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Open Access Research article

Urgent surgical management for embolized occluder devices in childhood: single center experience

Gokhan Gokaslan1*, Hasim Ustunsoy1, Hayati Deniz1, Ozerdem Ozcaliskan1, Alptekin Yasim1, Osman Baspinar2 and Gokalp Guzel1

Author Affiliations

1 Department of Cardiovascular Surgery, Gaziantep University Medical Faculty, Gaziantep, Sehitkamil, 27310, Turkey

2 Department of Pediatric Cardiology, Gaziantep University Medical Faculty, Gaziantep, Turkey

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Journal of Cardiothoracic Surgery 2012, 7:127  doi:10.1186/1749-8090-7-127

Published: 7 December 2012

Abstract

Background

In this study, we sought to analyze our experience in urgent surgical management for embolized cardiac septal and ductal occluder devices resulting from trans-catheter closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus in childhood patient group.

Methods

We retrospectively reviewed 9 patients (aged 2–15 years) who underwent urgent surgery due to cardiac septal and ductal occluder embolization between January 2007 and December 2010. Congenital defects were atrial septal defect (n = 6), ventricular septal defect (n = 1), and patent ductus arteriosus (n = 2). Risk factors for device embolization and urgent surgical management techniques for embolized device removal were discussed.

Results

Removal of embolized devices in all cases and repair of damaged tricuspid valve in 2 patients were performed. Inevitably, all congenital defects were closed or ligated up to the primary defect. Total circulator arrest necessitated in 1 patient with ascending aortic device embolization. All operations were completed successfully and no hospital mortality or morbidity was encountered.

Conclusions

Although closure of left to right shunting defects by percutaneous occluder devices has a lot of advantages, device embolization is still a major complication. If embolized device retrieval fails with percutaneous intervention attempts, surgical management is the only method to remove embolized devices. In this circumstance, to provide an uneventful perioperative course, urgent management strategies should be well planned.

Keywords:
Device embolization; Septal defect; Cardiac surgery