Yonsei Med J.  2017 Nov;58(6):1237-1240. 10.3349/ymj.2017.58.6.1237.

Simultaneous Closure of a Left Atrial Appendage through an Atrial Septal Defect and the Atrial Septal Defect

• Song S
• Lee OH
• Kim JS
• Cho IJ
• Shim CY
• Hong GR
• Pak HN
• Jang Y

• KMID: 2418908
• DOI: http://doi.org/10.3349/ymj.2017.58.6.1237

Abstract

Left atrial appendage (LAA) occlusion can be employed as an alternative treatment to oral anticoagulation in patients with atrial fibrillation to prevent embolic events. Atrial septal defect (ASD) may be related with right heart dysfunction and allow paradoxical embolism to occur. However, occlusion of both LAA through atrial access with ostium secundum ASD and ASD in the same setting is unusual. Therefore, we report a case in which a LAA and an ASD was sequentially occluded.

Keyword

Left atrial appendage occlusion; atrial septal defect occlusion; atrial fibrillation

MeSH Terms

Aged
Atrial Appendage/diagnostic imaging/physiopathology/*surgery
Atrial Fibrillation/*complications/physiopathology
Heart Atria/physiopathology
Heart Septal Defects, Atrial/diagnostic imaging/physiopathology/*surgery
Humans
Male
Pyrazoles/*administration & dosage
Pyridones/*administration & dosage
*Septal Occluder Device
Thrombosis/*prevention & control
Tomography, X-Ray Computed
Treatment Outcome
Pyrazoles
Pyridones

Figure

• 

  Fig. 1 Two dimensional TEE image of ASD (A). Fluoroscopic evaluation of ASD during expansion of the sizing balloon (B). TEE (C) and fluoroscopic images (D) of left atrial appendage before implantation. ASD, atrial septal defect; TEE, transesophageal echocardiographic.

• 

  Fig. 2 The deployed left atrial appendage closure device (ACP 30 mm) was confirmed with transesophageal echocardiographic imaging (arrow: left circumflex artery) (A) and fluoroscopic imaging (B). The Amplatzer septal occluder (11 mm) was located in the proper position, which was confirmed by transesophageal echocardiography (C). After the procedure, implanted Amplatzer septal occluder (11 mm) and ACP (30 mm) demonstrated by heart computed tomography (D). ACP, Amplatzer Cardiac Plug.

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