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A novel double snare technique to retrieve embolized septal and left atrial appendage occluders

Authors
 Kee Soo Ha  ;  Jae Young Choi  ;  Se Yong Jung  ;  Jung‐Sun Kim  ;  Ki Hyun Byun  ;  Teiji Akagi  ;  Mirjamol M. Zufarov 
Citation
 JOURNAL OF INTERVENTIONAL CARDIOLOGY, Vol.31(5) : 685-692, 2018 
Journal Title
 JOURNAL OF INTERVENTIONAL CARDIOLOGY 
ISSN
 0896-4327 
Issue Date
2018
Keywords
device removal ; double snare technique ; embolization ; septal defect
Abstract
BACKGROUND: Device embolization is the most frequent procedural complication during transcatheter closure of congenital cardiac defects. Retrieval of an embolized device may often be complicated by failure to introduce the right atrial (RA) disk hub into the sheath or difficulty in securely grasping the hub pin of RA disk. We aimed to evaluate the efficiency and success rate of device retrieval using a novel double snare technique. METHODS: We reviewed retrieval procedures of embolized atrial septal defect (ASD) or left atrial appendage (LAA) occluder using double snare technique reported from five tertiary referral centers in Korea, Japan, and Uzbekistan. A total of 16 retrieval procedures in 15 patients were reported, including 14 patients who were planned for ASD device closure while 1 patient was planned for LA appendage occlusion. RESULTS: Retrieved devices included 15 ASD occluders from six different manufacturers and one Amplantzer cardiac plug. Success rate of retrieval procedure was 100% using the double snare technique. There were no complications related to device retrieval. Most (15/16, 93.8%) of these devices could be retrieved through their original delivery sheaths. In six patients for whom retrieval was unsuccessful with conventional single snare technique and switched to double snare technique, the retrieval time was shortened significantly (P = 0.004*) by using the double snare technique. CONCLUSIONS: The double snare technique enables effective retrieval of various embolized devices. It abolishes the need of changing the sheath to a larger one in most patients.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/joic.12513
DOI
10.1111/joic.12513
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Jung, Se Yong(정세용) ORCID logo https://orcid.org/0000-0003-1337-563X
Choi, Jae Young(최재영) ORCID logo https://orcid.org/0000-0002-1247-6669
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165359
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