Thrombus formation on transcatheter ASD occluder device in a patient with coagulation factor XII deficiency

摘要: Transcatheter occlusion of cardiac defects has become an effective and less invasive alternative to open heart surgery. Thromboembolic complications are rare events, after both surgical transcatheter closure atrial septal [Galal et al.: Eur Heart J 15:1381–1384, 1994]. We report on a case thrombus formation the defect occluder system (ASDOS) [Sievert Cathet Cardiovasc Diagn 36:232–240, 1995; Hausdorf 75:83–88, 1996]. Two days occlusion, patient suffered acute stroke due embolism despite anticoagulation with intravenous heparin. A coagulation disorder reduced factor XII concentration was deduced as likely cause. Repeated transesophageal echocardiographic (TEE) studies revealed involution intracardial within weeks subsequent anticoagulatory treatment. Firstoff, this shows that patients deficiency at risk for thromboembolism. Second, it again clarifies even large amounts intraartrial thrombotic material may not be seen by transthoracic echocardiography (TTE) underscores necessity performing TEE. Screening disorders (Quick's value (Q), partial thromboplastin time (PTT)) before they selected treatment thrombogenic devices is indispensable. With regard their personal history (earlier thromboembolism) result screening (e.g., prolongation PTT), quantitative determination factors reasonable. If endangered thromboembolic nevertheless undergo ASD procedures, monitoring requires exceptional attention. Furthermore, recommended TEE should carried out in these 2 treatment, since might unable detect device. Cathet. Cardiovasc. Diagn. 43:81–83, 1998. © 1998 Wiley-Liss, Inc.