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Transhepatic atrial septal defect closure: simple way to achieve haemostasis in a patient with important co-morbidities

Published online by Cambridge University Press:  08 July 2020

Raymond N. Haddad Open the ORCID record for Raymond N. Haddad [Opens in a new window] ,
Geert Maleux Open the ORCID record for Geert Maleux [Opens in a new window] ,
Damien Bonnet Open the ORCID record for Damien Bonnet [Opens in a new window]  and
Sophie Malekzadeh-Milani Open the ORCID record for Sophie Malekzadeh-Milani [Opens in a new window]
Raymond N. Haddad*
Affiliation:
M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Université de Paris, Paris, France
Geert Maleux
Affiliation:
Department of Radiology, University Hospitals Leuven, Leuven, Belgium
Damien Bonnet
Affiliation:
M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Université de Paris, Paris, France
Sophie Malekzadeh-Milani
Affiliation:
M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Université de Paris, Paris, France
*
Author for correspondence: Dr. Raymond N. Haddad, MD, Unité médicochirurgicale de cardiologie congénitale et pédiatrique, centre de référence des malformations cardiaques congénitales complexes – M3C, Hôpital universitaire Necker-Enfants malades, 149, rue de Sèvres, 750015Paris, France. Tel.: +33 7 53 15 95 04; +961 70 605 800; Fax: +33 1 44 49 47 30. E-mail: raymondhaddad@live.com
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Abstract

Percutaneous closure is the gold standard treatment for atrial septal defects, but the procedure can be complex in case of femoral thrombosis. Although unusual for congenital interventionists, transhepatic atrial septal defect closure is an attractive alternative to the internal jugular vein, especially when approaching the interatrial septum. Herein, we report the case of an adult patient with significant co-morbidities who had successful transhepatic atrial septal defect closure after a failed transjugular attempt. We describe the use of an absorbable haemostatic gelatin sponge to efficiently and safely achieve haemostasis after the use of a large vascular sheath with combined anticoagulation and antiplatelet therapy.

Keywords

Atrial septal defectcardiac catheterisationdevice closuretranshepatic accesshaemostasis
Type
Brief Report
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1343 - 1345
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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