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Late bacterial endocarditis of an amplatzer atrial septal defect occluder device

Firas Zahr1, William E Katz, Yoshiya Toyoda

  • 1Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

The American Journal of Cardiology
|January 28, 2010
PubMed

Insights

Late infective endocarditis occurred in an adult with an Amplatzer ASD occluder (ASO) device 30 months after percutaneous atrial septal defect (ASD) repair. Poor device endothelialization was noted upon explantation.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Atrial septal defects (ASDs) are congenital heart conditions often treated percutaneously.
  • The Amplatzer ASD occluder (ASO) is a common device used for ASD closure.
  • Infective endocarditis is a serious infection of the heart lining or valves.

Observation:

  • A 66-year-old male presented with Staphylococcus aureus bacteremia and fevers.
  • Transesophageal echocardiography identified a vegetation on the Amplatzer ASD occluder (ASO).
  • The ASO device was explanted, revealing poor endothelialization on the left atrial side.

Findings:

  • This case represents the first documented instance of late infective endocarditis in an adult with an Amplatzer ASD occluder (ASO).
  • The infection occurred 30 months after percutaneous closure of a secundum atrial septal defect (ASD).
  • Poor endothelialization of the ASO device may have contributed to the development of infective endocarditis.

Implications:

  • This case highlights a potential, albeit rare, complication of percutaneous ASD closure with ASO devices.
  • Clinicians should maintain a high index of suspicion for infective endocarditis in patients with ASO devices, especially those with suboptimal endothelialization.
  • Further research may be warranted to investigate risk factors and preventative strategies for late device-related infections.

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