Surgical retrieval of an embolized atrial septal occluder device from the abdominal aorta: a rare case report.

introductionIn selected patients, transcatheter closure of atrial septal defects (ASD) with atrial septal occluder (ASO) devices has showed outstanding results. However, in very rare cases, there is a risk of device embolization. PRESENTATION OF CASE: This case is of a 16-year-old female, who presented to the paediatric outpatient department with acute abdominal pain. As a 9-year-old she was treated for an ASD with the implantation of ASO device. Five months after the treatment, the ASO was found to be embolised to the abdominal aorta. Another ASO device was implanted but transcatheter retrieval of the embolised ASO device was unsuccessful. Due to the very young age of the patient and her being asymptomatic, the patient was indicated for conservative management. The patient was asymptomatic for 7 years, where after the patient started having acute abdominal pain attacks and postprandial nausea, for which the surgical retrieval was indicated and successfully performed by open aortic surgery. DISCUSSION: Device embolization, reported in up to 0.5 % of cases, can be potentially fatal. In most cases, embolization occurs in the first 72 h, and immediate transcatheter retrieval is recommended, with open surgery being an efficient alternative if transcatheter retrieval fails.

conclusionASO device embolization should be promptly diagnosed and treated by a multidisciplinary team to achieve the best results. Open surgical retrieval of the occluder devices is a safe and a highly effective alternative method to retrieve embolised devices when transcatheter retrieval fails.