Early neurological complications after transcatheter closure of atrial septal defect with nitinol wire mesh occluder.
Atrial septal defect (ASD) was closed percutaneously in an 18-year-old boy with a 27 mm nitinol wire mesh occluder according to standard procedures. Three hours after the procedure, he presented anxiety attacks, aggression, a vacant stare and a verbal/speaking disorder. Small ischaemic stroke localised in the right temporal/parietal region of the central nervous system was confirmed by computed tomography examination. Activated partial thromboplastin time was then 54 s despite continuous heparin infusion. Heparin dose was increased and symptomatic treatment was introduced (mannitol, furosemide, propofol, haloperidol). The next day, all symptoms disappeared. He remained in good clinical condition, without neurological disorders 1.5 months after the procedure. Complications related to transcatheter ASD closure still exist despite the fulfillment of standard procedural criteria. Frequent coagulogical examinations during and after the procedure are necessary. Close observation and follow-up of treated patients is mandatory.
Siesian Center for Heart Diseaes. jabi_med@poczta.onet.pl.
Jeronimo Daniel
JD
Heredia
Małgorzata
M
Szkutnik
Roland
R
Fiszer
Maria
M
Żyła-Frycz
Jacek
J
Białkowski
D000293:Adolescent; D000374:Aggression; D000497:Alloys; D001007:Anxiety / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects*; D006344:Heart Septal Defects, Atrial / Q000628:therapy*; D006801:Humans; D008297:Male; D055989:Septal Occluder Device / Q000009:adverse effects*; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed
D000497:Alloys; C013616:nitinol