Suture fixation of migrated septal occluder device to prevent further migration: a simple surgical technique.

As the use of percutaneous intervention is increasing for the closure of the atrial septal defect, the procedure related complications are also on rise, migration of the device being most common. The migrated devices with failed percutaneous retrieval must be removed surgically under cardiopulmonary bypass. During establishment of cardiopulmonary bypass, the handling of heart may cause further migration of the device into other chambers of heart which leads to difficulty in finding and retrieval of the device.

Use of pericardial strip for reinforcement of proximal anastomosis in Bentall's procedure.

Bleeding from a proximal suture line is not uncommon following composite graft anastomosis in Bentall's procedure. Passage of valve sutures through the pericardial strip, which is used to encircle the sewing ring of the composite graft, strengthens the repair. The strip can also be sutured to the left ventricular outflow tract in case of bleeding from proximal anastomosis in that particular region.