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Atrial Septal Defect Closure Device Embolized To The Aortic Arch And Eroding Through It - A Video Presentation Of An Unusual Complication
Mahesh Ramchandani.
Houston Methodist, Houston, TX, USA.
Background:
Atrial septal defect (ASD) closure devices may migrate. However migration into the aortic arch is rare.
This video presentation presents such a case and shows the operative strategy for removal
Methods:
A 58 year old man presented with dyspnea on exertion. Four years earlier, he had undergone placement of an ASD closure device (Amplatzer; St Jude Medical Inc.)
Echocardiography showed a large ASD. Chest X-ray showed the device in the upper chest.
CT scan showed it to be lodged in the aortic arch
The patient had no neurological symptoms
Results:
The patient underwent a sternotomy and repair of the ASD with a pericardial patch. Then, under deep hypothermic circulatory arrest, the embolized ASD was removed from the arch. It was well endothelialized and had eroded through the underside of the arch. The device was removed and a primary repair performed of a defect in the underside of the aortic arch. The patient made a good recovery.
Conclusions:
This detailed video presentation shows the operative strategy employed in this unusual case.
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