DefinePK

Research Objective

To report on the successful transcatheter retrieval of an embolized Atrial Septal Defect (ASD) device from the left atrium using unconventional and innovative techniques.

Methodology

Case report detailing a technically difficult retrieval procedure. The approach involved multiple attempts using various snares and catheters, including an unconventional technique for extraction without a delivery sheath, followed by venesection and secure hemostasis.

Methodology Flowchart

                        graph TD
    A["Device Deployment"] --> B["Device Embolization to Left Atrium"];
    B --> C["Initial Retrieval Attempts with Conventional Snares/Sheaths"];
    C --> D["Failure of Conventional Methods"];
    D --> E["Innovative Retrieval Technique: Venesection & Secure Hemostasis"];
    E --> F["Successful Device Retrieval"];
    F --> G["Patient Recovery & Discharge"];                    

Discussion

Percutaneous ASD device closure is a common alternative to surgery, but device embolization is a known complication. This case highlights the importance of meticulous preprocedural assessment and the utility of innovative, improvised methods when conventional techniques fail, especially when specific equipment is unavailable. The authors emphasize that transcatheter device retrieval is safe with appropriate equipment and expertise.

Key Findings

A 38 mm ASD Cocoon Device, deployed in a 17-year-old male, embolized to the left atrium. After multiple failed attempts with conventional snares and sheaths, an innovative technique involving venesection and secure hemostasis was successfully employed to retrieve the device. The patient remained hemodynamically stable throughout the procedure and recovered smoothly.

Conclusion

Accurate preprocedural assessment and imaging are crucial to prevent device embolization. Innovative techniques can lead to successful outcomes in challenging catheterization procedures when conventional methods are insufficient.

Fact Check

1. Patient Age: The patient was 17 years old. (Confirmed in Case Report)
2. Device Size: A 38 mm ASD Cocoon Device was deployed. (Confirmed in Case Report)
3. Procedure Duration: The procedure run-time lasted 260 minutes, with a fluoroscopy run-time of 130 minutes. (Confirmed in Case Report)

Mind Map