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Delayed retrieval of embolized ductal stent: A surgical challenge
Biswa Ranjan Panda1, Jayashree Mishra2
1Department of Cardiac Surgery, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India.
Insights
Retrieving embolized ductal stents from pulmonary circulation is difficult. This case report details successful stent extraction from a pulmonary artery, preserving vessel growth.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Retrieval of embolized ductal stents from pulmonary or systemic circulation presents significant challenges.
- Stents lodged in peripheral pulmonary arteries can be difficult to access, complicating removal.
- In single ventricle physiology, retained stents may increase pulmonary arterial thrombosis risk.
Abstract:
Retrieval of embolized ductal stents from the pulmonary or systemic circulation can be challenging. Most children benefit from surgical shunts in such scenarios. Although early retrieval is advised, stents lodged in the peripheral pulmonary tree can be inaccessible, making the removal complicated. In such patients, stents can be "parked" in the segmental pulmonary arterial branches for retrieval later. In the low-pressure single ventricle pulmonary circulation, partially expanded embolized stents, if left in situ, can precipitate pulmonary arterial thrombosis. This subset of patients may benefit from meticulous anticoagulation and antiplatelet agents. In our case report, we describe the successful extraction of an embolized ductal stent without damage to the right lower lobe pulmonary artery (PA). In the follow-up evaluation, the growth of the right PA is good.
