title: Urgent surgical management for embolized occluder devices in childhood: single center experience.
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.
authors.affiliation: Department of Cardiovascular Surgery, Gaziantep University Medical Faculty, Gaziantep, Sehitkamil 27310, Turkey. cerrah06@yahoo.com
authors.forename: Gokhan
authors.initials: G
authors.lastname: Gokaslan
authors.forename: Hasim
authors.initials: H
authors.lastname: Ustunsoy
authors.forename: Hayati
authors.initials: H
authors.lastname: Deniz
authors.forename: Ozerdem
authors.initials: O
authors.lastname: Ozcaliskan
authors.forename: Alptekin
authors.initials: A
authors.lastname: Yasim
authors.forename: Osman
authors.initials: O
authors.lastname: Baspinar
authors.forename: Gokalp
authors.initials: G
authors.lastname: Guzel
mesh_terms: D000293:Adolescent; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000379:methods*; D004374:Ductus Arteriosus, Patent / Q000601:surgery; D004617:Embolism / Q000601:surgery*; D005260:Female; D006343:Heart Septal Defects / Q000601:surgery; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D055989:Septal Occluder Device