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Percutaneous Removal of an Embolized Atrial Septal Defect Device With a Novel Retrieval System
Jonathon A Hagel1, Anirudh Vinnakota2, Jimmy C Lu2
1Division of Cardiology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: https://twitter.com/drjonnyhagel.
Objective:
Successful use of the ŌNŌ retrieval system for percutaneous removal of an embolized 44-mm GORE CARDIOFORM ASD Occluder from the right pulmonary artery.
Key Steps:
A 24-F GORE DRYSEAL sheath was positioned in the main pulmonary artery, and then the ŌNŌ retrieval system was advanced coaxially through a 12-F Flexor sheath. Through this system, a 4-F Judkins Left 3.5 catheter and a 10-mm Amplatz Goose Neck snare were used to capture the device pin. Slow retraction of the device into the basket and then into the DRYSEAL was performed to safely extract the device.
Potential Pitfalls:
Tricuspid valve chordal injury, pulmonary artery dissection, and hemodynamic instability with a retrieval system across the tricuspid and pulmonary valves are some of the potential complications of the retrieval of atrial septal defect devices.
Take-Home Messages:
Percutaneous retrieval of embolized large atrial septal defect devices can be safely achieved using a dedicated retrieval system such as the ŌNŌ system, providing an effective alternative to surgical removal.
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