title: Surgical Removal of Embolized Ventricular Septal Occluder Device.
abstract: Ventricular septal defect (VSD) with valvar pulmonary stenosis (PS) is a combination of cardiac defects for which treatment by means of percutaneous catheter-directed intervention is sometimes considered. Septal occluder device embolization is a rare but potentially dreadful complication. Adequate precautions are of great importance, as operator-related and anatomical factors can contribute to the risk of device embolization. In this report, we present a case of a five-year-old patient with a perimembranous VSD and valvar PS with infundibular muscle hypertrophy. The PS was treated with balloon pulmonary valvotomy, and the VSD was closed with a catheter-directed duct occluder device. Soon after deployment, the device embolized to the aortic arch, possibly as a result of the single disc device being "milked" out of VSD by dynamic contractions of hypertrophied muscle in the right ventricular outflow tract. The embolized device was successfully retrieved and removed using cardiopulmonary bypass and a period of circulatory arrest.
authors.affiliation: 1 Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (affiliated to B.J. Medical College, Ahmedabad), Civil Hospital Campus, Asarwa, Ahmedabad, India.
authors.forename: Nikunj
authors.initials: N
authors.lastname: Vaidhya
authors.affiliation: 2 Department of Pediatric Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (affiliated to B.J. Medical College, Ahmedabad), Civil Hospital Campus, Asarwa, Ahmedabad, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Mishra
authors.affiliation: 1 Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (affiliated to B.J. Medical College, Ahmedabad), Civil Hospital Campus, Asarwa, Ahmedabad, India.
authors.forename: Sumbul
authors.initials: S
authors.lastname: Siddiqui
authors.affiliation: 3 Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Center (affiliated to B.J. Medical College, Ahmedabad), Civil Hospital Campus, Asarwa, Ahmedabad, India.
authors.forename: Harshil
authors.initials: H
authors.lastname: Joshi
authors.affiliation: 3 Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Center (affiliated to B.J. Medical College, Ahmedabad), Civil Hospital Campus, Asarwa, Ahmedabad, India.
authors.forename: Hardik
authors.initials: H
authors.lastname: Patel
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002675:Child, Preschool; D002932:Cineangiography; D020878:Device Removal / Q000379:methods*; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D055989:Septal Occluder Device / Q000009:adverse effects*
keywords: device embolization; pulmonary stenosis; transcatheter interventions; ventricular septal defect