Cobrahead malformation of the Amplatzer septal occluder device: An avoidable complication of percutaneous ASD closure

During deployment of an Amplatzer atrial septal occluder device to close a secundum ASD, the right atrial disk and waist of the device twisted, result ing in the cobrahead malformation, Postulated mechanisms for this complicat ion include twisting of the device during loading into the delivery cathete r and catching of leading edge of the device on the LA free wall or appenda ge, causing twisting during deployment. Retrieval of the device into the ca theter and even removal of the device from the patient to allow manual untw isting may be required to allow the device to return to its original confor mation for successful redeployment. Cathet Cardiovasc Intervent 2001;52:83- 85. (C) 2001 Wiley-Liss, Inc.