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1.
Eur Heart J ; 45(3): 198-210, 2024 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-37874971

RESUMEN

BACKGROUND AND AIMS: Transcatheter pulmonary valve implantation (TPVI) is indicated to treat right-ventricular outflow tract (RVOT) dysfunction related to congenital heart disease (CHD). Outcomes of TPVI with the SAPIEN 3 valve that are insufficiently documented were investigated in the EUROPULMS3 registry of SAPIEN 3-TPVI. METHODS: Patient-related, procedural, and follow-up outcome data were retrospectively assessed in this observational cohort from 35 centres in 15 countries. RESULTS: Data for 840 consecutive patients treated in 2014-2021 at a median age of 29.2 (19.0-41.6) years were obtained. The most common diagnosis was conotruncal defect (70.5%), with a native or patched RVOT in 50.7% of all patients. Valve sizes were 20, 23, 26, and 29 mm in 0.4%, 25.5%, 32.1%, and 42.0% of patients, respectively. Valve implantation was successful in 98.5% [95% confidence interval (CI), 97.4%-99.2%] of patients. Median follow-up was 20.3 (7.1-38.4) months. Eight patients experienced infective endocarditis; 11 required pulmonary valve replacement, with a lower incidence for larger valves (P = .009), and four experienced pulmonary valve thrombosis, including one who died and three who recovered with anticoagulation. Cumulative incidences (95%CI) 1, 3, and 6 years after TPVI were as follows: infective endocarditis, 0.5% (0.0%-1.0%), 0.9% (0.2%-1.6%), and 3.8% (0.0%-8.4%); pulmonary valve replacement, 0.4% (0.0%-0.8%), 1.3% (0.2%-2.4%), and 8.0% (1.2%-14.8%); and pulmonary valve thrombosis, 0.4% (0.0%-0.9%), 0.7% (0.0%-1.3%), and 0.7% (0.0%-1.3%), respectively. CONCLUSIONS: Outcomes of SAPIEN 3 TPVI were favourable in patients with CHD, half of whom had native or patched RVOTs.


Asunto(s)
Endocarditis Bacteriana , Endocarditis , Cardiopatías Congénitas , Implantación de Prótesis de Válvulas Cardíacas , Prótesis Valvulares Cardíacas , Insuficiencia de la Válvula Pulmonar , Válvula Pulmonar , Trombosis , Adulto , Humanos , Cateterismo Cardíaco/efectos adversos , Endocarditis/epidemiología , Endocarditis Bacteriana/complicaciones , Cardiopatías Congénitas/complicaciones , Prótesis Valvulares Cardíacas/efectos adversos , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Diseño de Prótesis , Válvula Pulmonar/cirugía , Insuficiencia de la Válvula Pulmonar/epidemiología , Insuficiencia de la Válvula Pulmonar/cirugía , Sistema de Registros , Estudios Retrospectivos , Trombosis/etiología , Resultado del Tratamiento
2.
Catheter Cardiovasc Interv ; 103(2): 322-325, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38091330

RESUMEN

Aortic wall injuries may occur after interventional treatment of aortic coarctation (CoA), especially after balloon angioplasty. We reported on a patient who presented with an intra-stent aneurysm formation after direct stenting of a native near atretic aortic CoA by using a BeGraft Aortic stent. This evidence supports the need to maintain a strict follow-up protocol. A computed tomography scan is mandatory, after covered stent implantation as well, especially in high-risk cases and even in the absence of any immediate apparent complication.


Asunto(s)
Aneurisma de la Aorta , Coartación Aórtica , Humanos , Resultado del Tratamiento , Aorta/lesiones , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/etiología , Aneurisma de la Aorta/cirugía , Stents/efectos adversos , Coartación Aórtica/diagnóstico por imagen , Coartación Aórtica/cirugía
3.
Pediatr Cardiol ; 45(3): 695-698, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38308059

RESUMEN

The Atrial Flow Regulator (AFR) is a self-expandable double-disc device with a central fenestration, intended to maintain a calibrated communication across the interatrial septum. We reported for the first time a stent implantation across an AFR device in an adolescent born with complex congenital heart disease with duct-dependent systemic circulation and severe combined pulmonary hypertension.


Asunto(s)
Tabique Interatrial , Hipertensión Pulmonar , Adolescente , Humanos , Atrios Cardíacos/cirugía , Tabique Interatrial/diagnóstico por imagen , Tabique Interatrial/cirugía , Stents
4.
Pediatr Cardiol ; 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38727825

RESUMEN

This study aimed to evaluate the current state of congenital interventional cardiology training worldwide, with a focus on case volumes, competency assessment, and the need for ongoing mentorship during early career stages. A survey was conducted among program directors (PDs) of congenital interventional training programs across the globe. The survey gathered data on training pathways, case volumes, types of procedures performed, trainee competency assessment, and the role of ongoing mentorship. Of the 79 PDs who completed the survey, it was observed that training pathways and case volumes varied significantly, particularly between the United States and other countries. Most PDs reported an annual laboratory case volume of >500 congenital cardiac cases, with most cases being interventional. While trainees demonstrated competency in simple procedures (diagnostic cases, simple ASD closure), complex interventions (such as patent ductus arteriosus closure in premature infants) require ongoing mentorship for graduates. PDs recommended a minimum case volume of 400 total cases for trainees, including 250 interventional cases. In addition to case volumes, assessing trainee competency was deemed important, with clinical reasoning, judgment, skillset, teamwork, and complication management being key areas of evaluation. The study highlights the variability in congenital interventional cardiology training and the need for ongoing mentorship during the early career years. External mentorship programs, facilitated by national and international societies, are proposed to provide critical support for early career interventionalists thus enhancing patient care for congenital heart disease. Ultimately, the findings of this survey may serve as a framework for future training standards and guidelines in this specialized field.

5.
Catheter Cardiovasc Interv ; 101(6): 1098-1107, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37002948

RESUMEN

BACKGROUND: The superior sinus venosus atrial septal defect is a congenital communication between the left and right atria. Open surgical approach by patch closure has historically been the only treatment option. Recently, a transcatheter approach has been developed. This study aims to compare the efficacy and safety of surgical and transcatheter approach in treatment of sinus venosus atrial septal defect. METHODS: Between March 2010 and December 2020, 58 patients (median age: 45.4, range 14.8-73.8) underwent either surgical or transcatheter correction of superior sinus venosus atrial septal defect with partial anomalous pulmonary venous drainage. RESULTS: Twenty-four patients (median age: 35.4, range 14.8-66.8) underwent surgery while 34 patients (median age: 46.8, range 15.5-73.8) had a transcatheter treatment. During the catheterization era, 41 patients was considered suitable for a transcatheter closure. In 5 patients, surgery was the patient's or referring physician's choice. In 2 cases, the procedure was unsuccessful; the remaining 34 were successfully closed (94.4% of cases). Intensive care unit stay (median of 1 day, range 0.5-4, vs. 0, range 0-2, p < 0.0001) and hospital stay (median 7 days, range 2-15 vs. 2 days, range 1-12, p < 0.0001), were significantly longer in the surgery group. Total early complication rate, consisted on procedural and in-hospital complication, were higher in the surgical group (62.5% vs. 23.5%; p = 0.005). However, complications in both groups were clinically mild. At follow-up, a small residual shunt was present in 6 patients (surgery group: 2 pts; catheterization group: 4 pts; p: NS). Imaging studies showed significant improvement of right ventricular size and unobstructed pulmonary venous return in all patients. No late complications occurred at follow-up. CONCLUSIONS: Transcatheter correction of sinus venosus atrial septal defect is effective and safe in selected patients and may be considered as a valid alternative to surgery.


Asunto(s)
Apéndice Atrial , Defectos del Tabique Interatrial , Humanos , Persona de Mediana Edad , Adulto , Resultado del Tratamiento , Atrios Cardíacos , Defectos del Tabique Interatrial/diagnóstico por imagen , Defectos del Tabique Interatrial/terapia
6.
Pediatr Cardiol ; 2023 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-36795121

RESUMEN

The Atrial Flow Regulator (AFR) is a self-expandable double-disk device with a central fenestration, intended to maintain a calibrated communication across the interatrial septum. Only case reports and small case series have been published about its use in the pediatric and congenital heart disease (CHD) population. We described AFR implantation in three congenital patients with different anatomies and indications. In the first case, the AFR was deployed to create a stable fenestration in a Fontan conduit, while in the second, it was used to reduce a Fontan fenestration. In the third case, we implanted an AFR to decompress the left atrium of an adolescent with complex CHD in natural history, with complete mixing, ductal-dependent systemic circulation and combined pulmonary hypertension. This case series demonstrates the great potential of the AFR device in the CHD field, showing versatility, efficacy, and safety in establishing a calibrated and stable shunt, with promising hemodynamic and symptomatic benefits.

7.
Cardiol Young ; 33(8): 1468-1470, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36720716

RESUMEN

Pulmonary artery stenosis is one of the most common complications after arterial switch operation. Stent implantation is an effective treatment with some risks related to coronary artery compression. We present the case of a patient affected by pulmonary stenosis after arterial switch operation. Coronary compression testing demonstrated compression of the left coronary artery from the balloon inflated in the left pulmonary artery. We should systematically consider the use of coronary balloon testing before stent implantation in patients with a history of switch operation.


Asunto(s)
Operación de Switch Arterial , Transposición de los Grandes Vasos , Humanos , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Operación de Switch Arterial/efectos adversos , Transposición de los Grandes Vasos/cirugía , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/cirugía , Stents
8.
Cardiol Young ; : 1-8, 2023 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-37212061

RESUMEN

To reflect new developments in imaging, indications, and techniques in catheterisation of patients with CHD, the training recommendations of the Association for European Paediatric and Congenital Cardiology (AEPC) for the training in interventional catheterisation for CHD have been reviewed and updated after more than 7 years. They include detailed information about knowledge, skills, and approach to clinical practice expected from trainees at basic, intermediate, and advanced level.

9.
Am J Med Genet A ; 185(10): 3153-3160, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34159694

RESUMEN

Biallelic mutations in B3GALT6, coding for a galactosyltransferase involved in the synthesis of glycosaminoglycans (GAGs), have been associated with various clinical conditions, causing spondyloepimetaphyseal dysplasia with joint laxity type 1 (SEMDJL1 or SEMDJL Beighton type), Al-Gazali syndrome (ALGAZ), and a severe progeroid form of Ehlers-Danlos syndrome (EDSSPD2). In the 2017 Ehlers-Danlos syndrome (EDS) classification, Beta3GalT6-related disorders were grouped in the spondylodysplastic EDSs together with spondylodysplastic EDSs due to B4GALT7 and SLC39A13 mutations. Herein, we describe a patient with a previously unreported homozygous pathogenic B3GALT6 variant resulting in a complex phenotype more severe than spondyloepimetaphyseal dysplasia with joint laxity type 1, and having dural ectasia and aortic dilation as additionally associated features, further broadening the phenotypic spectrum of the Beta3GalT6-related syndromes. We also document the utility of repeating sequencing in patients with uninformative exomes, particularly when performed by using "first generations" enrichment capture methods.


Asunto(s)
Galactosiltransferasas/genética , Inestabilidad de la Articulación/genética , Osteocondrodisplasias/genética , Anomalías Múltiples/genética , Anomalías Múltiples/patología , Adolescente , Adulto , Segmento Anterior del Ojo/anomalías , Segmento Anterior del Ojo/patología , Huesos/anomalías , Huesos/patología , Niño , Preescolar , Síndrome de Ehlers-Danlos/genética , Síndrome de Ehlers-Danlos/patología , Femenino , Homocigoto , Humanos , Inestabilidad de la Articulación/diagnóstico , Inestabilidad de la Articulación/diagnóstico por imagen , Inestabilidad de la Articulación/patología , Inestabilidad de la Articulación/fisiopatología , Mutación/genética , Osteocondrodisplasias/diagnóstico , Osteocondrodisplasias/diagnóstico por imagen , Osteocondrodisplasias/fisiopatología , Fenotipo , Adulto Joven
10.
Catheter Cardiovasc Interv ; 98(1): 128-136, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33909945

RESUMEN

BACKGROUND: Covered stent correction of sinus venosus ASDs (SVASD) is a relatively new technique. Challenges include anchoring a sufficiently long stent in a nonstenotic superior vena cava (SVC) and expanding the stent at the wider SVC-RA junction without obstructing the anomalous right upper pulmonary vein (RUPV). The 10-zig covered Cheatham-platinum (CCP) stent has the advantage of being available in lengths of 5-11 cm and dilatable to 34 mm in diameter. METHODS: An international registry reviewed the outcomes of 10-zig CCP stents in 75 patients aged 11.4-75.9 years (median 45.4) from March 2016. Additional stents were used to anchor the stent in the SVC or close residual shunts in 33/75. An additional stent was placed in 4/5 (80%) with 5/5.5 cm CCPs, 18/29 (62%) with 6 cm CCPs, 5/18 (28%) with 7 cm CCPs, 5/22 (23%) with 7.5/8 cm CCPs and 0/1 with an 11 cm CCP. A "protective" balloon catheter was inflated in the RUPV in 17. RESULTS: Early stent embolization in two patients required surgical removal and defect repair and tamponade was drained in one patient. The CT at 3 months showed occlusion of the RUPV in one patient. Follow up is from 2 months to 5.1 years (median 1.8 years). QP:QS has reduced from 2.5 ± 0.5 to 1.2 ± 0.36 (p < .001) and RVEDVi from 149.1 ± 35.4 to 95.6 ± 21.43 ml/m2 (p < .001). CONCLUSIONS: Ten-zig CCPs of 7-8 cm appear to provide reliable SVASD closure with a low requirement for additional stents. Careful selection of patients and meticulous attention to detail is required to avoid complications.


Asunto(s)
Defectos del Tabique Interatrial , Platino (Metal) , Humanos , Sistema de Registros , Stents , Resultado del Tratamiento , Vena Cava Superior
11.
Cardiol Young ; 31(2): 224-228, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33172512

RESUMEN

OBJECTIVES: We report our experience of using the Bentley BeGraft Aortic stent in patients with severe or near-atretic aortic coarctation and small femoral arterial access. BACKGROUND: Use of covered stent is recommended in some settings such as aortic coarctation with associated aneurysm, Turner syndrome, and coarctation with aortic atresia. However, currently available covered stents need larger sheaths that may limit their use in children and patients with smaller arterial access. Newer stents may overcome this limitation. METHODS: Single-centre retrospective study of patients with severe or near-atretic aortic coarctation and small femoral arterial access. RESULTS: Between July and October, 2019, five patients (median age 15 years) with near-atretic or severe coarctation were treated with a Bentley BeGraft Aortic stent. Long sheaths between 9 and 11 Fr were used to implant stents, which were dilated up to 12-16 mm. None of the patients had residual coarctation (gradient >20 mm of mercury) after stenting. None of the patients developed acute vascular injuries or local access related complications at the end of the procedure or during follow-up (range 6-10 months). CONCLUSIONS: Bentley BeGraft aortic stents are important to consider in patients with severe coarctation and provided acute procedural success in patients with small femoral arterial access and widen the applicability in this patient population.


Asunto(s)
Coartación Aórtica , Adolescente , Coartación Aórtica/diagnóstico por imagen , Coartación Aórtica/cirugía , Niño , Arteria Femoral/diagnóstico por imagen , Arteria Femoral/cirugía , Humanos , Estudios Retrospectivos , Stents , Resultado del Tratamiento
12.
Catheter Cardiovasc Interv ; 95(5): 950-953, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-31912986

RESUMEN

Trans-apical approach has been proved successful in failing surgical bio-prosthesis in both mitral and aortic position in adult patients. Recently, valve-in-valve treatments have been applied even in patients with complex congenital heart disease. Here, we report the case of a 32 years old lady with left atrial isomerism, complete AV septal defect, interrupted inferior vena cava with azygos continuation who underwent Kawashima procedure with atrial Fontan. Severe systemic atrioventricular valve regurgitation necessitated a 33 mm Perimount valve implantation and conversion to lateral tunnel Fontan. After only 4 years there was severe valve stenosis and the patient underwent successful trans-apical transcatheter implantation of a 29 mm Sapien valve.


Asunto(s)
Cateterismo Cardíaco/instrumentación , Procedimiento de Fontan , Cardiopatías Congénitas/cirugía , Implantación de Prótesis de Válvulas Cardíacas/instrumentación , Prótesis Valvulares Cardíacas , Insuficiencia de la Válvula Tricúspide/cirugía , Estenosis de la Válvula Tricúspide/cirugía , Válvula Tricúspide/cirugía , Adulto , Femenino , Procedimiento de Fontan/efectos adversos , Cardiopatías Congénitas/diagnóstico por imagen , Cardiopatías Congénitas/fisiopatología , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Humanos , Diseño de Prótesis , Recuperación de la Función , Resultado del Tratamiento , Válvula Tricúspide/diagnóstico por imagen , Válvula Tricúspide/fisiopatología , Insuficiencia de la Válvula Tricúspide/diagnóstico por imagen , Insuficiencia de la Válvula Tricúspide/etiología , Insuficiencia de la Válvula Tricúspide/fisiopatología , Estenosis de la Válvula Tricúspide/diagnóstico por imagen , Estenosis de la Válvula Tricúspide/etiología , Estenosis de la Válvula Tricúspide/fisiopatología
13.
Catheter Cardiovasc Interv ; 93(1): 105-107, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30196553

RESUMEN

Here, we report on the case of a 4-year-old child with large atrial septal defect (ASD) and severe pulmonary hypertension presenting an ischemic cardiomyopathy secondary to left main (LM) compression by a dilated pulmonary artery trunk. Despite of surgical treatment consisting in ASD closure and coronary artery bypass grafting, the patient was not weanable from ECMO. Control coronarography showed a near-occlusion of the left mammary bypass. A rescue percutaneous LM angioplasty with drug-eluting stent implantation was performed.


Asunto(s)
Angioplastia Coronaria con Balón/instrumentación , Estenosis Coronaria/terapia , Stents Liberadores de Fármacos , Hipertensión Arterial Pulmonar/complicaciones , Antihipertensivos/uso terapéutico , Preescolar , Estenosis Coronaria/diagnóstico por imagen , Estenosis Coronaria/etiología , Estenosis Coronaria/fisiopatología , Urgencias Médicas , Humanos , Masculino , Hipertensión Arterial Pulmonar/diagnóstico por imagen , Hipertensión Arterial Pulmonar/tratamiento farmacológico , Hipertensión Arterial Pulmonar/fisiopatología , Resultado del Tratamiento
14.
Curr Cardiol Rep ; 21(7): 59, 2019 05 20.
Artículo en Inglés | MEDLINE | ID: mdl-31111245

RESUMEN

PURPOSE OF REVIEW: This review aims to delineate the actual role of percutaneous intervention in the closure of post-myocardial infarction ventricular septal defect (post-MI VSD) and to briefly summarize the main steps of this procedure. RECENT FINDINGS: Most of the published studies report experiences using Amplatzer devices for post-MI VSD closure. In the acute phase, morbidity and mortality are quite high up to 70%, with a mean success rate of 90%, with 95% confidence intervals from 60 to 100%, and a 30-day mortality of 40%, with 95% confidence intervals from 0 to 55%. In the chronic phase, that is 14 days after myocardial infarction, results are very encouraging, with lower morbidity and mortality (23% at 30 days) and a higher rate of complete closure. A multimodality imaging approach has been proposed in order to increase the success rate of this procedure. Percutaneous closure is a safe and effective procedure in highly specialized centers and an appropriate patient selection is of paramount importance to the success of the procedure. Device closure of post-MI VSD can be considered a true alternative to the standard surgical approach. However, many problems still exist for percutaneous post-MI VSD treatment.


Asunto(s)
Cateterismo Cardíaco/métodos , Defectos del Tabique Interventricular/cirugía , Infarto del Miocardio/complicaciones , Dispositivo Oclusor Septal , Cateterismo Cardíaco/efectos adversos , Defectos del Tabique Interventricular/diagnóstico , Defectos del Tabique Interventricular/etiología , Humanos , Infarto del Miocardio/cirugía , Complicaciones Posoperatorias , Pronóstico , Factores de Tiempo , Resultado del Tratamiento
15.
Cardiol Young ; 29(10): 1302-1304, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31475651

RESUMEN

A new approach was used in the percutaneous treatment of two patients with severe recoarctation involving the origin of the left subclavian artery. A tiny handmade fenestration was created in a NuMED-covered Cheatham-platinum stent before its implantation to avoid left subclavian artery occlusion. The stent placement was performed using a two-guidewire technique in which the different stiffness helped a proper positioning of the stent. After the stent deployment, the fenestration was enlarged performing a balloon angioplasty to improve flow in left subclavian artery.


Asunto(s)
Aorta Torácica/cirugía , Coartación Aórtica/cirugía , Implantación de Prótesis Vascular/métodos , Materiales Biocompatibles Revestidos , Platino (Metal) , Arteria Subclavia/cirugía , Adulto , Coartación Aórtica/diagnóstico , Aortografía/métodos , Niño , Femenino , Humanos , Masculino , Diseño de Prótesis
16.
Catheter Cardiovasc Interv ; 92(7): 1329-1333, 2018 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-30196540

RESUMEN

We report on three cases of atrial septal defect (ASD) closure where a handmade fenestration had to be modified after device implantation. Two patients suffered from left ventricular diastolic dysfunction and one had severe pulmonary arterial hypertension. Amplatzer ASD occluder fenestration was created in all patients. Devices were implanted using an "over-the-wire" implantation technique. Due to a sub-optimal hemodynamic result, fenestration was upsized by using a new technique.


Asunto(s)
Angioplastia de Balón/instrumentación , Cateterismo Cardíaco/instrumentación , Defectos del Tabique Interatrial/terapia , Dispositivo Oclusor Septal , Dispositivos de Acceso Vascular , Femenino , Defectos del Tabique Interatrial/diagnóstico por imagen , Defectos del Tabique Interatrial/fisiopatología , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Resultado del Tratamiento , Función Ventricular Izquierda
17.
Catheter Cardiovasc Interv ; 91(5): 927-931, 2018 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-29405557

RESUMEN

Nowadays, percutaneous pulmonary valve implantation (PPVI) is a suitable alternative to surgical procedure in patients with right ventricle outflow tract dysfunction. Two valves are currently available for PPVI: the Melody valve and the Edwards Sapien valve. The following complications may occur: coronary artery compression, deformation of the aortic root, stent or valve embolization, damage of distal pulmonary arteries, access site injuries. Here, we report on three cases of severe tricuspid regurgitation due to valvular and subvalvular apparatus damage during Edwards Sapien XT valve implantation.


Asunto(s)
Lesiones Cardíacas/etiología , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Implantación de Prótesis de Válvulas Cardíacas/instrumentación , Prótesis Valvulares Cardíacas , Válvula Pulmonar/cirugía , Insuficiencia de la Válvula Tricúspide/etiología , Válvula Tricúspide/lesiones , Adolescente , Angiografía , Anuloplastia de la Válvula Cardíaca , Ecocardiografía Doppler en Color , Femenino , Lesiones Cardíacas/diagnóstico por imagen , Lesiones Cardíacas/fisiopatología , Hemodinámica , Humanos , Masculino , Diseño de Prótesis , Válvula Pulmonar/diagnóstico por imagen , Válvula Pulmonar/fisiopatología , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Válvula Tricúspide/diagnóstico por imagen , Válvula Tricúspide/fisiopatología , Válvula Tricúspide/cirugía , Insuficiencia de la Válvula Tricúspide/diagnóstico por imagen , Insuficiencia de la Válvula Tricúspide/fisiopatología , Insuficiencia de la Válvula Tricúspide/cirugía
18.
Cardiol Young ; 28(11): 1345-1347, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-29998810

RESUMEN

Disconnection of a pulmonary artery needs early surgical treatment in order to support the growth of the vessel. However, owing to the high rate of re-stenosis after traditional surgical reconstruction, we developed a hybrid approach involving the creation of pulmonary artery continuity by using autologous or heterologous tissue supported by stent implantation.


Asunto(s)
Prótesis Vascular , Procedimientos Quirúrgicos Cardíacos/métodos , Cardiopatías Congénitas/cirugía , Complicaciones Posoperatorias/prevención & control , Arteria Pulmonar/anomalías , Stents , Angiografía , Ecocardiografía , Cardiopatías Congénitas/diagnóstico , Humanos , Lactante , Recién Nacido , Masculino , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía
19.
Catheter Cardiovasc Interv ; 89(1): 120-123, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27315359

RESUMEN

Secundum atrial septum defect (ASD) is the most common congenital heart disease. It is usually treated by a transcatheter approach using a femoral venous access. In case of bilateral femoral vein occlusion, the internal jugular venous approach for ASD closure is an option, in particular in cases where ASD balloon occlusion test and sizing is needed. Here, we report on a new technique for ASD closure using a venous-arterial circuit from the right internal jugular vein to the femoral artery. Two patients (females, 4 and 10 years of age) had occlusion of both femoral veins because of a previous history of pulmonary atresia and intact ventricular septum, for which they underwent percutaneous radiofrequency perforation and balloon angioplasty. These subjects needed balloon occlusion test of a residual ASD to size the hole and to check for hemodynamic suitability to ASD closure. After performing a venous-arterial circuit, a 24 mm St Jude ASD sizing balloon catheter was advanced over the circuit and the defect closed for 15 min to check hemodynamics and size the defect. ASD was closed is hemodinamically suitable. This technique was safe and reliable. © 2016 Wiley Periodicals, Inc.


Asunto(s)
Oclusión con Balón/instrumentación , Cateterismo Cardíaco/instrumentación , Catéteres Cardíacos , Cateterismo Venoso Central/métodos , Defectos del Tabique Interatrial/terapia , Venas Yugulares , Dispositivo Oclusor Septal , Oclusión con Balón/métodos , Cateterismo Cardíaco/métodos , Niño , Preescolar , Femenino , Defectos del Tabique Interatrial/diagnóstico por imagen , Defectos del Tabique Interatrial/fisiopatología , Hemodinámica , Humanos , Venas Yugulares/diagnóstico por imagen , Flebografía , Diseño de Prótesis , Resultado del Tratamiento
20.
Catheter Cardiovasc Interv ; 89(3): 480-483, 2017 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-27515784

RESUMEN

INTRODUCTION: Patent foramen ovale (PFO) closure is a widely performed procedure. Understanding the anatomy is mandatory in order to perform the procedure successfully. The degree of overlap between the septum primum and secundum is called the tunnel. In particular, long and stiff tunnels may prevent the correct positioning of devices that have a fixed distance between the right and left atrial discs. PATIENTS AND METHODS: We evaluated retrospectively 361 patients with PFO closure between January 2012 and June 2014 in our institution and were treated due to previous history of ischemic stroke. By TEE, the overlap between septum primum and secundum is usually better seen on the bicaval view that is obtained at 75-90° midesophageal views. Tunnel length and PFO opening were measured. Twelve subjects (median age 35 years; range 30-58 years; three females) showed a long (median 22 mm; range 15-32 mm) and rigid tunnel (median opening 2 mm; range 1-4 mm). RESULTS: Angioplasty of the tunnel was performed by using peripheral angioplasty balloons with a length ranging from 4 to 8 cm and a diameter between 8 and 12 mm. After angioplasty, the tunnel appeared shorter (12 mm; range 8-16 mm) and less rigid (median opening 8 mm; range 7-12 mm). The following devices were implanted: 25 mm Amplatzer PFO occluder in three patients; 25 mm Gore septal occluder in nine subjects. Median fluoroscopy time was 8 min (range 6-10 min). No complications occurred. At a median follow-up of 12 months (range 2-18 months), no problems occurred and all subjects but one (trivial residual shunting) showed a complete closure. CONCLUSIONS: Angioplasty of a PFO rigid and stiff tunnel is a feasible and safe option. © 2016 Wiley Periodicals, Inc.


Asunto(s)
Angioplastia Coronaria con Balón/instrumentación , Cateterismo Cardíaco/instrumentación , Catéteres Cardíacos , Foramen Oval Permeable/terapia , Dispositivo Oclusor Septal , Adulto , Angioplastia Coronaria con Balón/efectos adversos , Cateterismo Cardíaco/efectos adversos , Ecocardiografía Tridimensional , Ecocardiografía Transesofágica , Femenino , Fluoroscopía , Foramen Oval Permeable/diagnóstico por imagen , Foramen Oval Permeable/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Radiografía Intervencional , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
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