Surgical Removal of Amplatzer Duct Occluder for a Patent Ductus Arteriosus

Gen Shinohara

Koji Nomura and Kouichi Muramatsu

（Department of Cardiac Surgery, Jikei University School of Medicine＊, Tokyo, Japan, Department of Cardiovascular Surgery, Saitama Children’s Medical Center＊＊, Saitama, Japan, and Department of Cardiac Surgery, Jikei University Kashiwa Hospital, Kashiwa, Japan）

A 1-year-old girl with patent ductus arteriosus（PDA）was admitted for cardiac catheter examination which identified a 7.8mm Krichenko D type PDA. An Amplatzer duct occluder（ADO）was used but fluoroscopy showed the device at an oblique angle and residual shunt. The girl underwent surgical removal of the device 2 days after deployment because of progression of residual PDA shunt and left pulmonary artery encroachment, suggesting device dislodgement. Median sternotomy was performed, cardiopulmonary bypass was established and dissection was carried out around the PDA. Marked protrusion of the PDA wall made by the ADO retention disc was noted. The main pulmonary artery was incised under cardioplegic arrest. The device was incarcerated in PDA and attempts to remove the device failed. Therefore delivery cable through sheath was reconnected to the device by its microscrew, and the pulmonary end of the device was recaptured into sheath. The incarceration was dissolved and the device was removed. PDA was ligated.

 

Jpn. J. Cardiovasc. Surg. 44:25-28（2015）

Keywords：patent ductus arteriosus;Amplatzer duct occluder;surgical removal