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Thorac Cardiovasc Surg 2001; 49(6): 338-342
DOI: 10.1055/s-2001-19010
Original Cardiovascular
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Surgical Management of Complications Caused by Transcatheter ASD Closure[∗]

F. Mellert1 , C. J. Preusse1 , M. Haushofer1 , K. Winkler1 , C. Nill1 , D. Pfeiffer4 , D. Redel2 , B. Lüderitz3 , A. Welz1
  • 1Department of Cardiac Surgery
  • 2Department of Cardiology at the Children’s Hospital Medical Center
  • 3Department of Internal Medicine II, Cardiology, Pneumonology
  • Heart Center of the Friedrich Wilhelms University, Bonn, Germany
  • 4Department of Internal Medicine, Cardiology/Angiology Unit, University of Leipzig, Germany
Further Information

Publication History

Publication Date:
17 December 2001 (online)

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Background: Transcatheter occlusion of uncomplicated atrial septum defects (ASD) is recognized as an effective and minimally invasive method. Sometimes, serious early and late complications require surgical intervention. We therefore investigated reasons and outcomes of the secondary surgical approach. Methods: 5 patients (aged 5 - 73 yrs) were admitted to our institution for device explantation and surgical ASD closure. ASDOS devices (A devices) had to be explanted in 4 patients and a SIDERIS “buttoned” occluder (S device) had to be explanted in 1 patient. The period from transcatheter implantation to surgical explantation ranged from 1 hour to 3 years. Results: 3 patients (60 %) had to be operated in an emergency setting. In our youngest patient (5 yrs), the A device separated and embolized into the aorta and pulmonary artery. A pregnant women who needed emergent cesarean section developed hemopericard and tamponade due to atrial perforation by a fractured leg of an A device. In another A device, a suspect endocarditis caused membrane perforation. Malpositioning of an S device was the reason for operation. All patients recovered well without neurological symptoms. Conclusions: Transcatheter closure of uncomplicated ASD is a feasible alternative but surgical stand-by is essential. Nevertheless more complicated ASD should be operated, especially since the cosmetically satisfactory techniques of minimal invasive heart surgery are available.

Key words:

Complications - Transcatheter ASD closure - Surgical repair

1 This paper was presented at the 30. Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery, Leipzig, Germany, February 18 - 21, 2001

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1 This paper was presented at the 30. Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery, Leipzig, Germany, February 18 - 21, 2001

Fritz Mellert,MD 

Department of Cardiac Surgery
Friedrich Wilhelms University

Sigmund-Freud-Straße 25

53105 Bonn

Germany

Phone: +49 (228) 287-4190

Fax: +49 (228) 287-4195

Email: fritz.mellert@uni-bonn.de