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封堵器移位至主动脉弓后成功取出封堵器并重新封堵房间隔缺损:一例病例报告

Successful occluder removal and reocclusion of an atrial septal defect after occluder immigration to aortic arch: a case report.

作者信息

Zhang Zaiqiang, Ding Jiawang

机构信息

Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, 443000, Hubei Province, P. R. China.

Institute of Cardiovascular Diseases, Three Gorges University, Yichang, 443000, Hubei Province, China.

出版信息

J Cardiothorac Surg. 2024 Oct 1;19(1):575. doi: 10.1186/s13019-024-03107-w.

DOI:10.1186/s13019-024-03107-w
PMID:39354534
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11443626/
Abstract

BACKGROUND

Atrial septal defect (ASD) is a common congenital heart disease, and currently, transcatheter intervention is the most common clinical treatment method. However, certain complications still occur during the percutaneous process, among which occluder loss and displacement are rare but serious complication. Although the probability of occluder loss and displacement is low, severe cases can endanger life.

CASE PRESENTATION

Here, we report the case of a patient who underwent ASD closure in which the occluder fell off into the aortic arch, the detached occluder was recovered through catheter intervention, and the patient underwent ASD closure again.

CONCLUSIONS

In this case report, we highlight that although percutaneous closure of an ASD is regarded as a routine procedure, clinicians should remember the possibility of complications, especially occluder loss and displacement. Therefore, interventionist should carefully evaluate the situation before intervention closure, establish standardized interventional treatment procedures, and provide timely treatment follow-up.

摘要

背景

房间隔缺损(ASD)是一种常见的先天性心脏病,目前,经导管介入是最常见的临床治疗方法。然而,在经皮操作过程中仍会出现某些并发症,其中封堵器脱落和移位虽罕见但属于严重并发症。尽管封堵器脱落和移位的概率较低,但严重时可危及生命。

病例报告

在此,我们报告一例房间隔缺损封堵术患者,其封堵器掉入主动脉弓,通过导管介入回收了脱落的封堵器,患者再次接受了房间隔缺损封堵术。

结论

在本病例报告中,我们强调尽管房间隔缺损的经皮封堵被视为常规手术,但临床医生应牢记并发症的可能性,尤其是封堵器脱落和移位。因此,介入医生在介入封堵前应仔细评估病情,建立标准化的介入治疗程序,并提供及时的治疗随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/2690f2c4a313/13019_2024_3107_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/59cbe4e2822e/13019_2024_3107_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/6acb5f7226f7/13019_2024_3107_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/8632bc08b2da/13019_2024_3107_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/744c1835b09f/13019_2024_3107_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/4ec18f940992/13019_2024_3107_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/2690f2c4a313/13019_2024_3107_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/59cbe4e2822e/13019_2024_3107_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/6acb5f7226f7/13019_2024_3107_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/8632bc08b2da/13019_2024_3107_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/744c1835b09f/13019_2024_3107_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/4ec18f940992/13019_2024_3107_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee65/11443626/2690f2c4a313/13019_2024_3107_Fig6_HTML.jpg

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本文引用的文献

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2020 ESC Guidelines for the management of adult congenital heart disease.2020年欧洲心脏病学会成人先天性心脏病管理指南。
Eur Heart J. 2021 Feb 11;42(6):563-645. doi: 10.1093/eurheartj/ehaa554.
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Long term outcomes among adults post transcatheter atrial septal defect closure: Systematic review and meta-analysis.经导管房间隔缺损封堵术后成年人的长期结局:系统评价和荟萃分析。
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Transcatheter device closure of atrial septal defects: a safety review.
经导管封堵房间隔缺损:安全性综述。
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Transcatheter closure of atrial septal defect with amplatzer septal occluder in adults: immediate, short, and intermediate-term results.成人经导管使用Amplatzer房间隔封堵器闭合房间隔缺损:即刻、短期和中期结果
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Atrial septal occluder device embolization to an iliac artery: a case highlighting the utility of three-dimensional transesophageal echocardiography during percutaneous closure.房间隔封堵器栓塞至髂动脉:1例凸显经皮封堵术中三维经食管超声心动图应用价值的病例
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Presentation of an embolised Amplatzer septal occluder to the main pulmonary artery 2 years after implantation.植入后2年,一枚封堵器栓塞至主肺动脉。
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