Robotic-assisted removal of an Amplatzer atrial septal occluder device for residual shunting, closure of septal defect and simultaneous tricuspid annuloplasty.

Complications after percutaneous atrial septal defect closure such as residual shunting or device-related events are generally treated using conventional sternotomy or thoracotomy incisions. In these cases, minimally invasive approaches including mini-sternotomy, mini-thoracotomy or endoscopic techniques can also be used in the management of complications, residual defects and concomitant procedures. However, robotic surgery is a reasonable alternative for removal of septal occluder devices and concomitant repair procedures to prevent cardiopulmonary morbidities. Herein, we report an adult, who underwent a totally endoscopic robotic removal of septal occluder device, closure of septal defect with autologous pericardial patch and tricuspid valve annuloplasty through a right atriotomy approach.