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Transcatheter retrieval of atrial septal defect and patent ductus arteriosus occluder: a guidance for device retrieval based on comprehensive bench tests

Published online by Cambridge University Press:  12 September 2022

Takanari Fujii Open the ORCID record for Takanari Fujii [Opens in a new window] ,
Hisashi Sugiyama ,
Hideaki Kanazawa ,
Hidehiko Hara ,
Jun Muneuchi  and
Satoshi Yazaki
Takanari Fujii*
Affiliation:
Pediatric Heart Disease and Adult Congenital Heart Disease Center, Showa University Hospital, Tokyo, Japan
Hisashi Sugiyama
Affiliation:
Pediatric Cardiology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
Hideaki Kanazawa
Affiliation:
Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
Hidehiko Hara
Affiliation:
Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
Jun Muneuchi
Affiliation:
Department of Pediatrics, Japan Community Healthcare Organization, Kyushu Hospital, Fukuoka, Japan
Satoshi Yazaki
Affiliation:
Department of Pediatric Cardiology, Sakakibara Heart Institute, Fuchu, Tokyo, Japan
*
Author for correspondence: Takanari Fujii, MD, PhD, Pediatric Heart Disease and Adult Congenital Heart Disease Center, Showa University Hospital, 1-5-8, Hatanodai, Shinagawa-Ku, Tokyo 142-8666, Japan. Tel: +81-3-3784-8000; Fax: +81- 3-3784-8714. E-mail: takanarifujii@gmail.com
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Abstract

Objectives:

The aim of this study is to establish a guidance for device retrieval based on comprehensive bench tests.

Background:

Device embolisation remains a major complication in transcatheter closure of atrial septal defect and patent ductus arteriosus. Although percutaneous retrieval is feasible in the majority of cases, surgical retrieval may be required in complicated circumstances. However, the methods of transcatheter device retrieval have not been completely established.

Methods:

Bench tests of device retrieval were performed to verify the appropriate retrieval method according to device type/size. The devices used for testing were Amplatzer Septal Occluder (Abbott, Chicago, IL, United States of America), Figulla Flex II (Occlutech GmbH, Jena, Germany), Amplatzer Duct Occluder-I (Abbott), Amplatzer Duct Occluder-II (Abbott), and Amplatzer Vascular Plug-II (Abbott). The retrieval equipment constituted diagnostic catheters (multipurpose catheter and right Judkins catheter, 4-Fr or 5-Fr, Gadelius Medical, Tokyo, Japan), delivery sheath and cables for each device, Amplatz goose neck snares (Medtronic, Minneapolis, MN, United States of America), OSYPKA CATCHER (Osypka ag, Rheinfelden-Herten, Germany), and OSYPKA LASSOS (Osypka). We investigated the retrieval equipment and sheath sizes required for a successful retrieval procedure for variously sized devices.

Results:

For patent ductus arteriosus devices, the type of snare and the snaring position are considered important. For atrial septal defect devices, simple snare capture or a double-snare technique with a sufficiently large sheath is effective. Special care should be taken when using the OSYPKA CATCHER for device retrieval.

Conclusions:

The results of this study may assist in the selection of both capture devices and a retrieval sheath or a catheter for complete retrieval.

Keywords

Percutaneous device retrievalatrial septal defectpatent ductus arteriosusAmplatzer deviceFigulla flex II
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 9 , September 2023 , pp. 1597 - 1605
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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