Safe retrieval of embolized patent ductus arteriosus coil via left thoracotomy
Melanie Finkbeiner1, Jacques Leblanc, Martin Hosking
1Department of Pediatric Surgery;
Insights
Coil embolization during patent ductus arteriosus closure can occur. Surgical removal may be necessary when percutaneous retrieval fails, as seen in a case requiring thoracotomy.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Transcatheter occlusion is a common procedure for patent ductus arteriosus (PDA).
- Coil embolization is a known complication, potentially leading to pulmonary artery or aortic obstruction.
- Percutaneous retrieval is the preferred method for managing embolized coils.
Observation:
- A case report details a patient experiencing coil migration to the left pulmonary artery post-PDA occlusion.
- Multiple percutaneous attempts to retrieve the embolized coil were unsuccessful.
- The patient subsequently required surgical intervention.
Findings:
- Surgical removal via left thoracotomy successfully retrieved the embolized coil.
- The patent ductus arteriosus was definitively treated with ligation during the surgical procedure.
- This case highlights the limitations of percutaneous retrieval in specific embolization scenarios.
Implications:
- Highlights the need for surgical preparedness in interventional cardiology settings.
- Suggests that complex coil embolization may necessitate a shift to surgical management.
- Emphasizes the importance of considering surgical options when percutaneous interventions fail to resolve complications like coil embolization.
Abstract:
During transcatheter occlusion of a patent ductus arteriosus, one potential complication is that the coil can embolize into one of the branch pulmonary arteries or the aorta. It is often possible to remove this coil percutaneously, but at times, surgical intervention is required. The present report describes a case in which the coil migrated to the left pulmonary artery and repeated attempts to retrieve the coil were unsuccessful. A left thoracotomy was performed, the coil was removed and the patent ductus arteriosus was ligated.
