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Related Experiment Videos

Delivery sheath tear after modification for ASD closure.

Mark H Hoyer1

  • 1Section of Pediatric Cardiology, Indiana University School of Medicine, Indianapolis, 46202, USA. mhoyer@iupui.edu

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|June 10, 2006
PubMed
Summary

Modified delivery sheaths can aid atrial septal defect closure but may split. Troubleshooting enabled successful device implantation, highlighting methods to prevent left atrial disk prolapse.

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Area of Science:

  • Cardiology
  • Medical Device Engineering
  • Interventional Procedures

Background:

  • Transcatheter closure of atrial septal defects (ASDs) is a common procedure.
  • An insufficient aortic rim presents a challenge for device stability and orientation.
  • Standard delivery sheaths may require modification for optimal device deployment in complex anatomies.

Observation:

  • A modified delivery sheath with a beveled tip was used for ASD closure with an insufficient aortic rim.
  • The modified sheath experienced a longitudinal split during device recapture.
  • The closure device was successfully implanted after troubleshooting the sheath issue.

Findings:

  • Sheath modification, while intended to improve device orientation, carries a risk of structural failure.

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  • Successful implantation was achieved despite the sheath complication.
  • Techniques to manage left atrial disk prolapse into the right atrium are crucial for procedural success.

    • Implications:

    • This case highlights potential pitfalls of sheath modification in transcatheter ASD closure.
    • Effective troubleshooting strategies are essential for managing unexpected device or delivery system complications.
    • Further research may be needed to refine delivery sheath designs for challenging ASD anatomies.