1
|
Li A, Aboulhosn JA. Update on Transcatheter Interventions in Adults with Congenital Heart Disease. J Clin Med 2024; 13:3685. [PMID: 38999250 PMCID: PMC11242816 DOI: 10.3390/jcm13133685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 07/14/2024] Open
Abstract
The field of adult congenital interventions is unique in the world of cardiac catheterization, combining the structural concepts commonly employed in pediatric heart disease and applying them to adult patients, who are more amenable to device intervention as they no longer experience somatic growth. Rapid advances in the field have been made to match the growing population of adult patients with congenital heart disease, which currently surpasses the number of pediatric patients born with congenital heart disease. Many congenital defects, which once required surgical intervention or reoperation, can now be addressed via the transcatheter approach, minimizing the morbidity and mortality often encountered within adult congenital surgeries. In this paper, we aim to provide a focused review of the more common procedures that are utilized for the treatment of adult congenital heart disease patients in the catheterization laboratory, as examples of current practices in the United States, as well as emerging concepts and devices awaiting approval in the future.
Collapse
Affiliation(s)
- Angela Li
- Division of Cardiology, UCLA Medical Center, Los Angeles, CA 90095, USA;
| | | |
Collapse
|
2
|
Bergmann M, Germann CP, Nordmeyer J, Peters B, Berger F, Schubert S. Short- and Long-term Outcome After Interventional VSD Closure: A Single-Center Experience in Pediatric and Adult Patients. Pediatr Cardiol 2021; 42:78-88. [PMID: 33009919 PMCID: PMC7864847 DOI: 10.1007/s00246-020-02456-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Abstract
Interventional closure of congenital ventricular septal defects (VSD) is recording a continuous rise in acceptance. Complete atrioventricular block (cAVB) and residual shunting are major concerns during follow-up, but long-term data for both are still limited. We retrospectively evaluated the outcome of patients with interventional VSD closure and focused on long-term results (> 1 year follow-up). Transcatheter VSD closures were performed between 1993 and 2015, in 149 patients requiring 155 procedures (104 perimembranous, 29 muscular, 19 residual post-surgical VSDs, and 3 with multiple defects). The following devices were used: 65 × Amplatzer™ Membranous VSD Occluder, 33 × Duct Occluder II, 27 × Muscular VSD Occluder, 3 × Duct Occluder I, 24 × PFM-Nit-Occlud®, and 3 × Rashkind-Occluder. The median age at time of implantation was 6.2 (0.01-66.1) years, median height 117 (49-188) cm, and median weight 20.9 (3.2-117) kg. Median follow-up time was 6.2 (1.1-21.3) years and closure rate was 86.2% at last follow-up. Complications resulting in device explantation include one case of cAVB with a Membranous VSD occluder 7 days after implantation and four cases due to residual shunt/malposition. Six (4%) deaths occurred during follow-up with only one procedural related death from a hybrid VSD closure. Overall, our reported results of interventional VSD closure show favorable outcomes with only one (0.7%) episode of cAVB. Interventional closure offers a good alternative to surgical closure and shows improved performance by using softer devices. However, prospective long-term data in the current era with different devices are still mandatory to assess the effectiveness and safety of this procedure.
Collapse
Affiliation(s)
- M. Bergmann
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - C. P. Germann
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - J. Nordmeyer
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - B. Peters
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - F. Berger
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - S. Schubert
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany ,grid.418457.b0000 0001 0723 8327Clinic for Pediatric Cardiology and Congenital Heart Defects, Herz- Und Diabeteszentrum NRW, Ruhr University of Bochum, Georgstraße 11, 32545 Bad Oeynhausen, Germany
| |
Collapse
|
3
|
Lin ZW, Huang ST, Xu N, Cao H, Chen Q. Parents' knowledge and attitudes regarding transthoracic device closure of VSD in children: a cross-sectional study. J Cardiothorac Surg 2020; 15:75. [PMID: 32381035 PMCID: PMC7206819 DOI: 10.1186/s13019-020-01124-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/28/2020] [Indexed: 12/04/2022] Open
Abstract
Objectives This study aimed to identify Chinese parents’ knowledge and attitudes toward transthoracic device closure of ventricular septal defect (VSD). Methods This cross-sectional study collected data on a total of 203 Chinese parents of patients with VSD were included, and an author-designed three-page questionnaire was used. Results A total of 73.9% of the parents had heard of transthoracic device closure of VSD; however, they lacked detailed knowledge. 88.2% parents expressed their willingness to undergo this procedure. Although there was no significant correlation between knowledge about the occluder material and acceptance of the method, knowledge of other information was significantly related to willingness to undergo the procedure. Some parents expressed some concerns and high expectations, but the postoperative risk reduced their desire for accepting the procedure. This study also found that most parents did not have a detailed understanding of such procedure. Conclusion Parents of patients with VSD in China need continued education regarding transthoracic device closure of VSD, especially in terms of its benefits and limited postoperative complications. In addition, it is essential to reduce the cost of this procedure to promote its development and application.
Collapse
Affiliation(s)
- Ze-Wei Lin
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Shu-Ting Huang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Ning Xu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China. .,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
| |
Collapse
|
4
|
Shah JH, Saraiya SP, Nikam TS, Jha MJ. Transcatheter Device Closure of Perimembranous Ventricular Septal Defect in Pediatric Patients: Long-Term Outcomes. Heart Views 2020; 21:17-21. [PMID: 32082495 PMCID: PMC7006324 DOI: 10.4103/heartviews.heartviews_13_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/25/2019] [Indexed: 11/04/2022] Open
Abstract
Aims The aim of this study is to evaluate the safety and efficacy of transcatheter device closure of perimembranous ventricular septal defects in pediatric patients at long-term follow-up. Materials and Methods We prospectively studied 376 patients with perimembranous VSDs between September 2008 and December 2015 who underwent percutaneous closure at our center. Transthoracic echocardiography (TTE) and electrocardiogram were done before and after the procedure in all the patients. All patients were subjected to follow-up evaluation at 1, 3, 6, 12 months, and annually thereafter with TTE and electrocardiogram. Results A total of 376 patients (210 males and 166 females) underwent transcatheter closure of perimembranous VSD. Mean age of patients was 8.67 ± 3.02 (range 3-18 years) and mean weight was 21.15 ± 8.31 (range 8-65 kg). The procedure was carried out successfully in 98.93% of patients with no reported mortality. Rhythm disturbances occurred in 8.5% of patients after the procedure which included three cases of complete atrioventricular block. Conclusion This study shows that in experienced hands transcatheter closure of perimembrnous VSD is safe and effective at long-term follow-up. With minimal morbidity and no mortality, the transcatheter is an effective alternative to surgical closure in selected patients.
Collapse
Affiliation(s)
- Jayal Hasmukhbhai Shah
- Department of Cardiology, U N Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Ahmedabad, Gujarat, India
| | - Sanket Pravinchandra Saraiya
- Department of Cardiology, U N Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Ahmedabad, Gujarat, India
| | - Tushar Sudhakarrao Nikam
- Department of Cardiology, U N Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Ahmedabad, Gujarat, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, U N Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Ahmedabad, Gujarat, India
| |
Collapse
|
5
|
Chen Q, Hong ZN, Zhang GC, Chen LW, Zhang QL, Lin ZW, Cao H. Intraoperative Device Closure of Isolated Ventricular Septal Defects: Experience on 1,090 Cases. Ann Thorac Surg 2018; 105:1797-1802. [DOI: 10.1016/j.athoracsur.2018.02.059] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/13/2018] [Accepted: 02/20/2018] [Indexed: 10/17/2022]
|
6
|
Hong ZN, Chen Q, Lin ZW, Zhang GC, Chen LW, Zhang QL, Cao H. Surgical repair via submammary thoracotomy, right axillary thoracotomy and median sternotomy for ventricular septal defects. J Cardiothorac Surg 2018; 13:47. [PMID: 29783998 PMCID: PMC5963097 DOI: 10.1186/s13019-018-0734-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 05/10/2018] [Indexed: 11/12/2022] Open
Abstract
Background Right submammary thoracotomy and right vertical infra-axillary thoracotomy are performed for ventricular septal defect (VSD) to reduce the invasiveness of the conventional surgical repair through median sternotomy approach. No comparative studies have been conducted among these three procedures. Methods From January 2016 to December 2016, 182 patients with isolated VSD who underwent surgical repair via one of these 3 approaches were reviewed to compare these three procedures. Results The procedure success rates were similar in these three groups. There was no statistically significant difference in operative time, aortic cross-clamping time, the duration of CPB, blood transfusion amount and medical cost. However, postoperative mechanical ventilation time, the duration of intensive care and postoperative length of hospital stay were longer in median sternotomy group than the other two groups. (P < 0.05) The median sternotomy group required the longest incision. No significant difference was noted in major adverse events. There were different advantages and disadvantages in the three kinds of operative procedures. Conclusions Regarding conventional surgical repair VSD, right submammary thoracotomy and right vertical infra-axillary thoracotomy both delivered better cosmetic results for patients with isolated VSD, while all the three procedures could obtain satisfactory clinical effect.
Collapse
Affiliation(s)
- Zhi-Nuan Hong
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - Qiang Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - Ze-Wei Lin
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - Gui-Can Zhang
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - Liang-Wan Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - Qi-Liang Zhang
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - Hua Cao
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.
| |
Collapse
|
7
|
Gu X, Zhang Q, Sun H, Fei J, Zhang X, Kutryk MJ. Transcatheter Closure Versus Repeat Surgery for the Treatment of Postoperative Left-to-Right Shunts: A Single Center 15-Year Experience. Cardiol Res 2018; 8:286-292. [PMID: 29317971 PMCID: PMC5755660 DOI: 10.14740/cr629e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 12/05/2017] [Indexed: 11/28/2022] Open
Abstract
Background Repeat surgery and the percutaneous approach (transcatheter closure (TCC)) have been used for the management of postoperative left-to-right shunts. In this study, we described our 15 years of experience in treating postoperative left-to-right shunts with these two approaches. Methods From February 2002 to February 2017, 50 patients with residual left-to-right shunts, following cardiac surgery, were treated using TCC or repeat surgery. Clinical examination, standard 12-lead electrocardiography, chest X-ray, and a transthoracic echocardiogram were performed before hospital discharge and at all follow-ups. Results The closure rate was 100% in both groups and there was no procedure-related mortality. Patients with TCC had few complications. The procedure time and duration of hospital stay for TCC patients were 58.9 ± 27.7 min and 6.1 ± 0.8 days, respectively. Eleven out of 19 patients receiving reoperation suffered serious complications after surgery, e.g., bleeding and nosocomial infections. The operation time and duration of hospital stay for reoperation patients were 256.7 ± 60.5 min and 17.0 ± 4.0 days, respectively. No other serious complications were seen at all follow-up visits for both groups. Conclusions In conclusions, TCC is safe and effective for the management of postoperative left-to-right shunts, and is associated with few complications, which can be the favored closure strategy over repeat surgery for the management of postoperative left-to-right shunts.
Collapse
Affiliation(s)
- Xinghua Gu
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, 107 Wenhua West Road, Jinan 250012, China
| | - Qiuwang Zhang
- Division of Cardiology, Keenan Research Center for Biomedical Science at the Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Hourong Sun
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, 107 Wenhua West Road, Jinan 250012, China
| | - Jianchun Fei
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, 107 Wenhua West Road, Jinan 250012, China
| | - Xiquan Zhang
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, 107 Wenhua West Road, Jinan 250012, China
| | - Michael J Kutryk
- Division of Cardiology, Keenan Research Center for Biomedical Science at the Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
8
|
Acheampong B, Johnson JN, Hagler DJ, Cabalka AK, Cetta F, Taggart NW. Intracardiac Echocardiography-Guided Device Closure of Non-PFO/ASD Shunts. STRUCTURAL HEART-THE JOURNAL OF THE HEART TEAM 2017. [DOI: 10.1080/24748706.2017.1401757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Benjamin Acheampong
- Department of Pediatrics/Division of Pediatric Cardiology, Vanderbilt University, Nashville, Tennessee, USA
| | - Jonathan N. Johnson
- Department of Pediatrics/Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Medicine/Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Donald J. Hagler
- Department of Pediatrics/Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Medicine/Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Allison K. Cabalka
- Department of Pediatrics/Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Frank Cetta
- Department of Pediatrics/Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Medicine/Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Nathaniel W. Taggart
- Department of Pediatrics/Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
9
|
Xianglan L, Jian W, Xia G, Di C, Jingyi Z, Bo Z, Bo Y, Yong S. A case of acute myocardial infarction after successful transcatheter closure of ventricular septal defect. Eur Heart J Suppl 2017; 18:F31-F34. [PMID: 28533728 DOI: 10.1093/eurheartj/suw039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Congenital heart diseases can be treated without surgery through advances in interventional cardiology. Complications such as infection and thrombus formation may develop due to foreign materials used during these procedures. Paradoxical embolism is a rare complication of transcatheter closure of ventricular septal defect (VSD) and could be responsible for acute myocardial infarction. Herein, we present a case of coronary thrombosis in a 2-year-old patient with VSD, which was closed with the Amplatzer VSD device. Although extremely rare, it should be considered in the appropriate clinical setting.
Collapse
Affiliation(s)
- Liu Xianglan
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China.,Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wu Jian
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China.,Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Gu Xia
- Department of Cardiology, The Heilongjiang Provincial Hospital, Harbin, China
| | - Chi Di
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China.,Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhu Jingyi
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China.,Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhang Bo
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yu Bo
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China.,Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Sun Yong
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China.,Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
10
|
Directly ventricular septal defect closure without using arteriovenous wire loop: Our adult case series using transarterial retrograde approach. Anatol J Cardiol 2017; 17:461-468. [PMID: 28315566 PMCID: PMC5477076 DOI: 10.14744/anatoljcardiol.2017.7507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: The standard transcatheter ventricular septal defects (VSD) closure procedure is established with arteriovenous (AV) loop and is called as antegrade approach. The directly retrograde transarterial VSD closure without using AV loop might be better option as shortens the procedure time and decreases radiation exposure. Methods: Our series consist of twelve sequential adult cases with congenital VSDs (seven with perimembranous, four with muscular, one with postoperative residuel VSD). The mean age was 26.9 (Range 18–58), the mean height was 168.75 cm (Range 155–185cm), and the mean body mass index was 23.4 (Range 17.3–28.4). Maximum and minimum defect sizes were 10 and 5 mm and the mean defect size was 6.24 mm. The procedure was performed with left heart catheterization and advancing the delivery sheath over the stiff exchange wire then VSD occlusion from left side. Results: The defects were successfully closed with this technique in eleven patients. In sixth patient, the defect could not be cannulated by the delivery sheath, as the tip of the sheath did not reach the defect and VSD was closed with same sheath by standard transvenous approach using AV loop. We didn’t encounter any complication releated to semilunar or atrioventricular valves. Atrioventricular conduction system was not affected by the procedure in any patients. The median procedure and fluoroscopy times were 66 and 16.5 minutes respectively. Conclusion: Transarterial retrograde VSD closure without using AV loop simplifies the procedure, decreases the radiation exposure, and shortens the procedure time. The only limitation in adult patients is delivery sheath length.
Collapse
|
11
|
Zirpe D, Muthukumaran CS, Vaidya A, Ramamurthy A. Incidental Ventricular Septal Defect (VSD) in the Donor of a Live Donor Liver Transplant: Tackle and Proceed. J Clin Diagn Res 2016; 10:PD06-PD07. [PMID: 27790513 DOI: 10.7860/jcdr/2016/20839.8448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/21/2016] [Indexed: 01/10/2023]
Abstract
Live Donor Liver Transplantation (LDLT) is an act of selflessness on the part of the donor who is subjected to a major hepatectomy. Ensuring safety and long-term well being of the donor is of utmost priority. We describe a 21-year-old otherwise healthy donor with perimembranous Ventricular Septal Defect (VSD) who successfully underwent donor hepatectomy after closure of the VSD. There is no literature available to guide regarding course of action in such a condition neither any study to substantiate the risk involved. Optimum anticoagulation, endocarditis prophylaxis and optimum interval between the two procedures are areas to be defined as our experience with similar cases increases. Our case emphasizes the importance of multidisciplinary approach and management of such patient at high volume centers.
Collapse
Affiliation(s)
- Dinesh Zirpe
- Senior Registrar, Department of Surgical Gastroenterology, Centre for Liver, Pancreas and Small Bowel Transplantation, Apollo Hospitals , Chennai, Tamilnadu, India
| | - C S Muthukumaran
- Senior Consultant, Department of Cardiology, Apollo Hospitals , Chennai, Tamilnadu, India
| | - Anil Vaidya
- Senior Consultant, Department of Surgical Gastroenterology, Centre For Liver, Pancreas and Small Bowel Transplantation, Apollo Hospitals , Chennai, Tamilnadu, India
| | - Anand Ramamurthy
- Senior Consultant, Department of Surgical Gastroenterology, Centre For Liver, Pancreas and Small Bowel Transplantation, Apollo Hospitals , Chennai, Tamilnadu, India
| |
Collapse
|
12
|
Giamberti A, Varrica A, Pomè G, Micheletti A, Negura D, Ranucci M, Carminati M, Frigiola A, Chessa M. The care for adults with congenital heart disease: organization and function of a grown-up congenital heart disease unit. Eur Heart J Suppl 2016; 18:E15-E18. [DOI: 10.1093/eurheartj/suw011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
13
|
Percutaneous closure of ventricular septal defect with membraneous pouch and changing the device due to severe aortic regurgitation. Int J Cardiol 2016; 209:42-5. [PMID: 26878473 DOI: 10.1016/j.ijcard.2016.02.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/02/2016] [Indexed: 11/21/2022]
|
14
|
Chen F, Li P, Liu S, Du H, Zhang B, Jin X, Zheng X, Wu H, Chen S, Han L, Qin Y, Zhao X. Transcatheter Closure of Intracristal Ventricular Septal Defect With Mild Aortic Cusp Prolapse Using Zero Eccentricity Ventricular Septal Defect Occluder. Circ J 2015; 79:2162-8. [DOI: 10.1253/circj.cj-15-0301] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Feng Chen
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| | - Pan Li
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| | - Suxuan Liu
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| | - He Du
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| | - Bili Zhang
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| | - Xiucai Jin
- Department of Echocardiography, Changhai Hospital, Second Military Medical University
| | - Xing Zheng
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| | - Hong Wu
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| | - Shaoping Chen
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| | - Lin Han
- Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University
| | - Yongwen Qin
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| | - Xianxian Zhao
- Department of Cardiology, Changhai Hospital, Second Military Medical University
| |
Collapse
|
15
|
YANG LINQI, TAI BEECHOO, KHIN LAYWAI, QUEK SWEECHYE. A Systematic Review on the Efficacy and Safety of Transcatheter Device Closure of Ventricular Septal Defects (VSD). J Interv Cardiol 2014; 27:260-72. [DOI: 10.1111/joic.12121] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- LINQI YANG
- Department of Paediatrics; National University Health System; National University of Singapore; Singapore
| | - BEE-CHOO TAI
- Saw Swee Hock School of Public Health; National University of Singapore; Singapore Singapore
| | - LAY WAI KHIN
- Saw Swee Hock School of Public Health; National University of Singapore; Singapore Singapore
| | - SWEE CHYE QUEK
- Department of Paediatrics; National University Health System; National University of Singapore; Singapore
| |
Collapse
|
16
|
MacDonald ST, Carminati M, Chessa M. Managing adults with congenital heart disease in the catheterization laboratory: state of the art. Expert Rev Cardiovasc Ther 2014; 8:1741-52. [DOI: 10.1586/erc.10.165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
17
|
Jin Y, Han B, Zhang J, Zhuang J, Yan J, Wang Y. Postimplant complications with transcatheter closure of congenital perimembranous ventricular septal defects: a single-center, longitudinal study from 2002 to 2011. Catheter Cardiovasc Interv 2013; 81:666-73. [PMID: 22936471 DOI: 10.1002/ccd.24638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 08/26/2012] [Indexed: 11/09/2022]
Abstract
BACKGROUND Whether or not to close perimembranous VSDs (pmVSDs) by transcatheter techniques is controversial because of a high rate of complications as compared with surgical alternatives. OBJECTIVE We report the short- and long-term follow-up results of the use of several kinds of devices to close pmVSDs and the annual incidence of postimplant complications in our center. METHODS From June 2002 to June 2011, 232 patients with pmVSD underwent attempted transcatheter closure; closure was successful in 209 cases (90.1%). Six types of occlusive devices were used. Patient age, defect size, device type, device size and its relation to defect size, and transcatheter and fluoroscopy time were analyzed for correlation with annual incidence of postimplant complications. RESULTS There were no deaths during the follow-up period. Within 1 month after transcatheter closure, we found 91 adverse events (43.5%), but only 32 cases showed a trace amount of residual shunting. From 2002 to 2011, the annual incidence of postimplant complications gradually decreased, from 50% in 2002 to 17.6% in 2011. The use of Amplatzer occluder devices (r = 0.71, P = 0.033), double-disc symmetrical occluder devices (r = -0.68, P = 0.045), and transcatheter (r = 0.87, P = 0.003), and fluoroscopy time (r = 0.78, P = 0.02) were significantly correlated with the incidence of post-implant complications. CONCLUSIONS Results of transcatheter closure of pmVSD in terms of postimplant complications are encouraging in our center. It seemed that eccentric Amplatzer and domestic occluder may be at rather higher risk for postimplant complications. The incidence of postimplant complications may be minimized by skilled maneuvers, excluding rather small patients, and selecting the appropriate kind of occlusive device.
Collapse
Affiliation(s)
- Youpeng Jin
- Pediatric Department, Provincial Hospital Affiliated to Shandong University, Shandong, China
| | | | | | | | | | | |
Collapse
|
18
|
Li P, Chen F, Zhao X, Zheng X, Wu H, Chen S, Qin Y. Occurrence and clinical significance of in-hospital acquired thrombocytopenia in patients undergoing transcatheter device closure for congenital heart defect. Thromb Res 2012; 130:882-8. [PMID: 23026381 DOI: 10.1016/j.thromres.2012.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 08/12/2012] [Accepted: 09/03/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acquired thrombocytopenia in patients treated by percutaneous coronary intervention is associated with hemorrhagic complications and prolonged in-hospital stay. This study sought to study the prevalence of thrombocytopenia in patients who underwent transcatheter device closure for congenital heart defect (CHD) and its relationship with clinical consequences. METHODS AND RESULTS 299 patients with CHD who underwent successful transcatheter closure were prospectively studied. Thrombocytopenia developed in 135 (45.2%) patients; n=100 (33.4%) mild (100-150 × 10(9)/L), n=25 (8.4%) moderate (50-100 × 10(9)/L), and n=10 (3.3%) severe (P<50 × 10(9)/L), respectively. From baseline, platelet counts tended to decrease on the 1st day after the procedure and reached a nadir level on the 3rd day, then gradually recovered to baseline values on the 9th day. By multivariate analysis, severe thrombocytopenia developed more frequently in patients who had larger device size (OR 2.755, P=0.000), and residue shunt (OR 2.069, P=0.009). Patients who developed thrombocytopenia, compared with those who did not, had higher in-hospital rates of hemorrhagic complications (11.9% vs. 3.0%, P<0.003), greater requirement for elevating platelet medical treatment or platelet transfusion (4.4% vs. 0, P=0.021), longer hospital stay (median 14 vs. 9 days, P<0.001). Severe thrombocytopenia was an independent predictor of hemorrhagic complications (hazard ratio 8.083, 95% CI 4.021-16.237, P=0.001). Compare with patients without thrombocytopenia, bleeding events were markedly increased (11.9% vs. 3.0%, P=0.003) in those with thrombocytopenia during hospitalization. CONCLUSION The size of occluder and other risk factors are independently associated with thrombocytopenia. Thrombocytopenia provides prognostic information, related to increased bleeding events.
Collapse
Affiliation(s)
- Pan Li
- Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | | | | | | | | | | | | |
Collapse
|
19
|
Esteves CA, Solarewicz LA, Cassar R, Neves JR, Esteves V, Arrieta R. Occlusion of the perimembranous ventricular septal defect using CERA® devices. Catheter Cardiovasc Interv 2012; 80:182-7. [DOI: 10.1002/ccd.24371] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Accepted: 02/12/2012] [Indexed: 11/09/2022]
|
20
|
Chen Q, Cao H, Zhang GC, Chen LW, Li QZ, Qiu ZH. Atrioventricular block of intraoperative device closure perimembranous ventricular septal defects; a serious complication. BMC Cardiovasc Disord 2012; 12:21. [PMID: 22458934 PMCID: PMC3337292 DOI: 10.1186/1471-2261-12-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 03/29/2012] [Indexed: 12/02/2022] Open
Abstract
Background Atrioventricular block (AVB) is a well-reported complication after closure of perimembranous ventricular septal defects (VSDs). To report the occurrence of AVB either during or following closure of perimembranous VSDs using a novel "hybrid" method involving a minimal inferior median incision and of intraoperative device closure of the perimembranous VSDs. Methods Between January 2009 and January 2011, patients diagnosed with perimembranous VSDs eligible for intraoperative device closure with a domestic occluder were identified. All patients were assessed by real-time transesophageal echocardiography (TEE) and electrocardiography. Results Of the 97 included patients, 94 were successfully occluded using this approach. Complete AVB occurred in only one case and one case of Mobitz type II AVB was diagnosed intraoperatively. In both patients, the procedure was aborted and the AVBs quickly resolved. Glucocorticosteroids were administered to another two patients who developed Mobitz type II AVB intraoperatively. Those two patients converted to Mobitz type I AVB 3 days and 5 days postsurgically. During the follow-up period (range, 6-24 months), one patient developed complete AVB 1 week following device insertion. Surgical device removal was followed by a rapid and complete recovery of atrioventricular conduction. Conclusions Intraoperative device closure of perimembranous VSDs with a domestic occluder resulted in excellent closure rates; however, AVB is a serious complication that can occur either during or any time after device closure of perimembranous VSDs. The technique described herein may reduce the incidence of perioperative AVB complications. Surgeons are encouraged to closely monitor all patients postsurgically to ensure AVB does not occur in their patients. Additional long-term data to better identify the prevalence and risk factors for AVB in treated patients are needed.
Collapse
Affiliation(s)
- Qiang Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29#, Gulou District, Fuzhou 350001, People's Republic of China.
| | | | | | | | | | | |
Collapse
|
21
|
Cao H, Chen Q, Zhang GC, Chen LW, Li QZ, Qiu ZH. Intraoperative device closure of perimembranous ventricular septal defects in the young children under transthoracic echocardiographic guidance; initial experience. J Cardiothorac Surg 2011; 6:166. [PMID: 22204650 PMCID: PMC3259044 DOI: 10.1186/1749-8090-6-166] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 12/28/2011] [Indexed: 11/11/2022] Open
Abstract
Objectives This study aimed to assess the safety and feasibility of intraoperative device closure of perimembranous ventricular septal defects (VSD) in young children guided by transthoracic echocardiography (TTE). Methods We enrolled 18 patients from our hospital to participate in the study from June 2011 to September 2011. A minimal inferior median incision was performed after full evaluation of the perimembranous VSD by real-time TTE, and a domestically made device was inserted to occlude the perimembranous VSD. The proper size of the device was determined by means of transthoracic echocardiographic analysis. Results Implantation was ultimately successful in 16 patients using TTE guidance. In these cases, the complete closure rate immediately following the operation and on subsequent follow-up was 100%. Symmetric devices were used in 14 patients, and asymmetric devices were used in two patients. Two patient were transformed to surgical treatment, one for significant residual shunting, and the other for unsuccessful wire penetration of the VSD. The follow-up periods were less than nine months, and only one patient had mild aortic regurgitation. There were no instances of residual shunt, noticeable aortic regurgitation, significant arrhythmia, thrombosis, or device failure. Conclusions Minimally invasive transthoracic device closure of perimembranous VSDs is safe and feasible, using a domestically made device under transthoracic echocardiographic guidance, without the need for cardiopulmonary bypass. This technique should be considered an acceptable alternative to surgery or device closure guided by transesophageal echocardiography in selected young children. However, a long-term evaluation of outcomes is necessary.
Collapse
Affiliation(s)
- Hua Cao
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, P. R. China.
| | | | | | | | | | | |
Collapse
|
22
|
Patanè S, Marte F, Dattilo G, Tulino V, Pagano GT, Sturiale M. The chance finding of a ventricular septal defect in a 2-day-old newborn infant. Int J Cardiol 2011; 152:e45-6. [DOI: 10.1016/j.ijcard.2009.07.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Accepted: 07/25/2009] [Indexed: 11/26/2022]
|
23
|
Transcatheter closure of ventricular septal defect and atrial septal defect. Pediatr Neonatol 2011; 52:241-2. [PMID: 22036217 DOI: 10.1016/j.pedneo.2011.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
24
|
Dattilo G, Tulino D, Tulino V, Lamari A, Marte F, Patanè S. The chance finding of an aneurysm of the right sinus of Valsalva in an 11-year-old child with a ventricular septal defect and a pericardial effusion. Int J Cardiol 2011; 151:e77-9. [DOI: 10.1016/j.ijcard.2009.03.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2009] [Revised: 03/04/2009] [Accepted: 03/05/2009] [Indexed: 11/17/2022]
|
25
|
Tulino D, Dattilo G, Tulino V, Lamari A, Marte F, Patanè S. A case of spontaneous closure of a muscular ventricular septal defect. Int J Cardiol 2011; 150:e43-5. [DOI: 10.1016/j.ijcard.2009.02.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Accepted: 02/27/2009] [Indexed: 11/28/2022]
|
26
|
Percutaneous closure of perimembranous ventricular septal defect with an Amplatzer Duct Occluder in a dextrocardia patient. Int J Cardiol 2011; 150:e77-80. [DOI: 10.1016/j.ijcard.2009.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Accepted: 11/15/2009] [Indexed: 11/20/2022]
|
27
|
Few comments regarding transcatheter closure of congenital perimembranous and muscular ventricular septal defects. Int J Cardiol 2010; 145:69; author reply 70. [DOI: 10.1016/j.ijcard.2009.04.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 04/24/2009] [Indexed: 11/20/2022]
|
28
|
Yang R, Sheng Y, Cao K, Kong X, Xu D, Yong Y, Zhou L, Zhang H, Qian L, Sun W, Gu Z. Transcatheter closure of perimembranous ventricular septal defect in children: safety and efficiency with symmetric and asymmetric occluders. Catheter Cardiovasc Interv 2010; 77:84-90. [PMID: 20928839 DOI: 10.1002/ccd.22644] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 05/01/2010] [Indexed: 12/17/2022]
Abstract
OBJECTIVES This study was designed to determine the safety and efficiency of asymmetric and symmetric ventricular septal occluders (AVSDOs and SVSDOs, respectively) for closure perimembranous ventricular septal defect (PMVSD) in children. METHODS Between January 2003 and December 2007, 142 children with PMVSD were treated with occluders (64 with AVSDOs and 78 with SVSDOs). RESULTS The defect diameter was 5.3 ± 1.1 mm in the AVSDO group and 5.4 ± 1.3 mm in the SVSDO group (P > 0.05). The success rates were similar between two groups [93.8% (AVSDO) vs. 94.9% (SVSDO), P > 0.05]. Two patients in the AVSDO group were switched to the SVSDO group due to residual shunts, and one patient in the SVSDO group was switched due to aortic regurgitation after deployment of the occluder. After procedure, 17 patients [seven with AVSDOs and nine with SVSDOs (P > 0.05)] developed various types of heart block (HB). Among them, 13 patients converted to the normal sinus rhythm. The remaining four cases had not recovered at the end of the study. CONCLUSIONS Transcatheter closure of PMVSD using both AVSDO and SVSDO was safe and effective. Development of HB was the main complication for both devices.
Collapse
Affiliation(s)
- Rong Yang
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
The use of Impella Recover in the treatment of post-infarction ventricular septal defect: A new case report. Int J Cardiol 2010; 144:313-5. [DOI: 10.1016/j.ijcard.2009.03.042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 03/03/2009] [Indexed: 11/21/2022]
|
30
|
Yang J, Yang L, Wan Y, Zuo J, Zhang J, Chen W, Li J, Sun L, Yu S, Liu J, Chen T, Duan W, Xiong L, Yi D. Transcatheter device closure of perimembranous ventricular septal defects: mid-term outcomes. Eur Heart J 2010; 31:2238-45. [PMID: 20801925 PMCID: PMC2938468 DOI: 10.1093/eurheartj/ehq240] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aims The aim of this study was to evaluate the safety and efficacy of transcatheter closure for perimembranous ventricular septal defect (pmVSD) and its long-term results. The most common congenital heart condition is pmVSD. Transcatheter closure of pmVSD is a recently described technique with limited results for mid- to long-term follow-up. Methods and results Between June 2002 and June 2008, 848 patients with pmVSD were enrolled in our study and treated percutaneously with pmVSD occluders. All patients were followed up until December 2008, an average of 37 months. According to colour Doppler transthoracic echocardiography before the intervention and ventriculography, the average end-diastolic pmVSD size was 5.1 and 5.4 mm, respectively. Placement of the device was successful in 832 patients (98.1%) and the median device size was 8.6 mm. During follow-up, 103 adverse events (12.4%) were reported. Most adverse events were categorized as minor and there were nine major adverse events (8.7%), including two complete atrioventricular block requiring pacemaker implantation. Kaplan–Meier estimates showed >85% freedom from major or minor adverse events during a maximal follow-up of 79 months. Conclusions In experienced hands, transcatheter pmVSD closure can be performed safely and successfully with low morbidity and mortality. Long-term prognostic results are favourable, and the transcatheter approach provides a less-invasive alternative that may become the first choice in selected pmVSD patients. This trial is registered with ClinicalTrials.gov, number NCT00890799.
Collapse
Affiliation(s)
- Jian Yang
- Xijing Cardiovascular Hospital, Fourth Military Medical University, Xi'an, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Patanè S, Marte F, Di Bella G, Fazio G, Villari SA. Revelation of an asymptomatic ventricular septal defect in elderly patient before a surgical intervention. Int J Cardiol 2010; 142:e15-6. [DOI: 10.1016/j.ijcard.2008.11.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2008] [Accepted: 11/30/2008] [Indexed: 11/25/2022]
|
32
|
Dua JS, Carminati M, Lucente M, Piazza L, Chessa M, Negura D, Bussadori C, Saliba Z, Butera G. Transcatheter closure of postsurgical residual ventricular septal defects: Early and mid-term results. Catheter Cardiovasc Interv 2010; 75:246-55. [DOI: 10.1002/ccd.22262] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
33
|
Graham TP. The Year in Congenital Heart Disease. J Am Coll Cardiol 2010; 55:147-55. [DOI: 10.1016/j.jacc.2009.08.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 08/17/2009] [Accepted: 08/24/2009] [Indexed: 11/25/2022]
|