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Not just another large atrial septal defect: complex anatomy, challenging procedure, and an unusual complication

Published online by Cambridge University Press:  16 June 2020

Raymond N. Haddad Open the ORCID record for Raymond N. Haddad [Opens in a new window] ,
Tony Abdel Massih  and
Zakhia Saliba Open the ORCID record for Zakhia Saliba [Opens in a new window]
Raymond N. Haddad*
Affiliation:
Hotel Dieu de France University Medical Center, Department of Pediatrics, Saint Joseph University, Beirut, Lebanon
Tony Abdel Massih
Affiliation:
Hotel Dieu de France University Medical Center, Department of Cardiology, Saint Joseph University, Beirut, Lebanon
Zakhia Saliba
Affiliation:
Hotel Dieu de France University Medical Center, Department of Pediatric Cardiology, Saint Joseph University, Beirut, Lebanon
*
Author for correspondence: Dr. Raymond N. Haddad, MD, Department of Pediatrics, Hotel Dieu de France University Medical Center, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon BP. Tel: +33 7 53 15 95 04; +961 70 605 800; Fax: +961 1 604 976. E-mail: raymondhaddad@live.com
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Abstract

We report the case of a 59-year-old patient with a complex atrial septal defect in whom a 40-mm Amplatzer™ septal occluder was surgically extracted 50 days following implantation. Deployment manoeuvres were challenging leading to an immediate pericardial effusion that was closely monitored and uneventfully drained after 11 days. A dry pericardium was documented until 4 weeks of outpatient routine follow-up. However, the device was surgically explanted 2 weeks later, when an urgent chest computed tomography performed for worrisome symptoms showed pericardial effusion recurrence with peripheral contrast enhancement. Surprisingly, the surgical view showed a well-positioned device and an intact pericardium. We discuss the atypical sequence of clinical findings misleading our clinical judgement and precipitating surgery.

Keywords

Atrial septal defectAmplatzerseptal occludercomplicationerosiondevice removal
Type
Brief Report
Information
Cardiology in the Young , Volume 30 , Issue 7 , July 2020 , pp. 1052 - 1056
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

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