Surgical Treatment of Device Related Complications in Congenital Heart Diseases Treated with Percutaneous Modalities

Abstract

Secundum atrial sepal defect and patent ductus arteriosus are the most frequently encountered congenital heart diseases. They are treated with percutaneous modalities with high success rates and low morbidity and mortality rates. Peri-procedural complications may occur in the early period or in late follow-up. The most striking feature when complications occur is the high mortality rates observed when surgical treatment is required. Here we report one case with patent ductus arteriosus surgically treated due to broken coil and two cases of atrial septal defect directed to surgery one in the early (with the suspicion of device embolization during the procedure) and one in the late post-procedure period (residual shunt) of device closure. First two patients were directed to emergent surgery, whereas the last one underwent elective surgery. Coil was removed in the case with ductus. There was no embolus due to the device in the second case and defect was closed with a patch. The device was removed and patch closure of the defect was performed in the third case. We believe that, these percutaneous modalities should be employed in centers where cardiac surgical back-up is available.