Open AccessSuccessful closure of atrial septal defect by retrograde transarterial approach after unsuccessful transfemoral venous approach
Author(s) -
Sadık Volkan Emren,
Hamza Duygu,
Asım Oktay Ergene,
Rahman Bilal Gediz,
Cem Nazlı
Publication year - 2016
Publication title -
international journal of the cardiovascular academy
Language(s) - English
Resource type - Journals
eISSN - 2618-6012
pISSN - 2405-8181
DOI - 10.1016/j.ijcac.2016.05.006
Subject(s) - medicine , foramen secundum , primary interatrial foramen , percutaneous , patent foramen ovale , septum secundum , interatrial septum , catheter , surgery , ostium , cardiology , left atrium , atrial fibrillation
Although many of the ostium secundum atrial septal defects can be successfully closed by percutaneous transvenous approach, surgical method as well is preferred in some cases due to vascular reasons or due to the anatomical characteristics of the defect. Detecting ostium secundum atrial septal defect in a 26-year-old female patient, who presented with shortness of breath, percutaneous closure procedure was planned. During percutaneous closure, it was observed that guidewire and catheter persistently went towards patent foramen ovale because of quite flaccid structure of interatrial septum. For this reason, occluder could not be placed in the defect area. Before using the option of surgery for the patient, guidewire and simmons 1 diagnostic catheter were pushed forward towards to the left ventricle and then left atrium by transarterial approach through the femoral artery. Guidewire and the catheter were easily passed through atrial septal defect without passing through patent foramen ovale benefiting from the left atrial pressure. Occluder was retrogradely carried via transarterial route and successfully implanted in the defect area. Transarterial approach may be an alternative before surgery in selected cases in which percutaneous closure of atrial septal defect has failed