1
|
Sandhya R, Nazia H, Angira P, Andrada P, Joseph C, Paul T. 3D Echocardiographic and Computed Tomographic Angiography Guidance for Percutaneous Closure of a Type II (Intermediate) Aortopulmonary Window. Pediatr Cardiol 2024; 45:934-938. [PMID: 37823902 DOI: 10.1007/s00246-023-03293-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/29/2023] [Indexed: 10/13/2023]
Abstract
A 4-year-old female was diagnosed with Type II Aortopulmonary window after being seen for a murmur. By utilizing multimodality advanced imaging, including 2D and 3D echo, computed tomography (CTA) with semi-transparent overlay as a road map, we were able to preoperatively plan camera angles and device selection as well as close the defect percutaneously under echocardiography guidance. This report highlights the importance of a multimodality imaging approach to interventional procedures.
Collapse
Affiliation(s)
- Ramlogan Sandhya
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA.
| | - Husain Nazia
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
| | - Patel Angira
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
| | - Popescu Andrada
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
| | - Camarda Joseph
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
| | - Tannous Paul
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
| |
Collapse
|
2
|
Giordano M, Butera G. Percutaneous closure of an aortopulmonary window in a young adult patient: a case report of transcatheter closure with an occluder device. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-4. [PMID: 32617502 PMCID: PMC7319847 DOI: 10.1093/ehjcr/ytaa059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/27/2019] [Accepted: 02/26/2020] [Indexed: 11/13/2022]
Abstract
Background Aortopulmonary window is a congenital heart disease requiring a surgical approach to achieve a complete correction. Case summary We report on a case of a young female symptomatic adult patient with a significant aortopulmonary window. The patients refused surgical approach and since the defect was far enough from the pulmonary and aortic valve a percutaneous approach was proposed. The large aortopulmonary window was closed effectively with an Amplatzer Muscular Septal Occluder device (Abbott, Plymouth, MN, USA). At 1-year follow-up, the device was in a good position with no residual shunt. Discussion Transcatheter closure of an aortopulmonary window is an effective and safe procedure in specific anatomic defects.
Collapse
Affiliation(s)
- Mario Giordano
- Department of Congenital Cardiology and Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Gianfranco Butera
- Department of Congenital Cardiology and Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,King's College London, London, UK.,Department of Paediatric Cardiology, Evelina Children's Hospital, London, UK
| |
Collapse
|
3
|
Yu S, Han J, Gao S, Liu X, Gu X, Zhang Y, Sun L, He Y. The prenatal diagnosis of aortopulmonary window by fetal echocardiography. Echocardiography 2018; 35:1835-1840. [PMID: 30192407 DOI: 10.1111/echo.14131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 08/07/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The purpose of this study was to analyze the fetal echocardiographic features and the associated anomalies of prenatal aortopulmonary window (APW). METHODS We retrospectively reviewed the fetal echocardiographic database (n = 24 000) in our hospital between May 2012 and December 2017. The general clinical information, fetal echocardiographic features, and the associated anomalies in patients with APW were analyzed. Four patients had undergone whole genome sequencing using fetal tissues. RESULTS Six cases of APW confirmed by autopsy were identified in our fetal echocardiographic database. On the three-vessel view, a communication between the pulmonary artery trunk and ascending aorta was noted above the two semilunar valves in all cases. The most frequent type of APW among the cases was type II, and all cases were associated with other cardiac anomalies. No pathogenic or suspected pathogenic copy number variation or insertion-deletions were detected in this series. CONCLUSION Prenatal diagnosis of APW is feasible, which is helpful during prenatal consultations, so that parents can make better decisions regarding postpartum treatment options and pregnancy outcomes.
Collapse
Affiliation(s)
- Shaomei Yu
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiancheng Han
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Shuang Gao
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaowei Liu
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaoyan Gu
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ye Zhang
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lin Sun
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yihua He
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
4
|
He J, Yan D, Li B, Li H. Surgical Repair of Complex Aortopulmonary Window: A Case Study. Braz J Cardiovasc Surg 2018; 33:424-427. [PMID: 30184041 PMCID: PMC6122751 DOI: 10.21470/1678-9741-2017-0231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/26/2018] [Indexed: 11/04/2022] Open
Abstract
Aortopulmonary septal defect, also known as the aortopulmonary window, is a rare congenital macrovascular malformation. This case involves a 9-year-old boy with aortopulmonary septal defect (type I combined with type IV). Before surgery, milrinone and alprostadil were used to counteract high lung pressure. Surgery was performed under cardiopulmonary bypass, following which the pulmonary pressure decreased. The aorta was cut, and the right pulmonary artery opening was connected with the main pulmonary artery septal defect using polyester patch. An internal tunnel was made, and the deformity correction was completed. The child exhibited normal postoperative recovery with no discomfort. A complex aortopulmonary window is a rare condition that can be treated successfully with appropriate preoperative and surgical management.
Collapse
Affiliation(s)
- Jigang He
- Cardiovascular Surgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Dan Yan
- Cardiovascular Surgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Beibei Li
- Cardiovascular Surgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Hongrong Li
- Cardiovascular Surgery, The First People's Hospital of Yunnan Province, Kunming, China
| |
Collapse
|
5
|
Xu HX, Zheng DD, Pan M, Li XF. Transcatheter Treatment of Aortopulmonary Window with a Symmetrical Membranous Ventricular Septal Occluder. Cardiology 2017; 138:76-79. [PMID: 28609765 DOI: 10.1159/000475706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/04/2017] [Indexed: 11/19/2022]
Abstract
Aortopulmonary window (APW), the presence of a communication between aorta and pulmonary artery, is a rare congenital heart disease, and surgical intervention is the standard for closure. Recently, several cases have been treated with transcatheter device occluders. Here, we report an APW patient treated successfully using a transcatheter closure with a symmetrical membranous ventricular septal occluder. We are the first to report on a case treated with this type of occluder for APW.
Collapse
Affiliation(s)
- Hai-Xia Xu
- Department of Cardiology, Affiliated Hospital of Nantong University, Nantong, China
| | | | | | | |
Collapse
|
6
|
Percutaneous closure of an aortopulmonary window using Amplatzer Duct Occluder II: Additional Sizes: the first reported case. Cardiol Young 2017; 27:812-815. [PMID: 27869054 DOI: 10.1017/s1047951116002134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To date, there are no reported cases of the Amplatzer Duct Occluder II: Additional Sizes' use in percutaneous closure of an aortopulmonary window. We report a case of percutaneous closure of an aortopulmonary window in a 4.5-month-old, 6 kg child. Owing to the patient's low weight, high risk of damage to the pulmonary valve, as well as the possibility of aortic and pulmonary artery obstruction, classic implants were deemed unsuitable and a decision was made to use the Amplatzer Duct Occluder II: Additional Sizes. The implant performed very well - the soft waist filled the aortopulmonary connection and both retention discs were properly shaped and pressed against vessel walls. Echocardiogram performed 12 hours after the procedure confirmed a correct occluder position. Low-profile retention discs had no impact on pulmonary valve function, despite the defect's proximity to the valve. No obstruction of the aortic or pulmonary artery lumen was noted. The Amplatzer Duct Occluder II: Additional Size implant is a safe and useful device for percutaneous closure of an aortopulmonary window in a carefully selected group of patients.
Collapse
|
7
|
Góreczny S, Dryżek P, Morgan GJ, Mazurek-Kula A, Moll JJ, Moll JA, Qureshi S, Moszura T. Fenestration closure with Amplatzer Duct Occluder II in patients after total cavo-pulmonary connection. Arch Med Sci 2017; 13:337-345. [PMID: 28261286 PMCID: PMC5332453 DOI: 10.5114/aoms.2016.61836] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 03/16/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Creation of a fenestration during completion of a total cavopulmonary connection (TCPC) has been associated with a reduction in early mortality and morbidity. However, the long-term benefits are negated by an associated limitation in exercise tolerance and the potential risks of thrombo-embolic complications. We sought to describe the safety and efficacy of an Amplatzer Duct Occluder II (ADO II) for transcatheter fenestration closure following TCPC. MATERIAL AND METHODS Between January 2000 and July 2014, 102 patients underwent percutaneous closure of extra-cardiac TCPC fenestrations with a range of devices. Patients in whom fenestration closure was performed with an ADO II and who had at least 6 months of follow-up were included in this study. RESULTS Forty-seven patients had successful fenestration occlusion with an ADO II. The mean oxygen saturation and mean systemic venous pressures increased from 84.8 ±6.1% before to 97.6 ±2.9% (p < 0.001) after and from 14.2 ±2.15 mm Hg before to 15.6 ±2.2 mm Hg after closure (p < 0.001). Eight patients developed heart failure symptoms, managed by optimization of medical therapy, with 1 patient requiring device removal to reopen the fenestration. Color Doppler transthoracic echocardiography demonstrated residual flow across the device in 18 (38%), 10 (22%), 5 (11%) and 4 (9%) patients before discharge, at 1 and 6 months, and at the latest outpatient visit, respectively. CONCLUSIONS The ADO II can be safely and effectively used to close fenestrations in extra-cardiac type Fontan completions. Many of the design features of this device confer potential benefit in this population.
Collapse
Affiliation(s)
- Sebastian Góreczny
- Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, Lodz, Poland
| | - Paweł Dryżek
- Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, Lodz, Poland
| | - Gareth J. Morgan
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Anna Mazurek-Kula
- Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, Lodz, Poland
| | - Jacek J. Moll
- Department of Cardiac Surgery, Polish Mother’s Memorial Hospital, Research Institute, Lodz, Poland
| | - Jadwiga A. Moll
- Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, Lodz, Poland
| | - Shakeel Qureshi
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Tomasz Moszura
- Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, Lodz, Poland
| |
Collapse
|
8
|
Nayak HK, Islam N, Bansal BK. Transcatheter closure of aortopulmonary window with Amplatzer duct occluder II. Ann Pediatr Cardiol 2017; 10:93-94. [PMID: 28163441 PMCID: PMC5241858 DOI: 10.4103/0974-2069.197060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Hemant Kumar Nayak
- Department of Pediatric Cardiology, The Mission Hospital, Durgapur, West Bengal, India E-mail:
| | - Nurul Islam
- Department of Pediatric Cardiology, The Mission Hospital, Durgapur, West Bengal, India E-mail:
| | - Bhanu Kumar Bansal
- Department of Pediatric Cardiology, The Mission Hospital, Durgapur, West Bengal, India E-mail:
| |
Collapse
|
9
|
Odemis E, Guvenc O, Saygi M, Demir IH. Closure of aortopulmonary window using Nit-Occlud® PDA-R device in a 3-month-old infant. Pediatr Int 2016; 58:754-6. [PMID: 27374635 DOI: 10.1111/ped.12943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 01/18/2016] [Accepted: 02/01/2016] [Indexed: 11/28/2022]
Abstract
Aortopulmonary window (APW) is a rare abnormality in which a pulmonary defect exists between the ascending aorta and the main pulmonary artery. Given that it may result in cardiac failure and pulmonary vascular disease in the early period, treatment needs to be performed without delay. In addition to surgical treatment, transcatheter closure may also be performed for selected patients. This study describes the case of an infant diagnosed with APW and who underwent successful transcatheter closure using a Nit-Occlud® PDA-R device.
Collapse
Affiliation(s)
- Ender Odemis
- Department of Pediatric Cardiology, Medical Faculty, Acıbadem University, Istanbul, Turkey
| | - Osman Guvenc
- Division of Pediatric Cardiology, Batman Gynecologic and Pediatric Hospital, Batman, Turkey
| | - Murat Saygi
- Division of Pediatric Cardiology, Gaziosmanpasa Taksim Research and Training Hospital, Istanbul, Turkey
| | - Ibrahim Halil Demir
- Department of Pediatric Cardiology, Medical Faculty, Acıbadem University, Istanbul, Turkey
| |
Collapse
|
10
|
Use of an Amplatz Canine Ductal Occluder (ACDO) device to close an acquired aortopulmonary fistula with a hybrid approach in a dog. J Vet Cardiol 2016; 18:377-384. [PMID: 27449901 DOI: 10.1016/j.jvc.2016.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 05/17/2016] [Accepted: 06/01/2016] [Indexed: 11/22/2022]
Abstract
A 2-year-old recently spayed female Rottweiler was referred as an emergency with cardiac tamponade and the presence of an anomalous retrograde flow in the pulmonary artery. Echocardiography and angiography demonstrated a left-to-right aortopulmonary fistula. Clinical history and data indicated a possible infectious aetiology. Antibiotics and heart failure medications were administered for 30 days before intervention. Initial attempt at insertion of an Amplatz occluder by means of a percutaneous catheterization technique was tried but a safe release of the device was judged to be not possible due to the angle and the fragile and irregular margins of the window. A decision was made to proceed with a hybrid technique combining thoracotomy and direct pulmonary artery catheterization. This hybrid approach was successful with resolution of congestive heart failure with only residual mild paraprosthetic leakage.
Collapse
|
11
|
González-López MT, Gil-Jaurena JM, Zunzunegui-Martínez JL, Álvarez-García-Rovés R. Aortopulmonary window due to transcatheter pulmonary valve implantation after arterial switch operation: Where is the limit? J Thorac Cardiovasc Surg 2015; 149:e38-9. [DOI: 10.1016/j.jtcvs.2014.10.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 10/11/2014] [Indexed: 10/24/2022]
|
12
|
Coserria F, Mendez A, Moruno A, Valverde I, Santos de Soto J. Cierre percutáneo de fístula aortopulmonar iatrogénica con dispositivo Amplatzer Septal Occluder®. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2013.09.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Percutaneous closure of iatrogenic aortopulmonary fistula using the Amplatzer Septal Occluder. ACTA ACUST UNITED AC 2014; 67:228-9. [PMID: 24774403 DOI: 10.1016/j.rec.2013.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 09/13/2013] [Indexed: 11/20/2022]
|
14
|
Li X, Zhu D, Feng Y. Transcatheter Closure of Late-Onset Residual Aortopulmonary Septal Defect Using a Muscular Ventricular Septal Occluder. Int Heart J 2014; 55:89-91. [DOI: 10.1536/ihj.13-201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Xiao Li
- Department of Cardiology, West China Hospital, Sichuan University
| | - Da Zhu
- Department of Thoracic and Cardiovascular Surgery, West China Hospital, Sichuan University
| | - Yuan Feng
- Department of Cardiology, West China Hospital, Sichuan University
| |
Collapse
|