1 INTRODUCTION
Surgical repair has been traditionally considered the treatment of
choice for atrial septal defect (ASD) repair during decades. However,
nowadays the percutaneous deployment of Amplatzer septal occluder (ASO)
devices has become the standard technique for favourable ASD
closure1,2. These procedures are considered safe and
effective, with low rates of mortality and morbidity, and avoid
open-heart surgery2. However, device embolization to
different sites of the circulatory system or cardiac chambers is a
serious potential complication. In these cases, when the percutaneous
retrieval of the device fails, surgical removal is
needed3. We report a rare case of symptomatic
embolization of an ASO into the left ventricular outflow tract (LVOT)
after 24 hours of device deployment. During percutaneous retrieval the
device tangled with the mitral valve and the left ventricle was injured,
requiring emergent surgical removal with combined right atrial and
aortic approaches, and patch repair of the left ventricle.