Various Techniques for Transcatheter Retrieval of Atrial Septal Defect or Patent Foramen Ovale Closure Devices: A Systematic Review: An Interview with Mohammad Reza Movahed, MD

Dr Mohammad Reza Movahed shares background and insights on his paper, “Various Techniques for Transcatheter Retrieval of Atrial Septal Defect or Patent Foramen Ovale Closure Devices: A Systematic Review.” Read the article here.

Transcript:

I am Dr. Reza Movahed, clinical professor of medicine at the University of Arizona in Tucson, and at the University of Arizona College of Medicine in Phoenix. I also work in different hospitals in locom at this time, but my research is done at the University. The title of the review paper that we published is "Various Techniques for Transcatheter Retrieval of Atrial Septal Defect or Patent Foramen Ovale Closure Devices: A Systematic Review.” I myself am an interventional cardiologist also a non-invasive cardiologist and involved in different cardiac interventions.

01:59: What inspired your group to initiate this review?

So Dr. Khosravi, who's a co-author of this review, he had some cases where he had embolization of the closure devices. He had difficulty removing those devices by using conventional ways such as snares and other methods. But then he discovered a new way that you can retrieve a patent foramen ovale or septal defect device. So, what he discovered is that you can use a coronary wire by advancing a coronary wire through those embolized devices, and then by turning the tip of the wire you can remove those embolized devices by using this simple technique, which is called the coronary wire trap technique. And after many cases that he had, and he could remove those embolized devices— we published actually those cases in the Journal of Invasive Cardiology—and then we came to the idea that we should actually publish a review about all the methods that are available when such a complication occurs, and that includes the wire trap technique. That was the motivation for us to write this review.

02:30: Did any of your findings surprise you?

The basics of what we found is that there are different methods that you can use for device retrieval and we described every one of them in detail in this review, and we found out that each device or each method has its own limitation and that's why we recommend that the operator who does patent foramen ovale closure or septal defect closure devices read this review, which explains each step for removal of the devices, and familiarize himself, themselves, with the different methods in case such a complication occurs. So we found out, actually, what you can use depends on where the device embolization occurs, different technique, but the coronary wire technique as a last resort is a simple way that can be always utilized because it uses a very small, very narrow, tiny coronary wire that can usually be advanced through an embolized devices and then the tip can be snared in that technique, and it can be actually used universally when the other known techniques or method fails.

03:56: Based on what you discovered when performing this review, is there anything you'd like to study further?

Yeah, what we like to do is see what other methods maybe can be discovered if all these typical techniques fail. Again, this would be a future case report or a future review about device retrieval. But for now, we would like to see the feedback from readers and other colleagues to see if this new retrieval way by using coronary wire is working for them when they have this difficulty removing the embolized devices.

04:39: What can we look forward to seeing next from your group?

We're probably going to publish the other review about maybe different methods to implant foramen ovale devices because the method of implantation is very important to prevent embolization. So that would be our next goal, we plan to do a review of different methods and ways that we can implant those devices and, by doing it the appropriate way, reduce the risk of embolization.

05:27: Is there anything else you'd like to share with our audience about your research?

Well, this review, I think, is a very nice, comprehensive, first-of-its-kind review that I would recommend every interventional cardiologist who does closure devices to read, because this can be very handy—once an embolization occurs you have not much time to decide what to do. By reading this review article, I think an interventionalist will be ready to use different methods when such a complication occurs and hopefully this review article can help many interventional cardiologists handle this very life-threatening complication of embolization.