Department of Cardiovascular Surgery, Shandong Provincial Hospital Affiliated to Shandong Fist Medical University, No. 324, Jingwu Road, Jinan, 250021, China.
J Cardiothorac Surg. 2021 Sep 18;16(1):263. doi: 10.1186/s13019-021-01646-0.
Fatal pericardial tamponade caused by aortic or atrial perforation due to erosion of atrial septal occluders has been reported previously, but the timing of erosion is uncertain, and the process is also unclear.
We present a case of a 5-year-old boy with erosion of the aorta and atrium by the occluder not leading to perforation or pericardial tamponade because of early detection and timely surgery. A small amount of pericardial effusion may be the only manifestation of early erosion. This case firstly revealed the early process of device erosion in children.
An absent aortic rim may be a higher risk factor for erosion than oversized device for a child, and it is wise to choose a relatively small occluder or change to surgery. This may be helpful for preventing and treating serious complications caused by erosion of the occluder.
先前有报道称，因侵蚀导致的房间隔封堵器穿破主动脉或心房会引发致命性的心包填塞，但侵蚀的时间不确定，过程也不明确。
我们报告了一例 5 岁男孩的病例，他的主动脉和心房被封堵器侵蚀，但由于早期发现和及时手术，并未导致穿孔或心包填塞。少量的心包积液可能是早期侵蚀的唯一表现。该病例首次揭示了儿童时期器械侵蚀的早期过程。
对于儿童来说，主动脉瓣缘缺失可能比器械过大更易导致侵蚀，选择相对较小的封堵器或改为手术是明智之举。这可能有助于预防和治疗封堵器侵蚀引起的严重并发症。
