Late complications of an atrial septal occluder provoked by anticoagulant therapy

Late complications of an atrial septal occluder device (ASO) are rare but may be serious. We report a case with extensive hemopericardium five years after ASO implantation most likely triggered by anticoagulant therapy. Although not surgically confirmed, indirect clues for erosion of the atrial wall...

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Bibliographic Details
Published in:Journal of cardiology cases 2018-02, Vol.17 (2), p.68-71
Main Authors: Nguyên, Uyên Châu, Weijs, Bob, Luyten, Peter, Blokzijl, Carin, Witsenburg, Maarten, Volders, Paul G.A., Bekkers, Sebastiaan C.A.M.
Format: Article
Language:English
Subjects:
Anticoagulant therapy
Atrial septal occluder
Late complications
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Summary:Late complications of an atrial septal occluder device (ASO) are rare but may be serious. We report a case with extensive hemopericardium five years after ASO implantation most likely triggered by anticoagulant therapy. Although not surgically confirmed, indirect clues for erosion of the atrial wall by the device were the exclusion of other etiologies, lack of recurrence after pericardial drainage and withdrawal of anticoagulants. In addition, multimodality imaging using echocardiography, computed tomography, and cardiac magnetic resonance imaging were helpful to elucidate this unusual cause. Initiation of anticoagulant treatment in patients with an ASO should be carefully balanced and may warrant more frequent echocardiographic follow-up.
ISSN:1878-5409
1878-5409
DOI:10.1016/j.jccase.2017.09.010