Percutaneous ASD Closure Requiring Emergency Surgical Removal of Embolized Cardiac Occluder Devices

Abstract

Introduction: Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA) are most common congenital acyanotic heart diseases. Surgery is the gold standard treatment for these defects. Percutaneous device closure is now getting popular for closure of these defects (Ostium Secundum ASD, PDA, muscular VSD). Device dislodgement, migration and embolization is a cause of failure in this procedure. For this emergency surgical retrieval of migrated device becomes necessary at times. Here two different scenarios of failed device closure of ASD are presented who required emergency surgical retrieval of device. Case report: In the first case the device got embolized into the main pulmonary artery which was retrieved surgically and his post-operative period was uneventful. In the second case the device got embolized into right ventricle. Surgically the device was retrieved but post operatively the patient was found to have CVA from which she recovered gradually and discharged. Conclusion: Proper assessment of defect size and rim around the defect is necessary. Devices of all sizes should be available with the team doing the procedure. During implantation in case of unsatisfactory device position it should be retrieved and elective surgical closure should be planned. Surgeons should be kept in backup in all catheter based procedure.