Migração de dispositivo de oclusão do septo interatrial para a aorta torácica: relato de caso
Migration of atrial septal occluder device to the thoracic aorta: case report
Felipe Carrasco Ferreira Dionisio; Pedro Henrique Amaral Ângelo da Silva; Bruno Lima Moreira; Augusto Kreling Medeiros
Resumo
Palavras-chave
Abstract
Atrial septal defect (ASD) is a common cardiac defect with significant implications if left untreated. Although open heart surgery is the traditional approach, transcatheter closure devices, such as the Amplatzer™ Septal Occluder Device, have gained prominence due to advantages like shorter hospital stays and reduced costs. Among potential complications, device migration is a rare complication, with an incidence of 0.5 to 1.1%. We report a rare case of migration of an Amplatzer™ device in an asymptomatic patient, diagnosed 6 months after its implantation. After detecting the issue, the medical team opted for percutaneous device removal followed by open surgery to correct the ASD. In conclusion, managing Amplatzer™ device embolization requires careful consideration of the patient’s circumstances and device anatomy. This case highlights the importance of correlating clinical and imaging findings when selecting the management approach and assessing the feasibility of a less invasive approach in cases of late migration.
Keywords
References
1 Brida M, Chessa M, Celermajer D, et al. Atrial septal defect in adulthood: a new paradigm for congenital heart disease. Eur Heart J. 2022;43(28):2660-71.
2 Kim HH, Yi GJ, Song SW. Late migration of amplatzer septal occluder device to the descending thoracic aorta. Korean J Thorac Cardiovasc Surg. 2017;50(1):47-9.
3 Ooi YK, Kelleman M, Ehrlich A, et al. Transcatheter versus surgical closure of atrial septal defects in children: a value comparison. JACC Cardiovasc Interv. 2016;9(1):79-86.
4 Silvestre JMS, Silvestre GS, Sardinha WE, et al. Complicação após tratamento percutâneo de comunicação interatrial: migração de dispositivo Amplatzer® para bifurcação aórtica: relato de caso. J Vasc Bras. 2015;14(3):271-4.
5 Moore J, Hegde S, El-Said H, et al. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv. 2013;6(5):433-42.
6 Shrivastava S, Shrivastava S, Allu SVV, Schmidt P. Transcatheter closure of atrial septal defect: a review of currently used devices. Cureus. 2023;15(6):e40132.
7 Chessa M, Carminati M, Butera G, et al. Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol. 2002;39(6):1061-5.
8 Maleux G, Rega F, Heye S, Troost E, Budts W. Asymptomatic migration of a first-generation AMPLATZER vascular plug into the abdominal aorta: conservative management may be an option. J Vasc Interv Radiol. 2011;22(4):569-70.
Submitted date:
07/12/2024
Accepted date:
09/10/2024