Interesting cases

These cases are for the information and education of BSCI members. If you have a case you wish to submit please email This email address is being protected from spambots. You need JavaScript enabled to view it..

The most recent case is visible to all people viewing the website. However, to view other cases BSCI members must login

Amplatz device

Author: Dr Sze Mun Mak

Case report

A 73 year old female presented with atypical chest pain, and a coronary angiogram was performed. She was known to have a transcatheter ASD closure in 2009. The coronary angiogram showed some limited calcification, but no flow limiting disease.

Fig 1. 3D surface reconstruction of the Amplatz device occluding the ASD

Amplatz1

Fig 2. MIP reconstructions of the Amplatz device, showing the double disc configuration.  

Amplatz2

Fig 3. Axial image demonstrating the double disc Amplatz device.

Amplatz3

Discussion 

The AMPLATZER Septal Occluder (ASO) is a product by the St Jude company, which is designed for minimally-invasive atrial septal defect closure. This double-disc occluder is comprised of Nitinol mesh with polyester fabric. Nitinol is a braided metal that has shape memory characteristics, meaning the device will go back to its original shape even after it is stretched to pass through a catheter. The ASO is designed to appose the septal wall on each side of the defect and create a platform for tissue in-growth after implantation. Complications include arrhthmia, embolization, erosion, fracture, malfunction, malposition, stroke, and thrombus on the device. However, the rate of complication is extremely low. The commonest adverse event is embolization, mostly caused by undersizing, and occurs in less than 0.2% of the cases. [1,2] Erosion is a rare but serious complication, and is often due to over-sizing or deficient retro-aortic rims. [3] 

Reference

1) Transcatheter Retrieval of Embolized AMPLATZER Septal Occluder. Goel P, Kapoor A, Batra A et al. Tex Heart Inst J. 2012; 39(5): 653656.

2) St Jude Medical. AMPLATZER®Atrial Septal Occluder Executive Summary

3) Amin Z, Hijazi Z, Bass J. Erosion of Amplatzer septal occluder device after closure of secundum atrial septal defects: review of registry of complications and recommendations to minimize future risk. Catheter Cardiovasc Interv. 2004 Dec;63(4):496-502.