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A PICTURE IS WORTH A THOUSAND WORDS
Year : 2015  |  Volume : 16  |  Issue : 2  |  Page : 68-69  

Surgical retrieval of embolized atrial septal defect closure device in right ventricle


1 Department of Cardiac Anesthesia, BLK Hospital, Rajendra Place, New Delhi, India
2 Department of Cardiac Surgery, BLK Hospital, Rajendra Place, New Delhi, India

Date of Web Publication23-Jun-2015

Correspondence Address:
Dr. Monish S Raut
Department of Cardiac Anesthesia, BLK Hospital, Rajendra Place, New Delhi - 110 060
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1995-705X.159227

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How to cite this article:
Raut MS, Khanuja JS, Srivastava S, Mittal C M. Surgical retrieval of embolized atrial septal defect closure device in right ventricle. Heart Views 2015;16:68-9

How to cite this URL:
Raut MS, Khanuja JS, Srivastava S, Mittal C M. Surgical retrieval of embolized atrial septal defect closure device in right ventricle. Heart Views [serial online] 2015 [cited 2019 Jun 24];16:68-9. Available from: http://www.heartviews.org/text.asp?2015/16/2/68/159227

A 40-year-old male patient presented with shortness of breath. Transthoracic echocardiography showed ostium secondum atrial septal defect (ASD) with left-to-right shunt. ASD defect size was 34 mm with superior and inferior rim of 10-mm each. In cardiac cath lab, patient was scheduled for ASD device closure. While deploying and positioning the left atrial disc, the device got embolized to right ventricle,it could be seen on fluroscopy Patient's hemodynamics were stable. Considering the risk of further migration of the device, patient underwent emergent surgical removal of device and ASD closure by pericardial patch. Intraoperative transesophageal echocardiogram (TEE) revealed ASD and device in RV [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6].
Figure 1: Intra-op midesophageal 4 chamber TEE view showing ASD closure device embolized in RV

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Figure 2: Intra-op midesophageal 4 chamber TEE view with clockwise rotation showing ASD and device embolized in RV


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Figure 3: Intra-op midesophageal TEE view showing ASD

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Figure 4: Intra-op midesophageal left ventricular outflow tract long axis TEE view showing device in dilated RV

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Figure 5: Intra-op midesophageal aortic valve short axis TEE view showing device in RV

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Figure 6: Intra-op midesophageal 4 chamber TEE view showing ASD closed by patch with no shunting

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The incidence of device embolization is reported to be about 0.5% in experienced hands, with successful percutaneous retrieval being reported in approximately 70% of the cases [1] . In the present case, emergent surgical retrieval of device was done before any further complication.

 
   References Top

1.
Levi DS, Moore JW. Embolization and retrieval of the Amplatzer septal occluder. Catheter Cardiovasc Interv 2004;61:543-7.  Back to cited text no. 1
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]


This article has been cited by
1 Midterm follow-up of transthoracic device closure of an atrial septal defect using the very large domestic occluder (44–48 mm), a single Chinese cardiac center experience
Qiang Chen,Hua Cao,Gui-Can Zhang,Liang-wan Chen,Fan Xu,Jia-xin Zhang
Journal of Cardiothoracic Surgery. 2017; 12(1)
[Pubmed] | [DOI]



 

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