Clinical Application Effects of Preloaded Snare Technique in Patients With Risk of Occluder Displacement During Percutaneous Atrial Septal Defect Closure
10.3969/j.issn.1000-3614.2025.07.010
- VernacularTitle:预置圈套器技术在房间隔缺损介入封堵时有封堵器移位风险患者中的初步应用研究
- Author:
Gang HAN
1
;
Zirui SUN
1
;
Yan HAN
1
;
Lele BEN
1
;
Yuanhao ZHANG
1
;
Weizhen XING
1
;
Saifei WANG
1
;
Yu HAN
1
Author Information
1. 阜外华中心血管病医院 郑州大学华中阜外医院 结构性心脏病科,郑州 451464
- Publication Type:Journal Article
- Keywords:
atrial septal defect;
deficient margin;
atrial septal occluder migration;
snare
- From:
Chinese Circulation Journal
2025;40(7):703-707
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To analyze the clinical application effect of the preloaded snare technique in patients with risk of atrial septal occluder migration during percutaneous atrial septal defect(ASD)occlusion.Methods:The clinical data of 24 patients with secundum ASD who underwent preloaded snare-assisted transcatheter closure in Fuwai Central China Cardiovascular Hospital between December 2022 and August 2024 were retrospectively analyzed.The preprocedural echocardiography revealed that all patients presented with large secundum ASD or insufficient margins,indicating potential risk of device migration during percutaneous ASD occlusion.Consequently,preloaded snare technique was applied for ASD closure.Postprocedural evaluations were conducted to assess device stability(migration or shedding),residual shunt,pericardial effusion,and new-onset arrhythmia during the procedure,immediately after intervention,and at 1-month follow-up.Results:Among 24 patients,there were 4 males,with an average age of(37.88±13.18)years and an average weight of(59.70±10.78)kg.Twenty-two cases underwent successful interventional closure.Two cases occurred atrial septal occluder migration during the procedure,both were successfully retrieved using the preloaded snare and subsequently scheduled for surgical repair.Postprocedural electrocardiograms and echocardiograms(obtained immediately and at 1-month follow-up)demonstrated no device migration,residual shunt,occluder dislodgement,pericardial effusion,or new-onset arrhythmias.Conclusions:The preloaded snare technique can reduce the risk of atrial septal occluder migration and shedding,simplify the process of retrieving the occluder,enhance the safety of the intervention,and avoid emergency surgical intervention in high-risk populations.
