Transcatheter Treatment of Large Aortopulmonary Window: A Case Report

2015 ◽  
Vol 18 (6) ◽  
pp. 237 ◽  
Author(s):  
Zuoyuan Chen ◽  
Jidong Zhang ◽  
Xiaxia Wang ◽  
Quansheng Xing ◽  
Hui Xin ◽  
...  
Keyword(s):  
Case Report ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Heart Diseases ◽  
Aortopulmonary Window ◽  
Residual Shunt ◽  
Pulmonary Arterial ◽  
Muscular Vsd ◽  
Severe Pulmonary Arterial Hypertension

<strong>Introduction:</strong> Aortopulmonary window (APW), a large aortopulmonary septal defect (APSD), is a serious and rare defect within congenital heart diseases. <br /><strong>Case report:</strong> In this study, we reported an APW case with severe pulmonary arterial hypertension. This patient was successfully treated by transcatheter closure with a muscular ventricular septal defect (VSD) occluder. <br /><strong>Conclusion:</strong> We had a successful experience with transcatheter closure of a large APW using a muscular VSD occluder. There was no residual shunt or complications during the 6-month follow-up.

scholarly journals CATHETER BASED CLOSURE OF HYPERTENSIVE PDA(S) WITH UNCONVENTIONAL DEVICES –IMMEDIATE AND SHORT TERM FOLLOW UP

2020 ◽  
pp. 1-3
Author(s):  
Mirza Mohd Kamran ◽  
Mahua Roy ◽  
Amitabha Chattopadhyay ◽  
Sushil Shukla
Keyword(s):  
Ventricular Dysfunction ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Left Ventricular ◽  
Device Closure ◽  
Short Term ◽  
Pulmonary Arterial ◽  
Muscular Vsd ◽  
Severe Pulmonary Arterial Hypertension

Patent ductus arteriosus (PDA) is a common form of CHD, accounts for approximately 8% of congenital heart disease with the incidence of one in 2500 to 5000 live births. More common in female. It may be asymptomatic and is sometimes not diagnosed early resulting into prolonged abnormal aorto-pulmonary shunt which may result in silently progressing hypertension and left ventricular dysfunction. This study aims to evaluate the immediate &short-term follow up results after TCC of large PDAs with severe pulmonary arterial hypertension (PHT) in children.This is a observational study of 38 patients with Large PDA and severe PHT who were referred to this centre for treatment during the period from July 2015 to Feb 2018 . After evaluating clinical and hemodynamic parameters reversibility of severe PAH was established and transcatheter closure of PDA was performed. Patients were followed up clinically and echocardiographically at 24 hours, 1 month, 3 months, 6 months, 12 months and 24 months to assess the efficacy, safety of the procedure & its impact on PHT. Thirty eight patients, (26 females, 12males) patients between 6 months to 16 years of age had underwent successful device closure. 18 patients had PDA sizes between 6-8 mm,12 had between 8- 10 mm , 6 had between 10-15mm and only 2 patients had largest PDA more than 15 mm at PA end . 5 patients were selected for closure with muscular VSD device . We have successfully closed 3 of our largest PDA (12 mm , 16mm and 18mm) with Post Infarct Muscular VSD Occluder measuring 20 mm,22 mm and 24 mm respectively. TCC of hypertensive but reversible PDA is feasible. The immediate and short-term outcomes have proven this method to be safe and valid.

Transcatheter closure as standard treatment for most interatrial defects: experience in 200 patients treated with the Amplatzer ™ Septal Occluder

1999 ◽  
Vol 9 (5) ◽  
pp. 468-473 ◽  
Author(s):  
Felix Berger ◽  
Peter Ewert ◽  
Per G. Boöjrnstad ◽  
Ingo Dähnert ◽  
Gregor Krings ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Paradoxical Embolism ◽  
Residual Shunt ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Diagnostic Cardiac Catheterization ◽  
Long Term Follow Up

AbstractTo judge whether an Amplatzer™ Septal Occluder can be used as standard therapy instead of surgery for closure of atrial septal defects we report our experiences in 200 patients. Of these patients, 127 had an atrial septal defect with haemodynamically significant left-to-right shunt, 68 patients a persistent oval foramen after presumed paradoxical embolism, and 5 had a fenestration after Fontan-repair. Mean age was 29.8 years (0.8 to 77.7 years). Body weight ranged from 6.9 to 120.0 kg (mean 51.5 kg). After diagnostic cardiac catheterization, and balloon-sizing of the defect, we implanted Amplatzer™ Septal Occluders with stents of 4 to 28 mm diameter. Follow-up studies were obtained after 48hours, and one, six, and twelve months. Transcatheter closure of the atrial septal defect proved successful in all without any relevant residual shunts. In particular, complete closure was achieved in all patients after presumed paradoxical embolism. The mean period of follow-up is 9–5 months, with a range from 0.4 to 23.5 months, giving a total of 1898 patient months. The occlusion rate after three month was 98.1°. A trivial haemodynamically insignificant residual shunt remained in 1.9° of the patients. Fluoroscopy times ranged from 0 to 43.5 minutes, with a median of 8.7 minutes. The excellent results in the short and medium term in children and adults have resulted in using this device routinely at the present time for closure of central atrial septal defects up to a diameter of 28 mm. Final judgement, however, is only possible after long-term follow-up.

scholarly journals Post-interventional Evaluation and Follow-Up in Children With Patent Ductus Arteriosus Complicated With Moderate to Severe Pulmonary Arterial Hypertension: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xing Rong ◽  
Qiaofang Ye ◽  
Qiaoyu Wang ◽  
Jiajun Wang ◽  
Qiongjun Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Arterial Hypertension ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Interventional Therapy ◽  
Defect Correction ◽  
Pulmonary Arterial ◽  
Severe Pulmonary Arterial Hypertension ◽  
Patent Ductus

Background: Transcatheter closure is an important treatment for patent ductus arteriosus (PDA) complicated with moderate and severe pulmonary arterial hypertension (PAH). This report presents our experience with transcatheter closure of PDA complicated with moderate and severe PAH.Methods: The 49 cases of PDA complicated with moderate and severe PAH were collected in the Second Affiliated Hospital and Yuying Children's Hospital from January 2014 to December 2019 with transcatheter closure of PDA and follow-up. All patients were invited for transthoracic echocardiography, electrocardiogram, and thoracic radiography check-up.Results: Device implantation was successful in 48 of 49 patients (98.0%). Among them, 30 cases were in the PAH after defect correction (CD) group, and 19 examples were in the Non-PAH after defect correction (NCD) group. Pulmonary systolic pressure, left atrial diameter, and left ventricular end-diastolic diameter immediately after interventional therapy and 6 months later were lower than the pre-operative levels (p &lt; 0.05). The incidence of the immediate residual shunt (RS) in this study was 34.9%, most of which were minimal amount shunt. RS disappeared in all patients within 1 year of therapy. Four patients had thrombocytopenia and one patient had left pulmonary artery stenosis. No other serious adverse event occurred during the follow-up period. The pressure gradient tricuspid valve regurgitation (PGTI) and the right heart catheterization (RHC) consistency points were 93.75% (15/16) and were within the 95% consistency limit by the Bland-Altman method. The Logistic regression analysis concluded that the pre-operative Pp/Ps and the narrowest diameter of PDA are risk factors for post-operative PAH (p &lt; 0.05). The cut-off point of the pre-operative Pp/Ps and the narrowest diameter of PDA were calculated to be 0.595 and 4.75 mm, respectively.Conclusion: Interventional occlusion in children with PDA complicated with moderate and severe PAH is safe, effective, and has few complications. Targeted drug therapy has a good clinical effect. The narrowest diameter of PDA and the pre-operative Pp/Ps may be one of the risk factors of residual PAH after interventional therapy.

Imaging-guided transseptal puncture and transcatheter closure of patent foramen ovale/atrial septal defect, ventricular septal defect, and paravalvular leaks

2021 ◽  
pp. 287-302
Author(s):  
Itzhak Kronzon ◽  
Juan Manuel Monteagudo ◽  
Francesco F. Faletra ◽  
Priti Mehla ◽  
Muhamed Saric
Keyword(s):  
Septal Defect ◽  
Transcatheter Closure ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Structural Heart Disease ◽  
Interventional Cardiology ◽  
Structural Heart Diseases ◽  
Procedural Guidance

Repairing structural heart diseases without surgery has been a major challenge. The title ‘The Father of Interventional Cardiology’ belongs to William J. Rushkind (1922–1986) who performed atrial balloon septostomy in newborn babies with D-transposition as early as 1968. He also designed devices for the transcatheter closure of atrial defects and of patent ductus arteriosus. The introduction of better devices and skilled operators led to successful procedures which are less traumatic, shorter, and in many cases significantly less expensive. The various modalities of cardiac imaging have become a crucial ingredient of the preprocedural diagnosis, procedural guidance, and the assessment of procedural results and follow-up. This chapter will demonstrate and discuss the role of imaging in several catheter-based procedures that are now commonly practised by the current generation of interventional cardiologists who are involved in structural heart disease.

scholarly journals Transcatheter Closure of Perimembranous Ventricular Septal Defect with Aneurysm: Radiologic Characteristic and Interventional Strategy

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Weibing Guo ◽  
Yifan Li ◽  
Jinjin Yu ◽  
Junjie Li ◽  
Ling Sun ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Type A ◽  
Left Ventricular ◽  
Type B ◽  
Residual Shunt ◽  
Perimembranous Ventricular Septal Defect ◽  
Type C

Objectives. We aimed to explore the radiologic characteristics and interventional strategies for perimembranous ventricular septal defect (pmVSD) with aneurysm. Methods. 257 patients who underwent transcatheter closure of pmVSD with aneurysm were included in our study. We retrospectively reviewed the left ventricular opening of the aneurysm (a), diameter of the midsegment of the aneurysm (b), and diameter of the right ventricular opening of the aneurysm (c). If there were multiple defects within the aneurysm, the largest defect was denoted as c1 and so forth. We developed a novel VSD classification method in which pmVSD with aneurysm was classified into three types (A, B, and C). When a >b ≥ c, it was classified as type A, when b > a ≥ c, it was type B, and when c > a ≥ b, it was type C; c/c1 described the relationship among defects. Results. All of the 257 cases of pmVSD with aneurysm were defined using left ventriculography: type A, 60, type B, 58, and type C, 139. Transcatheter closure was attempted in 244 patients and succeeded in 227 cases (success rate was 93.0%; 227/244). Forty symmetric VSD occluders and 13 asymmetric VSD occluders were used for type A aneurysm occlusion; 31 symmetric VSD occluders, 19 asymmetric VSD occluders, and one Amplatzer duct occluder II (ADOII) were used for type B; 59 VSD symmetric occluders, 59 asymmetric VSD occluders, three eccentric VSD occluders, and two ADOII were used for type C. Within 24 hours after procedure, 2.2% patients had postprocedural residual shunt, and 2.2% experienced malignant arrhythmia (including type II second-degree AVB, cAVB, and CLBBB). Two hundred and twelve patients completed follow-up (93%, 212/227). No new severe complications were reported during follow-up, except in one patient who underwent surgery (removal of the device, VSD repair, and tricuspid valvuloplasty) due to severe postprocedural tricuspid regurgitation. Conclusions. It is safe and effective to apply this method for the classification of pmVSD with aneurysm and its interventional strategy.

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