title: Percutaneous retrieval of an interatrial septal occluder device embolized into the aortic arch.
abstract: Percutaneous closure of secundum atrial septal defects (ASD) may be complicated by immediate embolization. We report on a 35-year-old woman who underwent percutaneous device closure for a secundum ASD. The diameter of the defect was measured as 4 mm by two-dimensional transesophageal echocardiography and a 7-mm Figulla ASD occluder device was implanted without prior balloon sizing of the defect. Immediate embolization was noted into the aortic arch. Attempts to pull the devices into the sheath with a loop snare failed even after replacing the delivery sheath with a bigger one. Finally, a bioptome was used to grab and place the screw mechanisms in the sheath and percutaneous retrieval of the embolized ASD occluder was achieved. Balloon sizing was performed after removal, yielding a stretched diameter of 12 mm and a 15-mm device was deployed with success.
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, İstanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Pala
authors.forename: Göksel
authors.initials: G
authors.lastname: Açar
authors.forename: Kürşat
authors.initials: K
authors.lastname: Tigen
authors.forename: Cevat
authors.initials: C
authors.lastname: Kırma
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic; D001706:Biopsy / Q000295:instrumentation; D002404:Catheterization; D020878:Device Removal / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000209:etiology* / Q000628:therapy; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D011475:Prosthesis Failure / Q000009:adverse effects* / Q000209:etiology; D055989:Septal Occluder Device / Q000009:adverse effects*