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Word of caution: silent late device embolisation after perimembranous ventricular septal defect closure in a 6-Kg infant

Published online by Cambridge University Press:  03 January 2024

Raymond N. Haddad Open the ORCID record for Raymond N. Haddad [Opens in a new window]  and
Zakhia Saliba Open the ORCID record for Zakhia Saliba [Opens in a new window]
Raymond N. Haddad*
Affiliation:
Centre de Référence Malformations Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker-Enfants malades, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
Zakhia Saliba
Affiliation:
Department of Pediatric Cardiology, Hotel Dieu de France University Medical Center, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon
*
Corresponding author: R. N. Haddad; Email: raymondhaddad@live.com
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Abstract

We report on a 6-month-old infant (6 Kg/ 64 cm) with perimembranous ventricular septal defect (absent sub-aortic rim, 10 mm left ventricular entry, and 4 and 6 mm right ventricular exists) and successful retrograde closure using an 8x6 mm KONAR-MF™ VSD occluder (Lifetech, China). Immediate and 48 hours post-procedure ultrasounds showed an accurately positioned device and two jets of mild-to-moderate residual shunts. At the 2-week follow-up, the device did not change position and the shunt was stable and intra-prosthetic. The scheduled 3-month follow-up was skipped for familial reasons. The patient came back without alarming symptoms for the regular 6-month follow-up, and the device was found embolised to the left pulmonary artery. The device was retrieved surgically, and the defect was patch-closed with excellent outcomes. There was a pseudoaneurysm involving the tricuspid valve chordae and the device was endothelialized partially on one edge suggesting that embolization occurred somewhere between 3 months and 6 months post-operative. Defects with compromised anatomies should be closed surgically to avoid suboptimal results, especially in small infants.

Keywords

Device closureperimembranousventricular septal defecttranscatheter interventions
Type
Brief Report
Information
Cardiology in the Young , Volume 34 , Issue 2 , February 2024 , pp. 455 - 458
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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