case_images: PMC10733004_01
case_images: Transoesophageal echocardiography (TOE) demonstrating a large PFO with right-to-left shunt after bubble contrast injection.
case_images: CRIC2023-5586197.001.jpg
case_images: PMC10733004_01_CRIC2023-5586197.001.jpg
case_images: fig1
case_images: Transoesophageal echocardiography (TOE) showed a large PFO with a right-to-left shunt on bubble contrast injection (Figure 1).
case_images: PFO occluder deployment. (a) Releasing the left-side disc of the occluder. (b) Deployment of the right-side disc with the pacemaker lead running beneath the occluder disc. (c) Entrapment of the atrial pacemaker lead between the occluder disc and intraatrial septum.
case_images: CRIC2023-5586197.002.jpg
case_images: PMC10733004_01_CRIC2023-5586197.002.jpg
case_images: fig2
case_images: The left-side disc was released, and the delivery system was slightly withdrawn to press the left disc against the left side of the interatrial septum (Figure 2(a)). However, during the deployment of the right disc, we noticed that the atrial pacemaker lead became trapped between the disc and interatrial septum (Figures 2(b) and 2(c)).
case_images: Salvage of the entrapped pacemaker lead using a sizing balloon. (a) Introduction of a 24 mm sizing balloon to the right atrium and inflation. (b) Freeing the entrapped lead by a careful pullback of the sizing balloon. (c) Confirming the correct position on fluoroscopy using a contrast agent.
case_images: CRIC2023-5586197.003.jpg
case_images: PMC10733004_01_CRIC2023-5586197.003.jpg
case_images: fig3
case_images: A 24 mm-sizing balloon (Abbott Amplatzer) was then introduced into the right atrium and inflated in a position superior to the entrapped pacemaker lead (Figure 3(a)). This was confirmed on fluoroscopy after the administration of a contrast agent (Figures 3(b) and 3(c)).