title: Inflammatory, abscess-forming foreign body reaction mimics a thrombus formation on an atrial septal defect closure device: A commented case report.
abstract: We are presenting a case of floating left and right atrial formations on an atrial septal defect occluder system (23mm StarFLEX)-Occluder) initially supposed to be thrombotic appositions in a 57-year-old man. The closure was performed on the background of left hemispheric stroke and atrial septal aneurysm (ASA) with patent foramen ovale (PFO). The suspect structures were detected in the 6-month follow-up by transesophageal echocardiography (TEE). The patient underwent a successful surgical explantation of the closure device and closure of the patent foramen ovale (PFO) using a pericardial patch. The pathological evaluation of the biatrial device associated appositions revealed hytrophic heart muscle tissue with perifocal scarring and purulent abscess-forming, granulating and foam-cell including inflammatory foreign body reaction instead of the expected thrombus formation.
authors.affiliation: Hannover Medical School, Department of Cardiology and Angiology, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. divchev.dimitar@mh-hannover.de
authors.forename: Dimitar
authors.initials: D
authors.lastname: Divchev
authors.forename: Edith Katharina
authors.initials: EK
authors.lastname: Podewski
authors.forename: Michael
authors.initials: M
authors.lastname: Mengel
authors.forename: Gerd Peter
authors.initials: GP
authors.lastname: Meyer
authors.forename: Helmut
authors.initials: H
authors.lastname: Drexler
authors.forename: Arnd
authors.initials: A
authors.lastname: Schaefer
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D006348:Cardiac Surgical Procedures; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000209:etiology*; D006322:Heart Aneurysm / Q000503:physiopathology; D006344:Heart Septal Defects, Atrial / Q000628:therapy*; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000503:physiopathology; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D014463:Ultrasonography