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ID 113465
Title Alternative
The repeating dislodgement of an ASO device
Author
Abe, Natsuki Tokushima Prefectural Central Hospital
Go, Masanori Tokushima Red Cross Hospital
Nakai, Kaori Tokushima Red Cross Hospital
Kato, Michihisa Tokushima Red Cross Hospital
Keywords
Atrial septal defect
Amplatzer Septal Occluder
Device dislodgement
Arrhythmia
Content Type
Journal Article
Description
Transcatheter closure with an Amplatzer Septal Occluder (ASO) has become the standard treatment for secundum atrial septal defect (ASD). However, this procedure is associated with complications, such as device dislodgement. A 52-year-old woman was admitted with exertional dyspnea. Transesophageal echocardiography showed an ASD involving a 29 mm defect. Calculated Qp/Qs was 5.6 and all the rims were > 5 mm, with the exception of the posterior rim, which was 3 mm. Transcatheter ASD closure with an ASO was performed under general anesthesia. During emergence from anesthesia, tachycardia developed and the ASO device became dislodged. Hemodynamic changes associated with the end of anesthetic administration were believed to have led to device dislodgement. In a second transcatheter ASD closure, a low dose of propofol and remifentanil was maintained during emergence from anesthesia to reduce hemodynamic changes. However, device dislodgement occurred with nonsustained ventricular tachycardia. Finally, surgical ASD closure was performed. The large defect size, high Qp/Qs, and rim deficiency may have predisposed to device dislodgement after transcatheter ASD closure with ASO. The risk of device dislodgement should be considered in advance of surgery and, in high-risk cases, the patient's cardiovascular status should be closely monitored.
Journal Title
The Journal of Medical Investigation
ISSN
13496867
13431420
NCID
AA12022913
AA11166929
Publisher
Tokushima University Faculty of Medicine
Volume
66
Issue
1-2
Start Page
194
End Page
198
Sort Key
194
Published Date
2019-02
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
Medical Sciences