title: Late migration of a Sideris buttoned device for occlusion of atrial septal defect.
abstract: We describe a 17-year-old patient with an atrial septal defect who underwent device closure with a second generation Sideris buttoned device at 4 years of age. She presented 13 years after the procedure with the acute onset of chest discomfort, at which time a chest radiograph showed migration of the wire of the right atrial counter-occluder to the lateral aspect of the right atrial wall, with an associated right atrial perforation. The patient underwent uneventful surgical device retrieval and atrial septal defect closure. Late migration of a portion of the Sideris buttoned device can occur, suggesting the need for continued follow up, and a high index of suspicion for device failure should a patient become symptomatic.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA. cottstim@umich.edu
authors.forename: Timothy
authors.initials: T
authors.lastname: Cotts
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Strouse
authors.forename: Joseph N
authors.initials: JN
authors.lastname: Graziano
mesh_terms: D000293:Adolescent; D021721:Balloon Occlusion / Q000009:adverse effects* / Q000295:instrumentation*; D006348:Cardiac Surgical Procedures; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology* / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000628:therapy*; D006801:Humans; D012086:Reoperation