Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Fistula of Ascending Aorta and Right Atrium Following Percutaneous Transcatheter Atrial Septal Defect Closure

경피적 카테타 심방중격결손 폐쇄술 후 발생한 상행 대동맥-우심방루

  • Um Hong Gook (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute) ;
  • Seo Hong Joo (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute) ;
  • Kim Chong Whan (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute) ;
  • Kim Jun Seok (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Konkuk University) ;
  • Lee Chang-Ha (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute)
  • 임홍국 (부천세종병원 흉부외과, 세종심장연구소) ;
  • 서홍주 (부천세종병원 흉부외과, 세종심장연구소) ;
  • 김종한 (부천세종병원 흉부외과, 세종심장연구소) ;
  • 김준석 (건국대학교병원 흉부외과) ;
  • 이창하 (부천세종병원 흉부외과, 세종심장연구소)
  • Published : 2006.02.01
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Abstract

Percutaneous transcatheter closure of atrial septal defects as a therapeutic alternative in appropriate patients provides superior cosmetic results, is less invasive, and allows for shorter hospital stays. Unfortunately, however, such percutaneous procedures can be associated with catastrophic procedure complications that may require immediate surgical intervention. We report a case of aorta-to-right atrial fistula two months after transcatheter occlusion of an atrial septal defect by an Amplatzer septal occluder. Revealed by dyspnea, palpitation and hemolysis, this complication needed an emergency surgical operation. The fistula between the noncoronary Valsalva sinus of the aorta and the right atrium was repaired. The atrial septal defect was closed by patch. The cause of this serious complication appears to be erosion into the aorta by the right atrial disk.

심방 중격 결손에 대한 경피적 카테타 폐쇄술은 적절한 환자에서 치료적 대안으로 이용되며, 미용적으로 우수하고, 덜 침습적이며, 재원 기간이 짧으나, 응급 수술이 요구되는 치명적인 합병증이 발생할 수 있다. 저자들은 Amplatzer septal occluder에 의한 심방 중격 결손의 경피적 카테터 폐쇄술 시행 후 발생한 대동맥-우심방루를 경험하였다. 시술 2개월 후에 호흡곤란, 심계항진과 용혈에 의한 황달로 발견되어, 대동맥의 무관상동맥동과 우심방 사이의 누공을 일차 봉합하고, 심방 중격 결손은 팻취로 봉합하는 응급수술을 시행하였다. 이 합병증은 우심방 원반(disk)이 대동맥으로 침식(erosion)하여 발생하였다.

Keywords

References

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