Surgical Retrieval Of An Embolized Ductus Arteriosus Occluder Device Without Cardiopulmonary Bypass Via Left Thoracotomy
VIJAYANT DEVENRAJ, SUSHIL KUMAR SINGH, VIVEK TEWARSON, SARVESH KUMAR, NAVNEET DEVENRAJ.
KING GEORGE'S MEDICAL UNIVERSITY, LUCKNOW, India.
OBJECTIVE: Surgical removal of an embolized patent ductus arteriosus (PDA) duct occluder device from left pulmonary artery (LPA) without cardiopulmonary bypass (CPB) and sternotomy via left thoracotomy.
METHODS: A nine year old girl was diagnosed to be suffering from persistent patent ductus arteriosus of 7mm diameter on 2D-echocardiography. She underwent percutaneous transcatheter closure of PDA with Cocoon Duct Occluder device (Vascular Innovations Co., Thailand). The device got dislodged immediately after being released across the PDA and embolized into left pulmonary artery . Several attempts to retrieve the embolized device by interventional cardiologists failed. Cardiothoracic surgeons were called for help. A left postero-lateral thoracotomy approach was planned for retrieval of embolized device and closure of the PDA at the same time, and try to avoid CPB and sternotomy in this child.
RESULTS: Patient underwent successful emergency removal of embolized duct occluder device along with PDA triple ligation without need for CPB or sternotomy.
CONCLUSIONS: We present an innovative technique for removal of embolized PDA duct occluder device into LPA via left postero-lateral thoracotomy thus avoiding the adverse effects of CPB and sternotomy and at the same time facilitating surgical closure of PDA.
LEGEND 1 : Pulmonary angiography showing the embolized cocoon duct occluder device in the left pulmonary artery.LEGEND 2 : Operative view of left pulmonary artery and removal of cocoon duct occluder device via thoracotomy.
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