Surgical retrieval of embolized patent ductus arteriosus occluder device in an adult after 12 years of initial deployment: A case report with perioperative considerations and decision-making in resource-limited settings

Abstract

Transcatheter closure of patent ductus arteriosus (PDA) is a well-established technique worldwide, with minimal incidence of associated major and minor complications. Surgical closure of PDA is equally effective with negligible mortality risk. We describe a case of an adult with unexpected diagnosis of PDA occluder device embolization in main pulmonary artery, presenting after 12 years of initial device deployment during childhood. Due to persistent duct flow, patient developed severe pulmonary hypertension and congestive heart failure. In this report, we are focusing on perioperative management of surgical retrieval of the embolized device along with the need of intermediate and sometimes long term follow up of patients planned for percutaneous closure, in order to avoid procedure-related complications and associated morbidity and mortality risk. At the same time, the socio-economic aspects of the patient should also be considered in decision-making in terms of choice of transcatheter versus surgical closure of the shunt.