scholarly journals Percutaneous transcatheter intervention in a cyanotic congenital heart disease at tertiary care hospital in Western Rajasthan: a single centre experience

Author(s):  
Rohit Mathur ◽  
Deepak Gupta ◽  
Goutam Kumar ◽  
Sanjeev Sanghvi ◽  
Anil Baroopal

Background: Treatment of congenital heart disease (CHD) is either surgical or interventional. Medical management is mainly symptomatic or palliative. Although surgery is the main mode of treatment but in the recent past non-surgical interventional method is replacing it because of its multiple advantages over surgical procedures. In this article, we report the success rate of the percutaneous transcatheter device closure procedures in our tertiary care hospital.Methods: The aim of this study is to review the short-term outcome of the non-surgical interventional treatment of congenital heart diseases. We included percutaneous transcatheter device closure of atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA) and ruptured sinus of valsalva aneurysm (SVA) performed at our hospital between September 2014 and November 2016.Results: We performed total 28 cases of ASD device, 3 cases of VSD device, 12 cases of PDA device, 2 cases of ruptured SVA device closures. Almost all our intervention procedures were successful except two cases of failure of ASD closure. There was no mortality and major complication related to procedures. All patients of successful interventional treatment are enjoying new life without any morbidity.Conclusions: Percutaneous transcatheter device closure for suitably selected cases of a cyanotic CHDs including ASD, VSD, PDA and ruptured SVA may be an alternative, lucrative, safe and effective option with least morbidity and mortality.

2014 ◽  
Vol 6 (2) ◽  
pp. 133-142
Author(s):  
ABMA Salam ◽  
AMA Kamali ◽  
KA Hasan ◽  
H Ataul ◽  
M Selim ◽  
...  

Background: Treatment of Congenital Heart Disease (CHD) is either Surgical or Interventional. Medical management is mainly symptomatic / palliative. Although surgery is the main mode of treatment but in the recent past non-surgical Interventional method is replacing it because of its multiple advantages over surgical procedures. Since 2005, we started our journey in National Institute of Cardiovascular Diseases with a PDA device closure. In this article we tried to review the success rate of the interventional procedures in this hospital. Methods: The aim of this retrospective study is to review the short term & Intermediate outcome of the non surgical interventional treatment of congenital heart diseases. We included all the interventional rocedures done in this Institute since 2005 upto December 2013. Results: During this period, we performed total 150 cases of patent ductus arteriosus (PDA) device, 20 cases of PDA Coil closure, 60 cases of atrial septal defect (ASD) device, 90 cases of Balloon Pulmonary Valvuloplasty (BPV), 20 cases of Balloon Aortic Valvuloplasty (BAV), 22 cases of Coarctation Balloon Angioplasty, 35 cases of Mitral Valvuloplasty (PTMC), 15 cases of Balloon Atrial Septostomy. Almost all of our intervention procedures were successful except one case of mortality related to procedure of PDA device closure, 4 device embolization (2 ASD & 2 PDA) and one case of PDA coil with persistent Intravascular hemolysis. All the embolized devices were subsequently retrieved surgically with repair. All other patients of interventional treatment are enjoying new life without any morbidity. Conclusion: Thus, we concluded that interventional methods of suitably selected case of congenital heart disease may be an alternative lucrative safe & effective option of remedy for many of the congenital heart diseases. DOI: http://dx.doi.org/10.3329/cardio.v6i2.18354 Cardiovasc. j. 2014; 6(2): 133-142


2021 ◽  
Vol 11 (3) ◽  
pp. 191-196
Author(s):  
Fahmida Zabeen ◽  
Fauzia Mohsin ◽  
Eva Jesmin ◽  
Sharmin Mahbuba ◽  
M Quamrul Hassan

Background: Down syndrome or trisomy 21 is one of the most common chromosomal disorders with moderate intellectual disability. In addition to mental retardation, this syndrome is associated with different congenital anomalies and characteristic dysmorphic features. Affected individuals are more susceptible to congenital heart disease and digestive anomalies, pulmonary complications, immune and endocrine system disorders. While several international studies have shown association of co-morbidities with trisomy 21, there is insufficient data available in Bangladesh.The present study aimed to evaluate the associated co-morbidities in children with Down syndrome. Methods: A cross-sectional study was conducted among pediatric cases with Down syndrome who attended the endocrine outpatient department (OPD) of BIRDEM General Hospital from June 2006 to December 2016. The cases were diagnosed either by Karyotyping or by characteristic phenotypes.The clinical and laboratory data of the patients were collected from outpatient history records for analysis. Results: There were total 42 children with Down syndrome, with mean age 4.2 years at assessment and female predominance (1.47:1). Thyroid dysfunction was the most common (69%) followed by congenital heart disease (57%). Among the thyroid disorders, acquired hypothyroidism was found in 55% cases, congenital hypothyroidism in 41% cases and only one had hyperthyroidism. Isolated patent ductus arteriosus (PDA) and atrial septal defect (ASD) comprised the commonest single congenital heart disease found in 53% and combined atrioventricular septal defect was the commonest among complex congenital cardiac defect observed in our study. Both thyroid dysfunction and congenital heart disease were found more in female children with Down syndrome than their male counterpart and it was found statistically significant. Fifty percent of our Down syndrome cases were referred from other healthcare centers to address developmental delay. Conclusion: Hypothyroidism and congenital heart disease are frequently associated in Down syndrome children in Bangladesh. This calls for developing awareness among health professionals to diagnose comorbidities at an early stage and to form recommendations for long term follow up. BIRDEM Med J 2021; 11(3): 191-196


Author(s):  
Zubair Mushtaq Tramboo ◽  
Aamir Rashid Patigaroo ◽  
Nazir Ahmad

Background: Congenital heart disease is one of the major causes of mortality and morbidity in the paediatric population of both the developing and developed countries. Variability in incidence and prevalence of CHD from various countries of Indian subcontinent and rest of the world could be because of genetic, cultural, and environmental factors.  The objective of the study was to find the prevalence and pattern of CHD in a tertiary care hospital in Kashmir (Jammu and Kashmir).Methods: All children admitted at territary care hospital with age 0-15 years were screened for congenital heart disease. The study was conducted for period of one year to ascertain the prevalence and spectrum of CHDs.Results: A total of 232 patients out of 23000, were found having CHDs measuring a prevalence of 10.5/1000. About 170 (73%) were the acyanotics, and 62 (27%) were cyanotic heart patients. Among the acyanotic heart diseases ventricular septal defect was the most frequent lesion seen in 54 (23%), followed by patent ductus arteriosus in 50 (22%) children. Among the cyanotic heart diseases tetralogy of Fallot was the most frequent cyanotic heart disease seen in 15 (6.4%) patients.Conclusions: Authors observed high prevalence of CHD in our population. The pattern and spectrum of CHD were comparable to national and international data.


2020 ◽  
Vol 13 (4) ◽  
pp. 163-165
Author(s):  
Misbah Majeed ◽  
Muhammad Ashfaq ◽  
Bader U Nisa ◽  
Aijaz Ahmed ◽  
Jai Parkash

Background: Congenital heart disease (CHD) is one of the frequent congenital health issues in neonates. Early diagnosis is a key factor to combat this problem. This study aims to assess the frequency and common types of CHD among neonates presenting to a tertiary care hospital, Karachi. Patients and methods: This descriptive cross-sectional study was conducted in a Neonatal Intensive Care Unit (NICU) of National Institute of Child Health (NICH), Karachi from March to September 2017. All neonates of gestational age ≥37 weeks with suspected CHD (presence of blue-tinged skin, i.e. cyanosis on routine clinical examination) were included. Information regarding presence of CHD and its types were collected along with the demographic characteristics and history of the patients. Results: Of 134, frequency of CHD was observed in 126 (94%) patients. Out of these 126 CHD patients, Ventricular septal defect (VSD) was observed in 49 (38.9%), patent ductal arteriosus (PDA) in 29 (23%), atrial septal defect (ASD) was observed in 19 (15.1%), Transposition of great arteries (TGA) in 18 (14.3%), and tetralogy of Fallot (TOF) in 14 (11.1%) patients. A significant association of VSD was observed with neonatal age (p = <0.001), ASD with neonatal age (p = 0.037) and maternal age (p = 0.025), while TGA was found significantly associated with neonatal age (p<0.001). Conclusion: CHD was observed in majority of the suspected patients with VSD as commonest type of congenital heart diseases among neonates.


2020 ◽  
Vol 15 (1) ◽  
pp. 3-9
Author(s):  
Nurun Nahar Fatema Begum ◽  
Nazmul Islam Bhuiyan ◽  
Md Ashfaque Ahemmed Khan ◽  
Md Jahangir Alam

Introduction: In Bangladesh, 25/1000 cases of neonates are born with mild to severe type of congenital heart disease. Significant numbers of cases from new born to adult age group are reporting to OPD clinics with broad spectrum of congenital and grown up untreated heart diseases. This study will cover pattern of diseases among cases selected for cardiac catheterization and intervention in study group in a cardiac hospital with limited facility for children. Objectives: To analyze all the cases who had cardiac catheterization and intervention in said period and to see the outcome. Materials and Methods: It is a retrospective study conducted in a cardiac hospital from December 2014 to December 2019. All cases of cardiac catheterization and interventions were included in the study. Pattern of diseases, interventions, management and outcomes were analyzed. Results: Out of 1179 cases, 44.87% were male and 55.13% were female. Two hundred fifty four cases(21.54%) were in 0-1 year age group, 44.02% were in >01-05 year age group, 18.66% cases were in > 5 to 10 year , 8.48% cases were in >10 to 20 years, 4.83% cases were in> 20 to 30 years and 2.46% cases were in more than 30 year age group. Among trans-catheter closure patent ductus arteriosus (PDA) was the commonest type of intervention (44.68%), followed by atrial septal defect (ASD) (25.20%), ventricular septal defect (VSD) (11.83%) and balloon valvoplasty (BVP) for pulmonary stenosis (11.63%). Neonatal interventions were minimum as the coronary care unit used as post cathward had limited facility for neonatal care. PDA stenting was performed in 0.81% cases and BAS in 0.91% cases. Many patients underwent more than one intervention at a time; most common was ASD device closure and pulmonary valvoplasty. Cardiac Catheterization studies were minimum in this series and most of the cath study cases were VSD or/with other combinations (4.48%). Among infants (254), PDA device closure was the commonest intervention (64.56%) followed balloon valvoplasty for PS (15.35%) and balloon dilation of Coarctation on aorta (7.87%). Among implants, most commonly used were 8/6 mm (14.59%) Amplatzer Duct occluder (ADO), 6/4 ADOII, MF-Konar (9.79%) device and most common balloon used for valve or vessel dilation was 10x3 mm Tyshak II (3.26%). Only one mortality was noticed in a case of double intervention of critical Aortic and pulmonary valve stenosis. Conclusion: Commonest and established interventions were performed in this study other than few life saving interventions in neonates and outcome was excellent. Skilled team of pediatric cardiologist and technician in catheterization laboratory can bring success at the end of the day in spite of challenges. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 3-9


Author(s):  
Liz Orchard

Congenital heart disease is the most common congenital abnormality, affecting 0.8% of births. There have been major advances in both the surgical and interventional treatment of congenital heart disease, with about 85% of patients now surviving into adulthood. Congenital heart disease can be divided into simple and complex lesions. Simple lesions include atrial septal defect, ventricular septal defect, patent ductus arteriosus, coarctation of the aorta, and left ventricular outflow tract lesions. Complex lesions include tetralogy of Fallot, complete transposition of great arteries, single ventricle/Fontan physiology, pulmonary atresia, and Ebstein’s anomaly of the tricuspid valve. This chapter reviews the clinical features and management of those congenital cardiac disorders seen in adolescents and adults.


2017 ◽  
Vol 24 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Christopher A Rouse ◽  
Brandon T Woods ◽  
C Becket Mahnke

Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii. Results During the study period 100 infants received 192 tele-echocardiograms: 46% of infants had tele-echocardiograms completed for suspected patent ductus arteriosus, 28% for suspected congenital heart disease, 12% for possible congenital heart disease in the setting of likely pulmonary hypertension, and 10% for possible congenital heart disease in the setting of other congenital anomalies. Of these, 17 patients were aeromedically evacuated for cardiac reasons; 12 patients were transported to Hawaii, while five patients with complex heart disease were transported directly to the United States mainland for interventional cardiac capabilities not available in Hawaii. Discussion This study demonstrates the use of tele-echocardiography to guide treatment, reduce long and potentially risky trans-Pacific transports, and triage transports to destination centers with the most appropriate cardiac capabilities.


2001 ◽  
Vol 41 (5) ◽  
pp. 237
Author(s):  
Teddy Ontoseno

There were 40 adult congenital heart disease (CHD) patients seen in the Cardiology Division during 1 year (February 1993 - February 1994). The most frequently seen defect was atrial septal defect; however there were also cases with patent ductus arteriosus, pulmonary stenosis, ventricular septal defect, and tetralogy of Fallot. Hemodynamic disorder, serious hindrance to education achievement, and occupational threat due to limited physical capabilities as well as malnutrition are some of prominent issues to be closely anticipated. In general the older the patients the more serious hemodynamic disorder they suffer due CHD. It is worth thinking how to improve the quality of life of CHD patients who succeed to live their adult lives and minimize any possible fatal complication risks.


1970 ◽  
Vol 1 (1) ◽  
pp. 14-20 ◽  
Author(s):  
NN Fatema ◽  
RB Chowdhury ◽  
L Chowdhury

Background: Incidence of congenital heart disease is 8-10/1000 live birth which is established by many studies carried out in many centers worldwide. In Bangladesh no incidence study was carried out so far. Newborn children presenting with various forms of congenital heart disease is a common problem now a days. Neonatologists and paediatricians are now more conscious about early detection and treatment of newborn with congenital heart diseases. Diagnostic facilities are also available in many places. So an individual incidence record from an ideal center of our country is a demand of the time which led carrying out this study. Methods: This prospective study was carried out in Combined Military Hospital (CMH) Dhaka over a period of three years (2004 – 2006). All five thousand six hundred and sixty eight live births weighing more than 500 gm and more than 28 weeks gestational period were subjected to a thorough clinical examination within 72 hours of birth. Those suspected to have any form of congenital heart disease (CHD) were followed up every 4-6 wks for a period of 12 months. Echocardiography with color Doppler was performed in all these newborn including those who reported late but were delivered in obstetrics department of Combined Military Hospital Dhaka. Result: One hundred forty two babies out of 5668 live birth had CHD, ie, 25/1000 live births. Incidence of CHD was higher in pre terms as compared to full term live birth. Some of the patients (18.30%) has other associated somatic anomalies among which Down’s syndrome was commonest (9.15%). Most common congenital heart lesions were Atrial Septal Defect (ASD-26%), Ventricular Septal Defect (VSD-16.9%), Patent Ductus Arteriosus (PDA-18%), Tetralogy of Fallot (TOF-14%), Pulmonary Stenosis (PS-7.75%) etc. Those who were found to have congenital heart disease were managed accordingly. Some patients had spontaneous closure of defects in first year follow up period. Conclusion: The incidence of Congenital Heart Disease (CHD) depends upon various factors like nature of the samples (all live birth or all birth) or on the spot examination by a Paediatric cardiologist. A hospital which has Obstetric, Neonatal and Paediatric cardiology unit can carried out this kind of study successfully. In this study screening of asymptomatic high risk neonates also contributes in early detection of many trivial lesions. Severe lesions were also detected by the paediatric cardiologist who usually expire before being referred from other hospitals and before being diagnosis is established. So a higher incidence rate is recorded in this study. Key words: Congenital heart disease; Echocardiography DOI: http://dx.doi.org/10.3329/cardio.v1i1.8199 Cardiovasc. j. 2008; 1(1) : 14-20  


Author(s):  
Subha Sivagami Sengodan ◽  
Shobhika Selvaraj

Background: Incidence of pregnancy in women with heart disease is increasing due to the increasing number of women with congenital heart disease. Although most cardiac conditions are well tolerated during pregnancy, there are some conditions that have adverse fetal and maternal outcome. Objective of this study is to study the prevalence of heart disease in antenatal mothers and fetal outcome with obstetric management.Methods: This is a prospective observational study carried out in the Department of Obstetrics and Gynaecology at Government Mohan Kumaramangalam Medical College and Hospital during January 2018 to March 2019 for a period of fifteen months. Authors included 149 antenatal mothers with heart disease and analysed the data using percentage analysis through excel software.Results: Incidence of heart disease in pregnancy was observed to be 1.2%. Rheumatic heart disease being 73.8%, congenital being 22.8% and complete heart block was 3.4%. Among rheumatic heart disease mitral stenosis was the most common lesion. Atrial septal defect was the most common congenital heart disease. The mean gestational age of delivery was 37 to 38 weeks. 58% delivered by vaginal route. Most common neonatal complication was prematurity. Pregnancy and neonatal outcome were favorable.Conclusions: Heart disease complicating pregnancy has increased due to late marriage, obesity, hypertension and diabetes. Early referral, regular follow-up and multi-disciplinary approach with tertiary care back-up will bring a favorable maternal and neonatal outcome in patients with heart disease.


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