[Surgical considerations after patch closure of atrial septal defect with tricuspid annuloplasty]

Two patients with complications of embolism during the early postoperative period after patch closure of atrial septal defect with tricuspid annuloplasty were reported. Case 1: A 58-year-old woman underwent closure of an atrial septal defect and tricuspid annuloplasty by means of Kay's technique for tricuspid regurgitation. She had an episode of thromboembolism in the bilateral common femoral arteries 7 days after surgery. Thromboembolectomy was performed successfully using Fogarty's embolectomy catheter. Case 2: A 49-year-old woman underwent closure of an atrial septal defect and the tricuspid annuloplasty using Carpentier ring for tricuspid regurgitation. The patient had transient left hemiparesis on the 5th postoperative day. Both patients had atrial fibrillation and mild pulmonary hypertension before surgery. In relatively old patients (over 40 years old) with atrial septal defect, tricuspid regurgitation and atrial fibrillation, anticoagulant therapy should be started immediately after surgery to prevent thromboembolism.