Diagnosis and management of congenital umbilical arteriovenous malformation

2020 ◽  
pp. 1-3
Author(s):  
Shweta Bakhru ◽  
Vijayanand Jamalpuri ◽  
Nageswara Rao Koneti
Keyword(s):  
Arteriovenous Malformation ◽  
Primary Pulmonary Hypertension ◽  
Transcatheter Closure ◽  
Umbilical Vein ◽  
Pulmonary Artery Hypertension ◽  
Vascular Plug ◽  
Severe Respiratory Distress ◽  
Ct Angiogram ◽  
High Output

Abstract An 8-day-old neonate was presented with severe respiratory distress and diagnosed as primary pulmonary hypertension of the newborn on functional echocardiogram. Evaluation showed bounding pulse, enlarged umbilical cord, and bruit over the periumbilical region. Transthoracic echocardiography and CT angiogram showed a large fistulous communication between the umbilical vein and artery suggestive of congenital umbilical arteriovenous malformation leading to high-output cardiac failure and pulmonary artery hypertension. The patient was stabilised with medications and ventilation. Transcatheter closure of communication was done using coils, vascular plug, and KONAR-MFTM device. The patient improved from heart failure soon after the procedure and thriving normally at 6 months of follow-up.

Transcatheter closure of perimembranous ventricular septal defects with the Amplatzer Vascular Plug-II

2015 ◽  
Vol 26 (6) ◽  
pp. 1194-1201 ◽  
Author(s):  
Nancy Hua ◽  
Paolo Aquino ◽  
Carl Y. Owada
Keyword(s):  
Transcatheter Closure ◽  
Left Ventricular ◽  
Defect Size ◽  
Amplatzer Vascular Plug ◽  
Ventricular Septal Defects ◽  
Vascular Plug ◽  
Effective Treatment Option ◽  
Septal Defects ◽  
Amplatzer Vascular Plug Ii

AbstractObjectiveThe aim of this study was to evaluate the safety and efficacy of the Amplatzer Vascular Plug-II used for the closure of perimembranous ventricular septal defects.BackgroundThere are no FDA-approved transcatheter devices for the closure of perimembranous ventricular septal defects. Several studies have reported on the use of various devices either off-label or under clinical trial protocols. However these reports have described significant adverse events including residual shunts, complete heart block, arrhythmia, and new valve regurgitations. Thus far, no study on the Amplatzer Vascular Plug-II has been reported.MethodsWe conducted a 4-year retrospective chart review from August, 2010 to August, 2014, of patients with perimembranous ventricular septal defects associated with ventricular septal aneurysm who underwent transcatheter closure using the Amplatzer Vascular Plug-II.ResultsA total of 16 patients underwent Amplatzer Vascular Plug-II transcatheter closure of their perimembranous ventricular septal defects. The median age was 2.56 years (range: 0.5–27.3). Their median weight was 13.0 kg (range: 6.9–71.6). The left ventricular median defect size was 9.3 mm (range: 5.9–14.4). The right ventricular median defect size was 3.6 mm (range: 2.3–5.8). All the patients underwent successful device implantation with 83% of the patients having complete echocardiographic closure at the 1-year follow-up; however, one procedure was complicated by early device embolisation. The device was successfully retrieved and replaced with a larger device. There were no device-related outflow tract obstructions, rhythm abnormalities, or haemolysis.ConclusionApplication of the Amplatzer Vascular Plug-II for closure of perimembranous ventricular septal defects appears to be a safe and effective treatment option. Prospective clinical trials and longer follow-up periods are warranted.

Extended applications of the Amplatzer vascular plug IV in infants

2010 ◽  
Vol 21 (2) ◽  
pp. 178-181 ◽  
Author(s):  
Roland Adelmann ◽  
Alfred Windfuhr ◽  
Gerardus Bennink ◽  
Mathias Emmel ◽  
Narayanswami Sreeram
Keyword(s):  
Transcatheter Closure ◽  
Azygos Vein ◽  
Amplatzer Vascular Plug ◽  
Consecutive Series ◽  
Vascular Plug ◽  
Minimum Diameter ◽  
Mechanically Ventilated ◽  
Young Infants ◽  
Collateral Vessels

AbstractObjectiveA variety of devices are available for transcatheter closure of unwanted shunts. We describe our experience with the use of the Amplatzer vascular plug IV in a consecutive series of infants.MethodsA total of eight consecutive infants – all born preterm at gestational ages ranging from 24 to 35 weeks – undergoing transcatheter closure of unwanted shunts – persistently patent arterial duct in five patients, an aorta to right atrium fistula in one, multiple aortopulmonary collateral vessels in one, and an azygos vein to left atrium connection in one – are described. Their age, from birth, ranged between 3 and 11 months, and weight between 2.6 and 11.3 kilograms. All devices were delivered using percutaneous arterial or venous vascular access via a large lumen (0.038 inch) 4-French delivery catheter.ResultsAll lesions could be successfully occluded using one or more devices. Device diameters ranged between 4 and 8 millimetres, and exceeded the minimum diameter of the target vessel by 1 to 2 millimetres. Successful occlusion was confirmed either directly at angiography or on follow-up echocardiography. Of the infants who were mechanically ventilated prior to the procedure, three could be successfully weaned following closure of the shunt. There were no procedure-related complications.ConclusionsThe new vascular plug IV is cheap and efficacious in closing a variety of shunts in young infants, and warrants further extended clinical application.

Transcatheter closure of a large left ventricular pseudoaneurysm using an Amplatzer Vascular Plug 4 and stenting of the inferior caval vein in a child

2011 ◽  
Vol 22 (1) ◽  
pp. 106-109 ◽  
Author(s):  
Osman Baspinar ◽  
Ahmet Mete ◽  
Vedat Davutoglu
Keyword(s):  
Treatment Option ◽  
Transcatheter Closure ◽  
Left Ventricular ◽  
Amplatzer Vascular Plug ◽  
Vascular Plug ◽  
Caval Vein ◽  
Left Ventricular Pseudoaneurysm ◽  
Inferior Caval Vein ◽  
Amplatzer Vascular Plug 4

AbstractLeft ventricular pseudoaneurysm is especially rare in childhood, and its main treatment option should be surgery. We describe the case of a 9.5-year-old boy who first underwent mitral vegetation excision and then an unsuccessful pseudoaneurysm operation. Owing to pseudoaneurysmal sac dimensions, inferior caval vein syndrome developed. We delivered the Amplatzer Vascular Plug 4 into the pseudoaneurysm and treated the inferior caval vein syndrome with a bare Cheatham–Platinum stent. The patient was asymptomatic at the last follow-up.

scholarly journals Transcatheter Closure of Patent Ductus Arteriosus With Severe Pulmonary Artery Hypertension Through Single Venous Approach: a Propensity Score Match Analysis From Long-term Outcomes

2021 ◽  
Author(s):  
Danqing Hu ◽  
En Chen ◽  
Wei Cai ◽  
Lianglong Chen
Keyword(s):  
Pulmonary Artery ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Pulmonary Artery Hypertension ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Baseline Characteristics

Abstract Background: Up to now, transcatheter closure of patent ductus arteriosus(PDA) without severe pulmonary artery hypertension (PAH) has been well established and accepted in clinical practice. However, in PDA patients with severe PAH, transcatheter closure still remains a challenge, regardless of the tremendous advancement in devices and techniques.Methods: We reviewed the records of PDA patients who underwent transcatheter device closure though single femoral venous approach between January 2005 and December 2018. Severe PAH was defined as systolic pulmonary artery pressure (SPAP) measured by a catheter >70mmHg, excluding irreversible severe PAH assessed by trial occlusion. Propensity score matching was used to assemble a cohort of patients with similar baseline characteristics. Results: A total of 29 patients were in severe PAH (SPAH) group after excluding 2 for failing to the trial occlusion, and 468 in non-severe PAH(non-SPAH) group. After matching, 25 patients were in SPAH group, and 39 in non-SPAH group, without any significant difference in baseline characteristics. The median follow-up periods were 57 and 44 months for groups, respectively. No significant difference was noted in the rates of cumulative adverse events in the 2 groups (p=0.208). No poor effects in left ventricular function and residual shunt evaluated by transthoracic echocardiography(TTE) in SPAH group were detected in the short- and long-term follow-up.Conclusion: In the patients with PDA associated with reversible severe PAH, compared to non-severe PAH, transcatheter closure through single venous approach has comparable adverse events rates and successful closure rate, with equivalent results of TTE examination at the short- and long-term follow-up.

scholarly journals Transcatheter closure of atrial septal defect in the elderly: Early outcomes and mid-term follow-up

2020 ◽  
Vol 1 ◽  
pp. 100058
Author(s):  
Mario Giordano ◽  
Gianpiero Gaio ◽  
Michele D'Alto ◽  
Giuseppe Santoro ◽  
Giancarlo Scognamiglio ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
The Elderly

Transcatheter closure of Abernethy malformation associated with interrupted inferior caval vein and other systemic venous anomalies

2021 ◽  
pp. 1-3
Author(s):  
Samir Shakya ◽  
Anita Saxena ◽  
Sivasubramanian Ramakrishnan
Keyword(s):  
Pulmonary Hypertension ◽  
Transcatheter Closure ◽  
Rare Entity ◽  
Severe Pulmonary Hypertension ◽  
Device Closure ◽  
Venous Anatomy ◽  
Vascular Plug ◽  
Caval Vein ◽  
Abernethy Malformation ◽  
Inferior Caval Vein

Abstract Abernethy malformation is a rare entity. We report a 5-year-old boy presenting with severe pulmonary hypertension in whom Abernethy malformation and inferior caval vein interruption were diagnosed by CT angiography. In addition, the iliac veins were thrombosed with multiple venous collateral drainage. This abnormal venous anatomy caused difficulty in device closure of the Abernethy malformation, which was successfully closed using a vascular plug.

scholarly journals Plasma exosomal miR-596: a novel biomarker predicts survival in patients with idiopathic pulmonary artery hypertension

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110023
Author(s):  
Yang Huang ◽  
Zuo-Gang Wang ◽  
Liang Tang ◽  
Su-Gang Gong ◽  
Yuan-Yuan Sun ◽  
...  
Keyword(s):  
Right Heart Catheterization ◽  
Pulmonary Artery Hypertension ◽  
Right Atrial ◽  
Heart Catheterization ◽  
Distribution Analysis ◽  
Poor Overall Survival ◽  
Transmission Electron ◽  
Exosomal Mirnas ◽  
Pulmonary Arterial

Objective To determine if plasma exosomal microRNAs (miRNAs) can predict survival in patients with idiopathic pulmonary arterial hypertension (IPAH). Methods The study enrolled patients with IPAH that underwent right heart catheterization. Plasma was collected and exosomal miRNAs were extracted. Exosomes were evaluated using transmission electron microscopy, Western blot analysis and particle size distribution analysis. MiRNAs were evaluated using a miRNA microarray and validated using real-time polymerase chain reaction. Results This study included 12 patients with IPAH in the study group and 48 patients with IPAH in the validation group. The mean ± SD follow-up duration was 60.3 ± 35.4 months in the overall cohort. The levels of miR-596 were higher in the nonsurvivors compared with the survivors. The levels of miR-596 significantly correlated with survival time, mean right atrial pressure, pulmonary vascular resistance (PVR) and cardiac index. High levels of miR-596 and PVR were significantly associated with poor overall survival. Multivariate analysis demonstrated that exosomal miR-596 (hazard ratio [HR] = 2.119; 95% confidence interval [CI] 1.402, 3.203) and PVR (HR = 1.146; 95% CI 1.010, 1.300) were independent predictors of survival. Conclusions High levels of plasma exosomal miR-596 were significantly associated with disease severity and poor prognosis of patients with IPAH.

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