Erosion of an Amplatzer Septal Occluder Device Into the Aortic Root

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Presentation transcript:

Erosion of an Amplatzer Septal Occluder Device Into the Aortic Root Abdallah Kamouh, MD, Mohammed Najeeb Osman, MD, Noah Rosenthal, MD, Arie Blitz, MD The Annals of Thoracic Surgery Volume 91, Issue 5, Pages 1608-1610 (May 2011) DOI: 10.1016/j.athoracsur.2010.10.076 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Transesophageal echocardiography demonstrates the superior-most portion of a large ostium secundum atrial septal defect (ASD) and a small rim of interatrial septum adjacent to the aortic root at the noncoronary sinus. (AO = aorta, LA = left atrium, RA = right atrium.) The Annals of Thoracic Surgery 2011 91, 1608-1610DOI: (10.1016/j.athoracsur.2010.10.076) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Transesophageal echocardiography shows a deployed atrial septal occluder (ASO) device (white arrows) with splaying over the aortic root. (LC = left coronary sinus, NC = noncoronary sinus, RC = right coronary sinus.) The Annals of Thoracic Surgery 2011 91, 1608-1610DOI: (10.1016/j.athoracsur.2010.10.076) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Transesophageal echocardiography reveals a dehiscence of the aortic rim of the atrial septal occluder (ASO) with erosion of the device into the aortic root and resultant aortic-to-left atrial fistula (white arrow) arising in the noncoronary sinus. (AO = aorta, LA = left atrium, RA = right atrium.) The Annals of Thoracic Surgery 2011 91, 1608-1610DOI: (10.1016/j.athoracsur.2010.10.076) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Operative view of the opened aorta demonstrates a fistula orifice originating in the noncoronary sinus (NC). Although not clearly visualized in the picture, the rim of the atrial septal occluder was seen at the base of this orifice. The Annals of Thoracic Surgery 2011 91, 1608-1610DOI: (10.1016/j.athoracsur.2010.10.076) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Operative view of the opened aorta and atrium demonstrates passage of a right-angle clamp through a fistula in the noncoronary sinus (NC) into the left atrium (LA). The atrial septal occluder (ASO) device is visualized in the interatrial septum before its removal. (RA = right atrium.) The Annals of Thoracic Surgery 2011 91, 1608-1610DOI: (10.1016/j.athoracsur.2010.10.076) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions