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Journal of Cardiothoracic Surgery

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01-12-2021 | Sternotomy | Case report

Atrio-aortic erosion caused by Amplatzer Atrial Septal Occluder – a case report

Authors: Christine E. Kamla, Joscha Buech, Philipp M. Doldi, Christian Hagl, Gerd Juchem, Alexey Dashkevich

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

In specialized centers, percutaneous closure using specific occluders is the first-choice treatment in atrial septal defects (ASD). Late complications after this intervention, such as erosion of the aorta or the atria, are rare and have not been sufficiently approached and dealt with in literature. In our clinic we have been faced with the problematic situation of diagnosing and treating such cases. That is why, we have decided to share our experience with other colleagues.

Case presentation

We present two cases of severe late complications after percutaneous closure of atrial septal defects (ASD). In both cases, the atrial septal occluder (Amplatzer™ Atrial Septal Occluder Device, Abbott, Chicago USA) caused the erosion between the left atrium and the aortic root. The atrio-aortic erosion led to acute cardiac tamponade with upper venous congestion and shock. As the bleeding source remained undetectable for any imaging tools, a diagnostical sternotomy remained the only solution.

The cause of the acute bleeding was discovered to be the erosion between the left atrium and the aortic root. The treatment consisted in the removal of the occluder, direct suturing of the perforated areas and the surgical closure of the remaining ASD. The patients fully recovered within the nine to fourteen days’ hospital stay. Six months after surgery both patients were well and able to recover their daily routine.

Conclusions

The atrio-aortic erosion after percutaneous closure of atrial septal defects is a surgical emergency. The more so, since it can be complicated by the absence of specific symptoms. A key-element in the diagnosis of this rare pathology remains the medical history of the patient, which the surgeon has to consider thoroughly and launch the diagnostic sternotomy without delay.

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Title: Atrio-aortic erosion caused by Amplatzer Atrial Septal Occluder – a case report
Authors: Christine E. Kamla
Joscha Buech
Philipp M. Doldi
Christian Hagl
Gerd Juchem
Alexey Dashkevich
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Sternotomy
Atrial Septal Defect
Atrial Septal Defect
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01411-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Atrio-aortic erosion caused by Amplatzer Atrial Septal Occluder – a case report

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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