RESUMEN
"Cases of SCMR" is a case series on the SCMR website (https://www.scmr.org) for the purpose of education. The cases reflect the clinical presentation, and the use of cardiovascular magnetic resonance (CMR) in the diagnosis and management of cardiovascular disease. The 2022 digital collection of cases are presented in this manuscript.
Asunto(s)
Enfermedades Cardiovasculares , Valor Predictivo de las Pruebas , Humanos , Enfermedades Cardiovasculares/diagnóstico por imagen , Enfermedades Cardiovasculares/terapia , Persona de Mediana Edad , Femenino , Masculino , Anciano , Imagen por Resonancia Magnética , Adulto , Pronóstico , Adulto JovenRESUMEN
Transcatheter closure of septal defects using specialized devices is a common procedure that has a high success rate. Embolization of Atrial septal defect devices is a known complication seen at a rate of 0.5%. We report a case of late ASD device occluder embolization immediately after brain MRI with clinical consequences and intraoperative evidence of right atrial wall thermal injury. To our knowledge Atrial septal occluder (ASO) device embolization post magnetic resonance imaging (MRI) was not reported before, although theoretically possible and that's why six to eight weeks post device implantation MRI is prohibited even with current MRI compatible devices.
RESUMEN
Cardiac catheterization can affect clinical outcomes in patients on extracorporeal membrane oxygenation (ECMO) after congenital heart surgery; however, its effect in this group of patients remains unclear. This study aimed to evaluate the safety and outcome of cardiac catheterization in patients undergoing ECMO after congenital cardiac surgery and determine predictors that influence successful weaning. This retrospective cohort study included pediatric patients who underwent cardiac catheterization while on ECMO after congenital heart surgery in two cardiac centers between November 2012 and February 2020. Predictors of successful weaning from ECMO were studied using univariate and multivariate logistic regression analyses. Of 123 patients on ECMO support after congenital cardiac surgery, 60 patients underwent 60 cardiac catheterizations (31 diagnostic and 29 interventional). Thirty-four (56.7%) and 22 patients (36.7%) underwent successful decannulation from ECMO support and survived after hospital discharge, respectively. Patients who underwent earlier catheterization (within 24 h of ECMO initiation) had more successful weaning from ECMO and survival compared to others. Patients who underwent an interventional procedure (interventional catheterization or redo cardiac surgery after cardiac catheterization) had better survival than those who underwent only diagnostic catheterization (P = 0.038). Shorter durations of ECMO was the most important predictor of successful weaning from ECMO. Early cardiac catheterization greatly impacts successful weaning from ECMO and survival. Patients with correctable lesions amenable either by catheterization or redo surgery are more likely to survive. Shorter durations of ECMO could have a significant influence on successful weaning from ECMO and survival.
