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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We thank Bozyel and Sahin for their interest in our article &#8220;Successful percutaneous closure of a residual atrial septal defect due to device failure&#8221;&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> where we reported the case of an uncommon cause of residual shunt through an Ultrasept&#8482; ASD Occluder &#40;Cardia&#44; Egan MN&#44; USA&#41; due to polyvinyl alcohol &#40;PVA&#41; membrane perforation and subsequent transcatheter closure of the residual shunt&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Bozyel and Sahin question our choice of the second device&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> a 20-mm Ultrasept&#8482; PFO Occluder &#40;Cardia&#44; Egan MN&#44; USA&#41;&#44; as it is also covered with the same PVA membrane and there is no definitive explanation for the causal mechanism of the spontaneous perforation&#46; We chose the second device because &#40;a&#41; it has the same type of metal frame as the first device and we hoped this would help the second device achieve better apposition to the first&#59; &#40;b&#41; there are no reports of perforation for the PFO device&#59; and &#40;c&#41; it is a very low-profile device&#44; which we considered an important factor for device-in-device closure&#46; According to the company data&#44; all cases of device perforation occurred within one year of implantation&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Almost two years after the procedure&#44; the patient remains asymptomatic&#46; Transesophageal echocardiogram confirms that we made the right choice&#44; showing absence of residual shunt and a low device-in-device profile with no impingement on surrounding structures&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In our view&#44; this case report describes a successful way to correct ASD device perforations which avoids the need for a surgical procedure&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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Letter to the Editor
Reply to the Letter to the Editor “Residual shunt due to spontaneous perforation of polyvinyl alcohol membrane of ASD Occluder. What about after diagnosis?”
Resposta à Carta ao Editor «Shunt residual devido a perfuração espontânea da membrana de álcool polivinílico de um dispositivo de encerramento de CIA. O que sucede após o diagnóstico?»
Sílvia Aguiar Rosa
Cardiology Department, Santa Marta Hospital, Lisbon, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We thank Bozyel and Sahin for their interest in our article &#8220;Successful percutaneous closure of a residual atrial septal defect due to device failure&#8221;&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> where we reported the case of an uncommon cause of residual shunt through an Ultrasept&#8482; ASD Occluder &#40;Cardia&#44; Egan MN&#44; USA&#41; due to polyvinyl alcohol &#40;PVA&#41; membrane perforation and subsequent transcatheter closure of the residual shunt&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Bozyel and Sahin question our choice of the second device&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> a 20-mm Ultrasept&#8482; PFO Occluder &#40;Cardia&#44; Egan MN&#44; USA&#41;&#44; as it is also covered with the same PVA membrane and there is no definitive explanation for the causal mechanism of the spontaneous perforation&#46; We chose the second device because &#40;a&#41; it has the same type of metal frame as the first device and we hoped this would help the second device achieve better apposition to the first&#59; &#40;b&#41; there are no reports of perforation for the PFO device&#59; and &#40;c&#41; it is a very low-profile device&#44; which we considered an important factor for device-in-device closure&#46; According to the company data&#44; all cases of device perforation occurred within one year of implantation&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Almost two years after the procedure&#44; the patient remains asymptomatic&#46; Transesophageal echocardiogram confirms that we made the right choice&#44; showing absence of residual shunt and a low device-in-device profile with no impingement on surrounding structures&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In our view&#44; this case report describes a successful way to correct ASD device perforations which avoids the need for a surgical procedure&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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Informação do artigo
ISSN: 08702551
Idioma original: Inglês
DOI:10.1016/j.repc.2018.05.006
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