Acute and medium term results of balloon expandable stent placement in the transverse arch—a multicenter pediatric interventional cardiology early career society study

AbstractObjective:Stenting of ostial pulmonary artery stenosis presents several unique challenges. These include difficulty in defining anatomy and need for precise stent placement in order to avoid missing the ostial stenosis or jailing either the contralateral branch pulmonary artery or the ipsilateral upper lobe branch.Design:A retrospective review of outcomes was conducted in 1.5 or 2-ventricle patients who underwent stent placement for ostial branch pulmonary artery stenosis. Specific catheterisation lab techniques were reviewed.Results:Forty-seven branch pulmonary arteries underwent stent placement for ostial stenosis in 43 patients. The median age and weight were 3.7 (0.3–18.1) years and 14.2 (5.6–70.0) kg, respectively. Three (2–8) angiographic projections were needed to profile the ostial stenosis. Open-cell stents were used in 23 and stents were modified in 5 cases. Following stent implantation, the minimum diameter improved from 3.6 (0.8–10.5) to 8.1 (4.2–16.5) mm (p < 0.001). The gradient improved from 21 (0–66) to 4 (0–27) mmHg (p < 0.001). Stent malposition occurred in eight (17%) of the stents placed. Five migrated distally causing suboptimal ostial coverage necessitating placement of a second stent in four. Three migrated proximally and partially jailed the contralateral pulmonary artery. Intentional jailing of the upper lobe branch occurred in four additional cases. At a follow-up of 2.4 (0.3–4.9) years, 15 stents underwent further dilation and 1 had a second stent placed within the exiting stent.Conclusion:Ostial branch pulmonary artery stenosis may require additional angiography to accurately define the ostial stenosis. Treatment with stents is effective but carries high rates of stent malposition.

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Trans-catheter Bioprosthetic Heart Valve Implantation in Iran (Tehran Heart Centre Experiance)

Journal of Shahid Sadoughi University of Medical Sciences ◽

10.18502/ssu.v29i9.7906 ◽

2021 ◽

Author(s):

Ali Mohammad Haji Zeinali

Keyword(s):

Aortic Valve ◽

Heart Valve ◽

Interventional Cardiology ◽

Aortic Diseases ◽

Medium Term ◽

The World ◽

Valve In Valve ◽

Aortic Valve Implantation ◽

Valve Implantation ◽

Valve Diseases

Introduction: With the development of interventional cardiology in the world, in addition to coronary and aortic diseases, the treatment of heart valve diseases through catheters has recently begun. The treatment of aortic stenosis (which was only possible with open surgery and valve replacement) was first performed in the world in 2002 by Alain Cribier in France with catheter insertion of the valve and was called Trans catheter Aortic valve implantation TAVI. Trans catheter Aortic valve implantation (TAVI) was performed in Iran in 2009 in the Heart Centre of Tehran and now is routinely performed by both Balloon Expanding and self-expanding valves. In addition, we do valve in valve implantation for degenarative biopresthetic valve, in all Heart valve positions too. The short and medium term results of this treatment were reviewed in the form of research projects and published in several articles. In this review, we have explained the initiating of this new procedure in our country with the following results.

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Reconstructive endovascular treatment of intracranial aneurysms with the Willis covered stent: medium-term clinical and angiographic follow-up

Journal of Neurosurgery ◽

10.3171/2010.9.jns10373 ◽

2011 ◽

Vol 114 (4) ◽

pp. 1014-1020 ◽

Cited By ~ 16

Author(s):

Hua-Qiao Tan ◽

Ming-Hua Li ◽

Pei-Lei Zhang ◽

Yong-Dong Li ◽

Jian-Bo Wang ◽

...

Keyword(s):

Stent Placement ◽

Intracranial Aneurysms ◽

Therapeutic Option ◽

Covered Stent ◽

Aneurysm Rupture ◽

Neurological Deficits ◽

Parent Artery ◽

Covered Stents ◽

Medium Term

Object Placement of covered stents has emerged as a promising therapeutic option for cerebrovascular diseases. However, the medium- and long-term efficacy and safety of covered stents in the treatment of these diseases remain unclear. The purpose of this study was to evaluate the medium-term clinical and angiographic outcomes of covered stent placement for the treatment of intracranial aneurysms. Methods The authors' institutional review board approved the study. Thirty-four patients (13 females and 21 males; mean age 41.9 years) with 38 intracranial aneurysms were treated with the Willis covered stent. Clinical and angiographic follow-up were performed at 3 months, at 6–12 months, and annually thereafter. The initial procedural and follow-up outcomes were collected and analyzed retrospectively. Results Forty-two covered stents were successfully implanted into the target artery in 33 patients with 37 aneurysms, and 1 covered stent navigation failed in 1 patient. A complete aneurysm exclusion was initially achieved in 24 patients with 28 aneurysms, and a minor endoleak occurred in 9 patients with 9 aneurysms. Postoperatively, 2 patients died of complications related to the procedure. Angiographic and clinical follow-up data are available in 30 patients. The angiographic follow-up (17.5 ± 9.4 months [mean ± SD]) exhibited complete occlusion in 28 patients with 31 aneurysms, and incomplete occlusion in 2 aneurysms, with an asymptomatic in-stent stenosis in 3 patients (10%). The clinical follow-up (26.7 ± 13 months [mean ± SD]) demonstrated that 16 patients (53.3%) experienced a full recovery, and 14 patients (46.7%) improved. No aneurysm rupture, thromboembolic events, or neurological deficits resulting from closure of a perforating vessel by covered stent placement occurred. Conclusions Endovascular reconstruction with the Willis covered stent represents a safe, durable, and curative treatment option for selected intracranial aneurysms, yielding an excellent medium-term patency of the parent artery and excellent clinical outcomes.

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Simulator Training in Interventional Cardiology

Interventional Cardiology Review ◽

10.15420/icr.2016.11.01.70 ◽

2016 ◽

Vol 11 (1) ◽

pp. 70

Author(s):

Abhishek Joshi ◽

◽

Andrew Wragg

Keyword(s):

Simulation Training ◽

Human Factor ◽

Interventional Cardiology ◽

Technical Skills ◽

Early Career ◽

Simulator Training ◽

Simulated Patients ◽

Clear Link ◽

Future Direction ◽

National Training

Simulator training in interventional cardiology is becoming a central part of early career acquisition of technical and non-technical skills. Its use is now mandated by national training organisations. Haptic simulators, part-task trainers, immersive environments and simulated patients can provide benchmarked, reproducible and safe opportunities for trainees to develop without exposing patients to the learning curve. However, whilst enthusiasm persists and trainee-centred evidence has been encouraging, simulation does not yet have a clear link to improved clinical outcomes. In this article we describe the range of simulation options, review the evidence for their efficacy in training and discuss the delivery of training in technical skills as well as human factor training and crisis resource management. We also review the future direction and barriers to the progression of simulation training.

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Acute and mid-term outcomes of stent implantation for recurrent coarctation of the aorta between the Norwood operation and fontan completion: A multi-center Pediatric Interventional Cardiology Early Career Society Investigation

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.27231 ◽

2017 ◽

Vol 90 (6) ◽

pp. 972-979 ◽

Cited By ~ 4

Author(s):

Osamah Aldoss ◽

Bryan H. Goldstein ◽

Saar Danon ◽

Sebastian Goreczny ◽

Robert G. Gray ◽

...

Keyword(s):

Stent Implantation ◽

Coarctation Of The Aorta ◽

Interventional Cardiology ◽

Early Career ◽

Norwood Operation

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Simulator Training in Interventional Cardiology

Interventional Cardiology Review ◽

10.15420/icr.2016.11.1.70 ◽

2016 ◽

Vol 11 (1) ◽

pp. 70 ◽

Cited By ~ 2

Author(s):

Abhishek Joshi ◽

◽

Andrew Wragg

Keyword(s):

Simulation Training ◽

Human Factor ◽

Interventional Cardiology ◽

Technical Skills ◽

Early Career ◽

Simulator Training ◽

Simulated Patients ◽

Clear Link ◽

Future Direction ◽

National Training

Simulator training in interventional cardiology is becoming a central part of early career acquisition of technical and non-technical skills. Its use is now mandated by national training organisations. Haptic simulators, part-task trainers, immersive environments and simulated patients can provide benchmarked, reproducible and safe opportunities for trainees to develop without exposing patients to the learning curve. However, whilst enthusiasm persists and trainee-centred evidence has been encouraging, simulation does not yet have a clear link to improved clinical outcomes. In this article we describe the range of simulation options, review the evidence for their efficacy in training and discuss the delivery of training in technical skills as well as human factor training and crisis resource management. We also review the future direction and barriers to the progression of simulation training.

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Hybrid Surgical Repair for Recurrent Coarctation of the Transvers Arch: Case Report

10.22541/au.162595593.30345023/v1 ◽

2021 ◽

Author(s):

Kıvanc ATILGAN ◽

Alper TOSYA ◽

Fahri YEŞİL ◽

Pinar Koksal Coskun ◽

Burak ONUK ◽

...

Keyword(s):

Stent Placement ◽

Carotid Arteries ◽

Surgical Repair ◽

Median Sternotomy ◽

Coarctation Of The Aorta ◽

Complete Relief ◽

Hybrid Technique ◽

Transcatheter Intervention ◽

Transverse Arch ◽

Common Carotid Arteries

The incidence of postoperative recurrent coarctation of the aorta ranges from 5% to 50%, and largely depends on the age at initial repair. Due to the increased fibrosity and rigidity of the aorta in older age, stent placement is preferred instead of balloon angioplasty, resulting in an almost complete relief of the gradient in >95% of the patients. In patients with transverse arch hypoplasia, transcatheter intervention with further surgical intervention may be needed, and the use of stenting was shown to be effective in the treatment of patients with hypoplastic isthmus, arch or tubular coarctation. In this case of a late re-coarctation, we preferred to apply a hybrid technique for treatment. The first step of the treatment was debranching of the brachiocephalic and left common carotid arteries with upper mini median sternotomy. On the following day, the patient underwent a successful stent placement to the transvers arch.

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