Pediatric Transcatheter Atrial Septal Stent Removal Following ECMO Support Including Use of Novel Retrieval Device

Left atrial (LA) decompression is often performed in patients on venoarterial extracorporeal membrane oxygenation to help offload the left ventricle. Atrial septal stents may be used to ensure the adequacy of LA decompression; however, if there is cardiopulmonary recovery and extracorporeal membrane oxygenation support is no longer needed, the stents require removal. We describe 3 pediatric patients who required venoarterial extracorporeal membrane oxygenation support and atrial septal stent placement who underwent successful transcatheter removal of the stents after cardiac recovery. In the initial case, snares alone were used to remove the stent. In the 2 subsequent cases, a combination of snares and the ŌNŌ retrieval device (ŌNŌCOR LLC) were used to remove the stents. Transcatheter removal offers a less invasive approach for atrial septal stent removal after extracorporeal membrane oxygenation support. To our knowledge, this series is the first report of transcatheter removal of a large diameter atrial septal stent and the first report using the ŌNŌ retrieval device.