attack, and without clinical and anatomical risk factors (such as the presence of ASA, PFO, and basal shunt), pharmacological treatment with antiplatelets or anticoagulants is closely recommended. On the contrary, in patients following the first event of transient ischemic attack, or a recurrent event during antiplatelet treatment, the percutaneous closure of PFO is recommended.
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Affiliation(s)
- Alfonso Merante
- Geriatric Unit, "Pugliese-Ciaccio" Hospital, Catanzaro, Italy
| | - Pietro Gareri
- Azienda Sanitaria Provinciale (ASP), Catanzaro, Italy
| | | | | | | | - Alessandro Ferraro
- Intensive Cardiology Unit, "Pugliese-Ciaccio" Hospital, Catanzaro, Italy
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Abstract
Echocardiography provides a useful tool in the diagnosis of many congenital heart diseases, including atrial septal defects, and aids in further delineating treatment options. Although two-dimensional echocardiography has been the standard of care in this regard, technological advancements have made three-dimensional echocardiography possible, and the images obtained in this new imaging modality are able to accurately portray the morphology, location, dimensions, and dynamic changes of defects and many other heart structures during the cardiac cycle.
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Affiliation(s)
| | - Navin C Nanda
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Guidetti D, Rota E, Morelli N, Immovilli P. Migraine and stroke: "vascular" comorbidity. Front Neurol 2014; 5:193. [PMID: 25339937 PMCID: PMC4189436 DOI: 10.3389/fneur.2014.00193] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 09/15/2014] [Indexed: 01/03/2023] Open
Abstract
Several comorbidities are associated to migraine. Recent meta-analyses have consistently demonstrated a relationship between migraine and stroke, which is well-defined for ischemic stroke and migraine with aura (MA), even stronger in females on oral contraceptives or smokers. However, there seems to be no clear-cut association between stroke in migraineurs and the common vascular risk factors, at least in the young adult population. Migraineurs also run an increased risk of hemorrhagic stroke, while the association between migraine and cardiovascular disease remains poorly defined. Another aspect is the relationship between migraine and the presence of silent brain lesions. It has been demonstrated that there is an increased frequency of ischemic lesions in the white matter of migraineurs, especially silent infarcts in the posterior circulation territory in patients with at least 10 attacks per month. Although there is a higher prevalence of patent foramen ovale (PFO) in migraineurs, the relationship between migraine and PFO remains controversial and PFO closure is not a recommended procedure to prevent migraine. As an increased frequency of cervical artery dissections has been observed in migrainous patients, it has been hypothesized that migraine may represent a predisposing factor for cervical artery dissection. There still remains the question as to whether migraine should be considered a true “vascular disease” or if the comorbidity between migraine and cerebrovascular disease may have underlying shared risk factors or pathophysiological mechanisms. Although further studies are required to clarify this issue, current evidence supports a clinical management where MA patients should be screened for other concomitant vascular risk factors and treated accordingly.
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Affiliation(s)
- Donata Guidetti
- Neurology Unit, Guglielmo da Saliceto Hospital , Piacenza , Italy
| | - Eugenia Rota
- Neurology Unit, Guglielmo da Saliceto Hospital , Piacenza , Italy
| | - Nicola Morelli
- Neurology Unit, Guglielmo da Saliceto Hospital , Piacenza , Italy
| | - Paolo Immovilli
- Neurology Unit, Guglielmo da Saliceto Hospital , Piacenza , Italy
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Hoashi T, Yazaki S, Kagisaki K, Kitano M, Kubota SM, Shiraishi I, Ichikawa H. Management of ostium secundum atrial septal defect in the era of percutaneous trans-catheter device closure: 7-Year experience at a single institution. J Cardiol 2014; 65:418-22. [PMID: 25113951 DOI: 10.1016/j.jjcc.2014.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 06/19/2014] [Accepted: 07/11/2014] [Indexed: 01/25/2023]
Abstract
OBJECTIVES This study aimed to review the single institutional experience of the repair of secundum atrial septal defect (ASD) after the initiation of percutaneous trans-catheter device closure, to confirm the current management strategy and outcomes. METHODS From August 2005 to December 2012, a total of 1026 (659 females, age 27±21 years) consecutive patients underwent the repair of ASD. Including eight patients who converted to surgical repair, 317 patients (31%) underwent surgical repair and 709 (69%) underwent trans-catheter device closure. RESULTS An embolized device into the left atrium was surgically retrieved in one patient soon after trans-catheter device closure without any postoperative complications. The other patient developed left atrium to aorta fistula due to late erosion, and required the removal of implanted device and patch closure of fistula and ASD 3 months after trans-catheter device closure. Whereas serious central nerve system complications occurred in three patients after the surgical repair including a 75-year-old patient with postoperative transient atrial fibrillation who subsequently developed aspiration pneumonia and died; there were no mortalities and no morbidities associated with cranial nerve function after trans-catheter device closure. A number of patients approached through partial sternotomy with limited skin incision have increased per year, and the length of skin incision was 5.1±1.2cm in pediatric patients weighing less than 15kg (n=40), 6.9±1.9cm in the remaining pediatric patients (n=91), and 10.0±2.5cm in young adult females (n=10). CONCLUSION Percutaneous trans-catheter ASD closure was safely performed under the support of a surgical team. The cosmetic outcome of surgical closure is improving after initiation of partial sternotomy via limited skin incision for the pediatric population and young adult females. Prior to the treatment, the physicians must thoroughly inform patients and families of the advantages and disadvantages of both treatment options.
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Affiliation(s)
- Takaya Hoashi
- Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
| | - Satoshi Yazaki
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Koji Kagisaki
- Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Masataka Kitano
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Sayaka Miura Kubota
- Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Isao Shiraishi
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hajime Ichikawa
- Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Morelli N, Rota E. Migraine and Patent Foramen Ovale: Barking up the Wrong Tree? Front Neurol 2014; 5:99. [PMID: 24982650 PMCID: PMC4058756 DOI: 10.3389/fneur.2014.00099] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 06/03/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nicola Morelli
- Neurology Unit, Guglielmo da Saliceto Hospital , Piacenza , Italy
| | - Eugenia Rota
- Neurology Unit, Guglielmo da Saliceto Hospital , Piacenza , Italy
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24
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Gupta VK. Patent foramen ovale closure and migraine: science and sensibility. Expert Rev Neurother 2014; 10:1409-22. [DOI: 10.1586/ern.10.125] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Gupta VK. CSD, BBB and MMP-9 elevations: animal experiments versus clinical phenomena in migraine. Expert Rev Neurother 2014; 9:1595-614. [DOI: 10.1586/ern.09.103] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Potwar SS, Bhosle KN, Joshi MM, Parashi HS, Gahlot AS, Saran NS, Thakare ND. Retrieval of embolized atrial septal defect closure device one year after insertion. Indian J Thorac Cardiovasc Surg 2013. [DOI: 10.1007/s12055-013-0215-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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27
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Bleich S, Nanda NC, Hage FG. The Incremental Value of Three-Dimensional Transthoracic Echocardiography in Adult Congenital Heart Disease. Echocardiography 2013; 30:483-94. [DOI: 10.1111/echo.12130] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Steven Bleich
- Division of Internal Medicine; Department of Medicine; University of Alabama at Birmingham; Birmingham; Alabama
| | - Navin C. Nanda
- Division of Cardiovascular Disease; University of Alabama at Birmingham; Birmingham; Alabama
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28
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Sathasivam S, Sathasivam S. Patent foramen ovale and migraine: What is the relationship between the two? J Cardiol 2013; 61:256-9. [DOI: 10.1016/j.jjcc.2012.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 11/23/2012] [Accepted: 12/04/2012] [Indexed: 01/16/2023]
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29
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Saillen E, Latremouille C, Pouchot J, Ranque B. A life-threatening umbrella. J Thorac Cardiovasc Surg 2013; 145:e53-4. [PMID: 23473016 DOI: 10.1016/j.jtcvs.2013.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 01/22/2013] [Accepted: 02/11/2013] [Indexed: 10/27/2022]
Affiliation(s)
- Elodie Saillen
- Internal Medicine Department, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
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30
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Mohite PN, Kuthe SA, Ranade SD, Kulkarni PP, Sabashnikov A, Popov AF. Suture fixation of migrated septal occluder device to prevent further migration: a simple surgical technique. J Cardiothorac Surg 2013; 8:10. [PMID: 23320504 PMCID: PMC3564840 DOI: 10.1186/1749-8090-8-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 01/11/2013] [Indexed: 11/29/2022] Open
Abstract
As the use of percutaneous intervention is increasing for the closure of the atrial septal defect, the procedure related complications are also on rise, migration of the device being most common. The migrated devices with failed percutaneous retrieval must be removed surgically under cardiopulmonary bypass. During establishment of cardiopulmonary bypass, the handling of heart may cause further migration of the device into other chambers of heart which leads to difficulty in finding and retrieval of the device. The authors propose a simple and unique technique to prevent further migration of the septal occluder device.
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Affiliation(s)
- Prashant N Mohite
- Department of Cardiothoracic and Vascular surgery, Postgraduation Institute of Medical Research and Education, Sector- 12, Chandigarh 160012, India.
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31
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Catheter interventions in congenital heart disease without regular catheterization laboratory equipment: the chain of hope experience in Rwanda. Pediatr Cardiol 2013; 34:39-45. [PMID: 22644416 DOI: 10.1007/s00246-012-0378-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 05/08/2012] [Indexed: 10/28/2022]
Abstract
This report describes the feasibility and safety of cardiac catheterization in a developing country without access to a regular cardiac catheterization laboratory. The equipment used for imaging consisted of a monoplane conventional C-arm X-ray system and a portable ultrasound machine using the usual guidewires and catheters for cardiovascular access. In this study, 30 patients, including 17 children younger than 2 years and 2 adults, underwent catheterization of the following cardiac anomalies: patent ductus arteriosus (20 patients) and pulmonary valve stenosis (9 patients, including 2 patients with critical stenosis and 3 patients with a secundum atrial septal defect). Except for two cases requiring surgery, the patients were treated successfully without complications. They all were discharged from hospital, usually the day after cardiac catheterization, and showed significant clinical improvement in the follow-up evaluation. Cardiac catheterization can be performed safely and very effectively in a country with limited resources. If patients are well selected, this mode of treatment is possible without the support of a sophisticated catheterization laboratory.
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Gokaslan G, Ustunsoy H, Deniz H, Ozcaliskan O, Yasim A, Baspinar O, Guzel G. Urgent surgical management for embolized occluder devices in childhood: single center experience. J Cardiothorac Surg 2012; 7:127. [PMID: 23217122 PMCID: PMC3540020 DOI: 10.1186/1749-8090-7-127] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 12/04/2012] [Indexed: 11/19/2022] Open
Abstract
Background In this study, we sought to analyze our experience in urgent surgical management for embolized cardiac septal and ductal occluder devices resulting from trans-catheter closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus in childhood patient group. Methods We retrospectively reviewed 9 patients (aged 2–15 years) who underwent urgent surgery due to cardiac septal and ductal occluder embolization between January 2007 and December 2010. Congenital defects were atrial septal defect (n = 6), ventricular septal defect (n = 1), and patent ductus arteriosus (n = 2). Risk factors for device embolization and urgent surgical management techniques for embolized device removal were discussed. Results Removal of embolized devices in all cases and repair of damaged tricuspid valve in 2 patients were performed. Inevitably, all congenital defects were closed or ligated up to the primary defect. Total circulator arrest necessitated in 1 patient with ascending aortic device embolization. All operations were completed successfully and no hospital mortality or morbidity was encountered. Conclusions Although closure of left to right shunting defects by percutaneous occluder devices has a lot of advantages, device embolization is still a major complication. If embolized device retrieval fails with percutaneous intervention attempts, surgical management is the only method to remove embolized devices. In this circumstance, to provide an uneventful perioperative course, urgent management strategies should be well planned.
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Affiliation(s)
- Gokhan Gokaslan
- Department of Cardiovascular Surgery, Gaziantep University Medical Faculty, Gaziantep, Sehitkamil 27310, Turkey.
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33
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Sahin DY, Koç M, Cakır H, Arık OZ, Elbasan Z, Caylı M. A silent and late embolization of atrial septal defect occluder device into the right pulmonary artery: a case report. Korean Circ J 2012; 42:781-3. [PMID: 23236332 PMCID: PMC3518714 DOI: 10.4070/kcj.2012.42.11.781] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 04/01/2012] [Accepted: 04/04/2012] [Indexed: 11/11/2022] Open
Abstract
Percutaneous device closure of atrial septal defect (ASD) is an alternative treatment to surgery. The main advantages of the percutaneous approach include avoidance of surgery, short procedure time and hospital length, in addition to comparable rates of complications. However, percutaneous device closure is associated with infrequent early and late complications including device embolization, air embolism, cardiac tamponade and thrombotic complications. We report a rare complication of silent and late device embolization of the ASD occluder device into the right pulmonary artery, three months after implantation.
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Affiliation(s)
- Durmuş Yıldıray Sahin
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
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34
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Tomizawa Y. Atrial septum defect closure device in a beating heart, from the perspective of a researcher in artificial organs. J Artif Organs 2012; 15:311-24. [PMID: 22729293 DOI: 10.1007/s10047-012-0651-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 05/28/2012] [Indexed: 11/24/2022]
Abstract
Transcatheter closure of atrial septum defect (ASD) with a closure device is increasing, but the history of clinical use of this procedure is still short, and the efficacy and long-term safety remain unproved. The total number of closure devices implanted throughout the world has not been counted accurately. Therefore, the probability of complications occurring after implantation is uncertain. Device-related complications that occur suddenly late after implantation are life-threatening, and quite often necessitate emergency surgical intervention. In Japanese medical journals, authors reporting closure devices have mentioned no complications and problems in their facilities. Detailed studies of device-related complications and device removal have not been reported in Japan. In fact, this literature search found an unexpectedly large number of reports of various adverse events from many overseas countries. When follow-up duration is short and the number of patients is small, the incidence of complications cannot be determined. Rare complications may emerge in a large series with a long observation period. Consequently, the actual number of incidents related to ASD closure devices is possibly several times higher than the number reported. Guidelines for long-term patient management for patients with an implanted closure device are necessary and post-marketing surveillance is appropriate. Development of a national database, a worldwide registration system, and continuous information disclosure will improve the quality of treatment. The devices currently available are not ideal in view of reports of late complications requiring urgent surgery and the need for life-long follow-up. An ideal device should be free from complications during life, and reliability is indispensable.
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Affiliation(s)
- Yasuko Tomizawa
- Department of Cardiovascular Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
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35
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Yan L, Zhou ZC, Li HP, Lin M, Wang HT, Zhao ZW, Gao QY, Ge JJ. Right vertical infra-axillary mini-incision for repair of simple congenital heart defects: a matched-pair analysis. Eur J Cardiothorac Surg 2012; 43:136-41. [DOI: 10.1093/ejcts/ezs280] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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36
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Yilmaz K, Ewert P, Hetzer R, Stamm C. Surgical repair after ineffective device closure of an inferior sinus venosus defect. Interact Cardiovasc Thorac Surg 2012; 14:485-7. [PMID: 22238133 DOI: 10.1093/icvts/ivr100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A young woman presented with severe heart failure symptoms 4 years after percutaneous device closure of an atrial septal defect (ASD). There was residual left-to-right shunting, and the device was obstructing the inferior caval vein and tricuspid valve flow. Intraoperatively, the ASD was shown to be an inferior sinus venosus defect, and reconstruction of the mitral valve and the posterior wall of the left atrium was required. This case emphasizes the importance of appropriate patient selection for interventional ASD closure and demonstrates that patients with less-than-optimal results should be referred for surgical correction early, before the device produces secondary damage to atrial structures and atrioventricular valves.
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Affiliation(s)
- Kadir Yilmaz
- Department of Thoracic and Cardiovascular Surgery, German Heart Institute Berlin, Berlin, Germany
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37
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Lodha A, Haran M, Enakpene E, Sadiq A, Shani J. Cor triatriatum dextro iatrogenica: an unusual complication of atrial septal defect closure device. Echocardiography 2011; 29:E45-7. [PMID: 22044592 DOI: 10.1111/j.1540-8175.2011.01545.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We present a case of a rare complication of atrial septal defect (ASD) device closure causing cor triatriatum dextro iatrogenica. A 29-year-old female presented with sudden onset dysarthria and ataxia and was found to have basilar and thalamic infarcts. Further evaluation using transthoracic echocardiography revealed an ASD which was repaired using the Gore HELEX septal occluder. Transesophageal echocardiography done after 2 months of ASD closure revealed an interesting finding termed cor triatriatum dextro iatrogenica. We briefly describe the case and discuss the relevant literature.
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Affiliation(s)
- Ankur Lodha
- Division of Cardiology, Maimonides Medical Center, Brooklyn, New York 11219, USA
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38
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Hage FG, Raslan S, Dean P, Nanda NC. Real Time Three-Dimensional Transthoracic Echocardiography in Congenital Heart Disease. Echocardiography 2011; 29:220-31. [DOI: 10.1111/j.1540-8175.2011.01555.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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39
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Abstract
Stroke from cardiac sources is a major cause of cerebral infarctions and ischemia. Cardiac sources of stroke include intracardiac thrombus, right-to-left shunts, tumors, and slow-flow states resulting from hemodynamic compromise. Computed tomography angiography of the neck is currently used for the evaluation of a suspected stroke. The availability of longer multidetector computed tomography detector arrays and prospective echocardiography triggering techniques could permit evaluation of the chest, head, and neck during the same examination, streamlining patient evaluation and management.
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40
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Dislocation of Amplatzer Septal Occluder Device after Closure of Secundum Atrial Septal Defect. J Am Soc Echocardiogr 2010; 23:1007.e1-2. [DOI: 10.1016/j.echo.2010.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Indexed: 11/23/2022]
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41
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Ulas MM, Lafci G, Tasoglu I, Kocabeyoglu S, Uzun A, Ozatik MA. The operative management of a displaced atrial septal occluder. J Card Surg 2010; 25:382-4. [PMID: 20412354 DOI: 10.1111/j.1540-8191.2010.01028.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We present a case of a displaced atrial septal defect (ASD) occluder in the left ventricle. We successfully adapted a strategy to remove the device through a single right atrial incision which permitted retrieval of the occluder and the closure of the ASD.
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Affiliation(s)
- Mahmut M Ulas
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
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Almeida-Chen G, Niezgoda J, Diaz-Gomez JL, Motta P. The role of echocardiography in the management of an embolized atrial septal Helex occluder. Anesth Analg 2010; 110:734-6; discussion 736. [PMID: 20042445 DOI: 10.1213/ane.0b013e3181cb3edc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Gracie Almeida-Chen
- Department of Cardiothoracic Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA
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43
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Jerath A, Jaura A, Karski J, Feindel C, Butany J, Vegas A. Left-sided migration of Sideris button atrial septal occluder device. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2010; 11:E21. [PMID: 20097746 DOI: 10.1093/ejechocard/jep228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report the case of a left-sided migrated 'Sideris button' atrial septal defect occlusion device 6 years post-implantation with a residual secundum atrial septal defect and left atrial mass. The aims of this case report are to highlight an uncommonly seen atrial septal occlusion device, the importance of a complete echocardiographic examination of the path traversed by the device to assess for local trauma to structures, and the additional anatomical information gained and diagnostic use of intraoperative 3D transoesophageal echocardiography.
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Affiliation(s)
- Angela Jerath
- Department of Anesthesia and Pain Medicine, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4.
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Khodaverdian RA, Jones KW. Metal allergy to Amplatzer occluder device presented as severe bronchospasm. Ann Thorac Surg 2010; 88:2021-2. [PMID: 19932286 DOI: 10.1016/j.athoracsur.2009.05.044] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Revised: 04/20/2009] [Accepted: 05/14/2009] [Indexed: 10/20/2022]
Abstract
Percutaneous closure of an atrial septal defect has become increasingly popular among interventional cardiologists. With this relatively new technology being more widespread, it is important to acknowledge any device-related complications. We report a case of severe bronchospasm secondary to a metal allergy after an atrial septal defect device closure requiring device removal.
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Affiliation(s)
- Reza A Khodaverdian
- Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, Utah 84132, USA.
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Aorto-Left Atrial Fistula Post-Percutaneous Device ASD Closure. Heart Lung Circ 2010; 19:53-5. [DOI: 10.1016/j.hlc.2008.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2008] [Revised: 12/29/2008] [Accepted: 12/30/2008] [Indexed: 11/24/2022]
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46
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Kutty S, Nykanen DG, Zahn EM. Early Experience with a Simplified Technique for Transcatheter Closure of the Patent Foramen Ovale. Heart Lung Circ 2009; 18:384-7. [DOI: 10.1016/j.hlc.2009.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2008] [Revised: 06/05/2009] [Accepted: 08/24/2009] [Indexed: 10/20/2022]
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47
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Li W, Han W, Yu C, Zhang C, Tu Z, Wu S, Huber CH, Ma L. Severe Mitral Valve Insufficiency After Transcatheter Atrial Septal Defect Closure with the Amplatzer Septal Occluder: A Device‐Related Complication. J Card Surg 2009; 24:672-4. [PMID: 20078713 DOI: 10.1111/j.1540-8191.2009.00871.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Weidong Li
- Department of Cardiothoracic Surgery, 1st Affiliated Hospital, School of Medicine, ZheJiang University, HangZhou, China
| | - Weili Han
- Department of Cardiothoracic Surgery, 1st Affiliated Hospital, School of Medicine, ZheJiang University, HangZhou, China
| | - Ceyan Yu
- Department of Cardiothoracic Surgery, 1st Affiliated Hospital, School of Medicine, ZheJiang University, HangZhou, China
| | - Chong Zhang
- Department of Cardiothoracic Surgery, 1st Affiliated Hospital, School of Medicine, ZheJiang University, HangZhou, China
| | - Zhengliang Tu
- Department of Cardiothoracic Surgery, 1st Affiliated Hospital, School of Medicine, ZheJiang University, HangZhou, China
| | - Shenjun Wu
- Department of Cardiothoracic Surgery, 1st Affiliated Hospital, School of Medicine, ZheJiang University, HangZhou, China
| | - Christoph H. Huber
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Liang Ma
- Department of Cardiothoracic Surgery, 1st Affiliated Hospital, School of Medicine, ZheJiang University, HangZhou, China
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Sinha A, Nanda NC, Misra V, Khanna D, Dod HS, Vengala S, Mehmood F, Singh V. Live Three-Dimensional Transthoracic Echocardiographic Assessment of Transcatheter Closure of Atrial Septal Defect and Patent Foramen Ovale. Echocardiography 2009; 21:749-53. [PMID: 15546377 DOI: 10.1111/j.0742-2822.2004.04037.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We report the usefulness of live three-dimensional transthoracic echocardiography in the accurate assessment of the morphology and efficacy of Amplatzer transcatheter devices used for closure of atrial septal defect and patent foramen ovale.
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Affiliation(s)
- Ashish Sinha
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA
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49
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Dod HS, Reddy VK, Bhardwaj R, Gudausky T, Warden BE, Beto RJ, Nanda NC, Jain AC. Embolization of Atrial Septal Occluder Device into the Pulmonary Artery: A Rare Complication and Usefulness of Live/Real Time Three-Dimensional Transthoracic Echocardiography. Echocardiography 2009; 26:739-41. [DOI: 10.1111/j.1540-8175.2009.00967.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Moiduddin N, Cheatham JP, Hoffman TM, Phillips AB, Kovalchin JP. Amplatzer septal occluder associated with late pulmonary venous obstruction requiring surgical removal with acquired aorta to left atrial fistula. Am J Cardiol 2009; 103:1039-40. [PMID: 19327438 DOI: 10.1016/j.amjcard.2008.11.057] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Revised: 11/21/2008] [Accepted: 11/21/2008] [Indexed: 12/31/2022]
Abstract
The Amplatzer septal occluder is currently the preferred device for the transcatheter closure of secundum atrial septal defects. Multiple studies have shown that device complications with the Amplatzer occluder are rare and often acute in presentation. The investigators describe the first reported case of late obstruction of the right pulmonary veins with an Amplatzer septal occluder and, in the same patient, an unusual intraoperative finding of a noncoronary aortic sinus to left atrium fistula after device removal.
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Affiliation(s)
- Nasser Moiduddin
- Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
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