Narayan Vidya, Puri Poonam, Mehra Anilkumar O
Division of Cardiology, LAC and USC Medical Center, Los Angeles, California, USA.
J Invasive Cardiol. 2008 Aug;20(8):E247-9.
Transcatheter closure of patent foramen ovale (PFO) is a promising alternative to surgical closure or anticoagulation therapy in patients with a history of cryptogenic stroke. Although a number of transcatheter closure devices have been developed and used outside of the United States, the two commonly used devices in the United States are the StarFLEX CardioSEAL and the Amplatzer Occluder. Several complications, both early and late, associated with the devices have been reported in 6-11% of patients. The rates of complication vary with the different devices. Complications include device-related thrombi, embolization, device malposition, fracture, air embolism, arrhythmias, pericardial effusion, need for surgical intervention and death. As reported in the literature, the incidence of longterm complications beyond 1 year is rare. We report a case of a very late presentation of CardioSEAL device arm fracture associated with left atrial thrombus 3 years after device implantation.
对于有隐源性卒中病史的患者，经导管闭合卵圆孔未闭（PFO）是手术闭合或抗凝治疗的一种有前景的替代方法。尽管在美国以外已研发并使用了多种经导管闭合装置，但在美国常用的两种装置是StarFLEX CardioSEAL和Amplatzer封堵器。据报道，6%-11%的患者会出现与这些装置相关的多种早期和晚期并发症。并发症发生率因不同装置而异。并发症包括与装置相关的血栓形成、栓塞、装置位置不当、断裂、空气栓塞、心律失常、心包积液、需要手术干预及死亡。如文献报道，1年以上的长期并发症发生率很低。我们报告1例在装置植入3年后出现CardioSEAL装置臂断裂并伴有左心房血栓形成的非常罕见的病例。
