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It was reported that on (b)(6) 2026, a 30-25mm amplatzer talisman pfo occluder was chosen for a procedure.On initial preparation, the tuohy would not tighten around the delivery system and kept leaking.The tuohy replaced with the other on the come with the trevisio and it worked/sealed.They completed the preparation of the 30 talisman and then attempted to introduced it into the trevisio sheath.The device would not pass through the hub, took the device out repressed, and reattempted to introduce into the sheath.But still would not pass through the hub of the treviso sheath hub.The treviso sheath was replaced with a new 9f trevisio and inserted the device it into the sheath without difficulty.The device got deployed the left atrial (la) disc, but when trying to deploy the right atrial (ra) disc the device pulled across the septum into the ra.They took the device out and re-prepped it.They re-inserted and deployed without difficulty.Upon disc deployment, both the ra and oa disc were bulbous in appearance.The device was replaced with a new 30mm talisman.The deformed device was never released from the delivery cable while inside the patient.There was no report of any interaction with cardiac structures during deployment and no report of any angulation/kink noticed with the delivery system.The new device got prepped and deployed without issue and patent foramen ovale (pfo) was successfully closed.The device was successfully detached from delivery catheter and patient was successfully closed.The patient remained hemodynamically stable throughout the procedure.There was some delay in the procedure, the delay was only related to the removal of the device followed by the prep, insertion, and deployment of the second device.The patient was reported discharged.
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