Inflammatory, abscess-forming foreign body reaction mimics a thrombus formation on an atrial septal defect closure device: A commented case report. |
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Authors: | Dimitar Divchev Edith Katharina Podewski Michael Mengel Gerd Peter Meyer Helmut Drexler Arnd Schaefer |
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Institution: | Hannover Medical School, Department of Cardiology and Angiology, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. divchev.dimitar@mh-hannover.de |
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Abstract: | We are presenting a case of floating left and right atrial formations on an atrial septal defect occluder system (23mm StarFLEX)-Occluder) initially supposed to be thrombotic appositions in a 57-year-old man. The closure was performed on the background of left hemispheric stroke and atrial septal aneurysm (ASA) with patent foramen ovale (PFO). The suspect structures were detected in the 6-month follow-up by transesophageal echocardiography (TEE). The patient underwent a successful surgical explantation of the closure device and closure of the patent foramen ovale (PFO) using a pericardial patch. The pathological evaluation of the biatrial device associated appositions revealed hytrophic heart muscle tissue with perifocal scarring and purulent abscess-forming, granulating and foam-cell including inflammatory foreign body reaction instead of the expected thrombus formation. |
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Keywords: | TEE transesophageal echocardiography ASD atrial septal defect PFO patent foramen ovale ASA atrial septal aneurysm INR international normalized ratio |
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