Pala Selçuk, Açar Göksel, Tigen Kürşat, Kırma Cevat
Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2010 Oct;38(7):502-4.
Percutaneous closure of secundum atrial septal defects (ASD) may be complicated by immediate embolization. We report on a 35-year-old woman who underwent percutaneous device closure for a secundum ASD. The diameter of the defect was measured as 4 mm by two-dimensional transesophageal echocardiography and a 7-mm Figulla ASD occluder device was implanted without prior balloon sizing of the defect. Immediate embolization was noted into the aortic arch. Attempts to pull the devices into the sheath with a loop snare failed even after replacing the delivery sheath with a bigger one. Finally, a bioptome was used to grab and place the screw mechanisms in the sheath and percutaneous retrieval of the embolized ASD occluder was achieved. Balloon sizing was performed after removal, yielding a stretched diameter of 12 mm and a 15-mm device was deployed with success.
继发孔型房间隔缺损（ASD）经皮封堵术可能并发即刻栓塞。我们报告一名35岁女性，她接受了继发孔型ASD的经皮器械封堵术。通过二维经食管超声心动图测得缺损直径为4 mm，植入了一个7 mm的菲古拉ASD封堵器，术前未对缺损进行球囊测量。发现封堵器即刻栓塞至主动脉弓。即使将输送鞘换成更大尺寸的，用圈套器将封堵器拉回鞘内的尝试仍失败。最后，使用活检钳抓取并将螺旋装置放入鞘内，成功实现了经皮取出栓塞的ASD封堵器。取出后进行了球囊测量，测得拉伸直径为12 mm，成功植入了一个15 mm的封堵器。
