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Related Experiment Video

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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
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Pacemaker Lead Entanglement during Interventional PFO Occlusion: Salvage Using a Sizing Balloon.

Andreas Goldschmied1, Juergen Schreieck1, Michal Droppa1

  • 1Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany.

Case Reports in Cardiology
|December 21, 2023
PubMed
Summary

A rare complication during patent foramen ovale (PFO) closure, pacemaker lead entrapment, was successfully managed. A sizing balloon prevented this issue, ensuring safe PFO closure in patients with pacemakers.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Neurology

Background:

  • Patent foramen ovale (PFO) is a potential cause of paradoxical embolism, leading to transient ischemic attacks (TIAs).
  • Patients with PFO and cardiac devices, such as pacemakers, present unique challenges during transcatheter closure procedures.
  • Second-degree heart block (Mobitz II) necessitating pacemaker implantation is a relevant comorbidity.

Observation:

  • During PFO closure, the atrial pacemaker lead became entrapped between the occluder device and the interatrial septum.
  • This entrapment posed a risk to the successful deployment of the PFO closure device and patient safety.

Findings:

  • Successful repositioning of the entrapped pacemaker lead was achieved using a 24 mm sizing balloon.
  • The PFO occluder device was subsequently deployed in the correct position without further complications.

Implications:

  • Pacemaker lead entrapment is a preventable complication during PFO closure procedures.
  • The use of a sizing balloon is a valuable technique to mitigate this risk.
  • This case highlights the importance of careful procedural planning and adaptation in patients with cardiac devices undergoing PFO closure.