Thrombus formation within the right ventricle-to-pulmonary artery conduit (Sano shunt) as a cause of acute cyanosis in a patient with hypoplastic left heart syndrome.

We describe a case of thrombus formation within a right ventricle-to-pulmonary artery conduit (Sano shunt) in a patient with hypoplastic left heart syndrome with resulting acute cyanosis and hypotension requiring emergency balloon angioplasty.

Use of the new IntraStent for treatment of transverse arch hypoplasia/coarctation of the aorta.

We report the use of a new biliary stent (IntraStent Double Strut LD) adapted for use in a 16-year-old young man with moderate-severe transverse arch hypoplasia/coarctation of the aorta following two surgical attempts at correction/relief of the coarctation. The stent implantation procedure resulted in complete relief of the coarctation.

Transcatheter coil occlusion of a thoracic arteriovenous fistula in an infant with congestive heart failure.

An 8-week-old baby boy presented at our institution with a continuous murmur and congestive heart failure. Echocardiography showed normal cardiac anatomy. Catheterization revealed the presence of a large thoracic arteriovenous fistula between the descending thoracic aorta and the hemiazygous system, with eventual drainage into the azygous vein and the innominate vein. Coil occlusion was performed successfully with a Gianturco coil.

Transcatheter closure of large persistent left superior vena cava causing cyanosis in two patients post-Fontan operation utilizing the Gianturco Grifka vascular occlusion device.

We report the successful transcatheter closure of a large persistent left superior vena cava draining into the pulmonary venous circulation causing cyanosis in two patients who had previously undergone the Fontan operation utilizing the Gianturco Grifka vascular occlusion device. Cathet Cardiovasc Intervent 2001;53:398-404.

Lymphocutaneous fistula as a long-term complication of multiple central venous catheter placement.

We report a case of a lymphocutaneous fistula in a 19-month-old boy who had been a premature neonate, born in the 23rd week of gestation. The fistula, an apparent complication of central venous line placement during the patient's first 5 months of life, was composed of a distinct lymphatic vessel bundle in the right supraclavicular region, with its exit point at the posterior aspect of the right shoulder. The drainage ceased immediately after resection and repair of a 1-cm obstruction in the superior vena cava.

A technique to prevent newly implanted stent displacement during subsequent catheter and sheath manipulation.

We describe a novel technique to prevent the displacement or migration of a newly implanted stent as a consequence of any subsequent catheter and sheath manipulation during the same catheterization procedure. The technique involves reinflation of the dilation balloon within the stent immediately after implant followed by advancing the long delivery sheath carefully over the balloon as the balloon is slowly deflated within the stent. The technique was used successfully in 78 stents in 30 patients without stent dislodgment or migration.

A method providing bidirectional control of coil delivery in occlusions of patent ductus arteriosus with shallow ampulla and Pott's shunts.

A novel method using a snare and bioptome to provide bidirectional control of a Gianturco coil for occlusion of a patent ductus arteriosus with a shallow ampulla and Pott's shunts is presented. This method greatly reduces the risk of coil embolization and optimizes coil position in difficult cases.

Clinical implications and possible association of malposition of the branch pulmonary arteries with DiGeorge syndrome and microdeletion of chromosomal region 22q11.

We describe a series of 10 patients with malposition of the branch pulmonary arteries (4 patients with crossing [crossed pulmonary arteries] and 6 patients without crossing), 2 of whom had a short main pulmonary artery segment that resulted in iatrogenic right pulmonary artery stenosis after pulmonary artery band placement. DiGeorge syndrome was seen in 5 patients and 4 had microscopic deletion of chromosomal region 22q11.

Acute cyanosis following balloon angioplasty of residual arch obstruction after the Norwood I operation.

A 7-month-old child with residual aortic arch obstruction following a modified Norwood I operation developed profound cyanosis with subsequent bradycardia and hypotension immediately after successful balloon angioplasty. This complication of aortic angioplasty is specific to patients with this physiology. The pathophysiology of the event is discussed.