经 Atriasept 封堵器闭合房间隔缺损后出现心房壁和主动脉窦穿孔：一例报告。
Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report.
机构信息
Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, 183 Yiling Road, Yichang, Hubei Province, 443000, People's Republic of China.
Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, Hubei Province, 443000, People's Republic of China.
出版信息
J Cardiothorac Surg. 2021 Mar 25;16(1):53. doi: 10.1186/s13019-021-01441-x.
BACKGROUND
While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it's life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976.
CASE PRESENTATION
We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition.
CONCLUSIONS
With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.
背景
尽管在房间隔缺损（ASD）封堵术后发生心房壁和主动脉窦穿孔较为罕见，但它可能危及生命，进展迅速，死亡率高。据我们所知，自 1976 年以来，已有 21 例类似病例报告。
病例介绍
我们报告了 1 例 16 岁男性患者，其 ASD 采用 12mm 的 Amplatzer 房间隔封堵器（ASO）进行了封堵。经导管封堵 3 个月后发生心房壁和主动脉窦穿孔，经紧急手术后患者出院。术后第 12 天，患者整体情况良好出院。
结论
通过本病例报告，我们希望说明，尽管经皮 ASD 封堵术被视为常规手术，但我们不应忽视潜在的致命并发症，尤其是心脏侵蚀。因此，我们应该在术前仔细评估侵蚀风险，需要进行终身的仔细随访。
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