E-page Original Images: Catheter entrapment around the Chiari Network during percutaneous atrial septal defect closure

A 24-year-old male presented with exertional dyspnea. He had a systolic murmur on physical examination and transthoracic echocardiography revealed secundum-type atrial septal defect (ASD) with a shunt fraction of 2.2. With transesophageal echocardiography the defect was found suitable for percutaneous closure with sufficient rims to support the device, and a prominent and large Chiari network was detected (Fig. 1A-B). During the closing procedure, an Occlutech ASD occlusion device (Occlutech AB, Sweden) was implanted successfully (Fig. 2). After deploying both parts of the occlusion device across the defect, Mullens’ sheath was pulled backwards, and the introducer was rotated in the clockwise direction to unscrew it from the device. Afterward, an attempt was made to pull the introducer wire out.