Mian Mustafa Kamal1, Abdul Ahad Sohail2, Mian Yasir Kamal3, Naveed A Pasha4, Syed Shahabuddin5, Hasanat Sharif6. 1. Department of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan. Electronic address: mian.kamal@aku.edu. 2. Department of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan. 3. Department of Cardiology, Khyber Teaching Hospital, Peshawar, Pakistan. 4. Department of General Surgery, Aga Khan University Hospital, Karachi, Pakistan. Electronic address: naveed.pasha@aku.edu. 5. Department of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan. Electronic address: syed.shahab@aku.edu. 6. Department of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan. Electronic address: hasanat.sharif@aku.edu.
Abstract
INTRODUCTION: Atrial Septal Defect (ASD) is one of the most common congenital cardiac defect. Even though surgical repair of ASD is the current method of choice but percutaneous device closure is rapidly gaining popularity as it is less invasive. Dislodgment and embolization of the device may occur requiring urgent surgical retrieval. CASE PRESENTATION: We report a case of 54-years-old female patient with a history of ASD device closure 4 years ago, presenting with progressive shortness of breath for past 2 months. She had a partial dehiscence of an ASD device causing a residual ASD of 17 mm. She underwent urgent surgical repair of an ASD with a bovine pericardial patch without ASD device being explanted. CLINICAL DISCUSSION: Management of a dislodged ASD device may be percutaneous or surgical. Dislodged ASD devices that present months after deployment may become fibro-adhered to the site of embolization. Hence its retrieval can be challenging even via open surgical method. Our case describes a novel method to repair a residual ASD and prevent complications associated with dislodgement of device without completely explanting the device. CONCLUSION: In this case, the late presentation of the patient with a partially dehisced device makes it a distinctive case with a novel way on how to treat such a presentation surgically, ensuring that the device doesn't embolize further causing fatal complications.
INTRODUCTION: Atrial Septal Defect (ASD) is one of the most common congenital cardiac defect. Even though surgical repair of ASD is the current method of choice but percutaneous device closure is rapidly gaining popularity as it is less invasive. Dislodgment and embolization of the device may occur requiring urgent surgical retrieval. CASE PRESENTATION: We report a case of 54-years-old female patient with a history of ASD device closure 4 years ago, presenting with progressive shortness of breath for past 2 months. She had a partial dehiscence of an ASD device causing a residual ASD of 17 mm. She underwent urgent surgical repair of an ASD with a bovine pericardial patch without ASD device being explanted. CLINICAL DISCUSSION: Management of a dislodged ASD device may be percutaneous or surgical. Dislodged ASD devices that present months after deployment may become fibro-adhered to the site of embolization. Hence its retrieval can be challenging even via open surgical method. Our case describes a novel method to repair a residual ASD and prevent complications associated with dislodgement of device without completely explanting the device. CONCLUSION: In this case, the late presentation of the patient with a partially dehisced device makes it a distinctive case with a novel way on how to treat such a presentation surgically, ensuring that the device doesn't embolize further causing fatal complications.
Authors: Ahmet Öz; Emre Aruğaslan; Tufan Çınar; Muhammed Keskin; Mert Ilker Hayıroğlu; Şahin Avşar; Mehmet Baran Karataş; Berat Arıkan Aydın; Koray Demir; Barış Güngör; Osman Bolca Journal: Int J Cardiovasc Imaging Date: 2018-07-30 Impact factor: 2.357
Authors: Jae Yeong Cho; Kye Hun Kim; Hyun Ju Yoon; Hyun Ju Seon; Youngkeun Ahn; Myung Ho Jeong; Jeong Gwan Cho; Jong Chun Park Journal: J Korean Med Sci Date: 2015-08-13 Impact factor: 2.153