I had a 31 year old female patient who started to complain one week after asd closure using a 24 amplatzer device with back pain followed by chest pain and left mammary tenderness which is now persistent for 3 months post device closure she sometimes describe a sense of knife in her chest and has extreme fatigability i do not want to extract the device on assumption of nickel allergy and at the same time i want to relieve her symptoms.
I would need an allergy consultation to have spesific allergy test for nickel and other materials consisting the device. If the tests show a clear sensitivity to a spesific device material and symptoms persist then I would try to retrieve the device percutaneosly before surgery.
Use you Clopidogrel associated to aspirin after closure of ASD with Amplatzer device?
A cardiologist in Melbourne said he's never seen a case of nickel allergy, very rare. Could there be another reason for her discomfort?
I disagree. Some patients have severe headache and other clinical manifestation after Amplatzer ASD device. The use of clopidogrel is very affective in this cases.
the patient has documented nickle allergy by both patch test and fin test
she was already on clopidogrel when she started to complain from this manifestation
she also had an intensive course of antihistaminic and steroids after consulting an immunologist but was not able to relieve her symptoms and she is refusing the idea of surgically extracting the device