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Case report: Atrioventricular block after transcatheter atrial septal closure using the Figulla® Flex II ASD occluder
Author(s) -
Sato Jun,
Kato Atsuko,
Takeda Sho,
Nishikawa Hiroshi
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28148
Subject(s) - medicine , endocardium , atrioventricular block , cardiology , sinus rhythm , heart block , surgery , atrium (architecture) , cardiac catheterization , atrial fibrillation , electrocardiography
We report a 7‐year‐old male patient who developed severe atrioventricular block after transcatheter closure of the atrial septal defect with an Occlutech Figulla® Flex II ASD occluder (FSO). He had a small aortic rim and the defect measuring 22.3 mm by balloon sizing. When a 24 mm FSO was deployed, he developed Wenckebach second‐degree heart block; however, it recovered to sinus rhythm. Hence, the device was implanted. The rhythm deteriorated to a fixed 2:1 heart block within 7 hr. He underwent surgical retrieval of the device and closure of the defect. Intraoperative findings demonstrated the right atrium disk compressing the triangle of Koch, resulting in a small hematoma. The rhythm recovered completely by 7 days after the surgery. Care must be taken when a relatively large device is deployed in a patient with small rims as even “soft and flexible” device like the FSO can injure the endocardium.