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Amplatzer Septal Occluder Migration Into the Pulmonary Trunk: Surgical Removal Through a Totally Thoracoscopic Approach

Cresce, Giovanni Domenico MD, PhD; Favaro, Alessandro MD; Auriemma, Stefano MD; Salvador, Loris MD

Innovations: Technology & Techniques in Cardiothoracic & Vascular Surgery: September/October 2013 - Volume 8 - Issue 5 - p 381–383
doi: 10.1097/IMI.0000000000000015
Case Reports

Abstract: The Amplatzer Septal Occluder for transcatheter closure of interatrial communications is a standard procedure and a widely accepted alternative to surgery in most patients with atrial septal defect (ASD). Device dislocation or embolization has been reported as one of the commonest complications of ASD percutaneous closure. In this case, if a transcatheter removal is not possible, it requires a surgical therapy, usually through a median sternotomy. We report on a case of a 30-year-old woman, who underwent percutaneous closure of an ostium secundum ASD. After a late embolization of the Amplatzer Septal Occluder into the pulmonary trunk 10 months later, the implant was successfully obtained via a surgical removal through a video-guided minimally invasive port-access approach. This case shows that, in experienced hands, the port-access technique for surgical procedures on the pulmonary trunk is feasible, and therefore, it might be a good alternative option to the traditional surgery, mainly in young patients.

From the Division of Cardiac Surgery, San Bortolo Hospital, Vicenza, Italy.

Accepted for publication August 3, 2013.

Presented at the Annual Scientific Meeting of the International Society for Minimally Invasive Cardiothoracic Surgery, May 30 – June 2, 2012, Los Angeles, CA USA.

Disclosure: The authors declare no conflicts of interest.

Address correspondence and reprint requests to Giovanni Domenico Cresce, MD, PhD, Division of Cardiac Surgery, San Bortolo Hospital, Viale Rodolfi 37 – Vicenza 36100, Italy. E-mail:

©2013 by the International Society for Minimally Invasive Cardiothoracic Surgery