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Atrio-aortic erosion caused by Amplatzer Atrial Septal Occluder - a case report.
- Source :
-
Journal of cardiothoracic surgery [J Cardiothorac Surg] 2021 Mar 20; Vol. 16 (1), pp. 36. Date of Electronic Publication: 2021 Mar 20. - Publication Year :
- 2021
-
Abstract
- Background: In specialized centers, percutaneous closure using specific occluders is the first-choice treatment in atrial septal defects (ASD). Late complications after this intervention, such as erosion of the aorta or the atria, are rare and have not been sufficiently approached and dealt with in literature. In our clinic we have been faced with the problematic situation of diagnosing and treating such cases. That is why, we have decided to share our experience with other colleagues.<br />Case Presentation: We present two cases of severe late complications after percutaneous closure of atrial septal defects (ASD). In both cases, the atrial septal occluder (Amplatzerâ„¢ Atrial Septal Occluder Device, Abbott, Chicago USA) caused the erosion between the left atrium and the aortic root. The atrio-aortic erosion led to acute cardiac tamponade with upper venous congestion and shock. As the bleeding source remained undetectable for any imaging tools, a diagnostical sternotomy remained the only solution. The cause of the acute bleeding was discovered to be the erosion between the left atrium and the aortic root. The treatment consisted in the removal of the occluder, direct suturing of the perforated areas and the surgical closure of the remaining ASD. The patients fully recovered within the nine to fourteen days' hospital stay. Six months after surgery both patients were well and able to recover their daily routine.<br />Conclusions: The atrio-aortic erosion after percutaneous closure of atrial septal defects is a surgical emergency. The more so, since it can be complicated by the absence of specific symptoms. A key-element in the diagnosis of this rare pathology remains the medical history of the patient, which the surgeon has to consider thoroughly and launch the diagnostic sternotomy without delay.
- Subjects :
- Aged
Aorta surgery
Heart Atria anatomy & histology
Hemorrhage
Humans
Male
Middle Aged
Sternotomy instrumentation
Sternotomy methods
Treatment Outcome
Cardiac Catheterization methods
Cardiac Surgical Procedures instrumentation
Cardiac Surgical Procedures methods
Heart Atria surgery
Heart Septal Defects, Atrial surgery
Septal Occluder Device
Subjects
Details
- Language :
- English
- ISSN :
- 1749-8090
- Volume :
- 16
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of cardiothoracic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 33743762
- Full Text :
- https://doi.org/10.1186/s13019-021-01411-3