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Akagi T, Hara H, Kanazawa H, Fukui S, Hashimoto Y, Iguchi Y, Iwama T, Kataoka H, Kawamura A, Kawano H, Oki K, Yamagami H. Real-World Patent Foramen Ovale (PFO) Closure in Japan - 30-Day Clinical Outcomes From the Amplatzer TM PFO Occluder Japan Post-Marketing Surveillance Study. Circ J 2024:CJ-24-0080. [PMID: 38735702 DOI: 10.1253/circj.cj-24-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
BACKGROUND The AmplatzerTM PFO Occluder was approved for marketing in Japan in May 2019, and the Amplatzer PFO Occluder Japan Post-marketing Surveillance (PFO Japan PMS) study was initiated in December 2019. This analysis presents 30-day clinical outcomes for PFO Japan PMS study patients.Methods and Results: PFO Japan PMS is a prospective single-arm non-randomized multicenter clinical study. Eligible patients were indicated for patent foramen ovale (PFO) closure and underwent an implant attempt with the AmplatzerTM PFO Occluder. Technical success was defined as successful delivery and release of the occluder; procedural success was defined as technical success with no serious adverse events (SAEs) within 1 day of the procedure. The primary safety endpoint includes predefined device- and/or procedure-related SAEs through 30 days after the procedure. From December 2019 to July 2021, 500 patients were enrolled across 53 Japanese sites. The mean (±SD) patient age was 52.7±15.4 years, and 29.8% of patients were aged >60 years. Technical and procedural success rates were both high (99.8% and 98.8%, respectively). Further, there was only one primary safety endpoint event (0.2%): an episode of asymptomatic paroxysmal atrial fibrillation that occurred 26 days after the procedure. CONCLUSIONS In this real-world Japanese study with almost one-third of patients aged >60 years, PFO closure with the AmplatzerTM PFO Occluder was performed successfully and safely, with a low incidence of procedure-related atrial arrhythmias.
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Affiliation(s)
- Teiji Akagi
- Department of Cardiovascular Medicine, Okayama University Hospital
| | - Hidehiko Hara
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center
| | | | | | | | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine
| | | | - Hiroharu Kataoka
- Department of Neurosurgery, National Cerebral and Cardiovascular Center
| | - Akio Kawamura
- Department of Cardiology, International University of Health and Welfare Narita Hospital
| | - Hiroyuki Kawano
- Department of Stroke and Cerebrovascular Medicine, Kyorin University
| | - Koichi Oki
- Department of Neurology, Tokyo Saiseikai Central Hospital
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Mouritane S, Florian A, Zimpfer D. Transatrial repair of a ventricular septal defect and tricuspid valve replacement after a blunt chest trauma. Multimed Man Cardiothorac Surg 2023; 2023. [PMID: 38031961 DOI: 10.1510/mmcts.2023.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
In this case report, we provide insight into how we managed this case of a large traumatic ventricular septal defect and concomitant tricuspid valve insufficiency with a transatrial approach to ensure a successful repair.
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Affiliation(s)
- Sami Mouritane
- University Clinical Center of Surgery, Department of Cardiac Surgery, 8036 Graz, Austria
| | - Alissa Florian
- University Clinical Center of Surgery, Department of Cardiac Surgery, 8036 Graz, Austria
| | - Daniel Zimpfer
- Department of Cardiac Surgery Medical University of Vienna Spitalgasse 23, A1090 Vienna, Austria
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3
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Singhi AK, Sivakumar K. Echocardiographic Classification of Perimembranous Ventricular Septal Defect Guides Selection of the Occluder Design for Their Transcatheter Device Closure. J Cardiovasc Imaging 2021; 29:316-326. [PMID: 34080335 PMCID: PMC8592680 DOI: 10.4250/jcvi.2020.0218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/31/2021] [Accepted: 02/14/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Perimembranous ventricular septal defects (VSDs) has proximate relation to the aortic and tricuspid valves as well as the conduction tissues. Transcatheter closure utilizes various off-label device designs. METHODS Perimembranous VSD without aortic margin were classified as group A, with thick aortic margin as group B, with membranous septal aneurysm as group C and defects restricted by tricuspid valve attachments as group D. The proposed ideal design was asymmetric device in group A; duct occluder I (ADOI) and muscular ventricular septal occluder (MVSO) in group B; thin profile duct occluder II (ADOII) in group C and ADOI in group D. Device was 0-2 mm larger than the defect. RESULTS Eighty patients with VSD measuring 6.83 ± 2.87mm underwent successful closure. Device was retrieved before release in one group A and one group C patient due to aortic regurgitation. Asymmetric device was used in 16 group A defects. Among group B defects, ADOI was used in 5, ADOII in 5, MVSO in one and asymmetric device in 3. Group C defects were closed with ADOI in 7, ADOII in 10 and asymmetric device in 3. Three patients with multiple exits had 2 ADOII devices. Group D defects were closed using ADOI in 20 and ADOII in 10 patients. There was no late aortic regurgitation or heart block on a follow-up exceeding 7 years. CONCLUSIONS This echocardiographic classification helps device selection in every single patient. While asymmetric device is uniquely suited for group A defects, different designs are appropriate in the other groups.
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Affiliation(s)
- Anil Kumar Singhi
- Department of Pediatric Cardiology, Medica Super Specialty Hospital, Kolkata, India
| | - Kothandam Sivakumar
- Department of Pediatric Cardiology, Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India.
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4
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Zhang W, Yang YW, Huang XM, Chu GJ, Kan T, Lu JD, Qin YW. The Application and Teaching Value of a Ventricular Septal Defect Canine Model Established by Transcatheter Puncture. Int Heart J 2021; 62:367-370. [PMID: 33731523 DOI: 10.1536/ihj.20-528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study aimed to improve and further explore a ventricular septal defect (VSD) canine model on the basis of the transcatheter puncture method and to evaluate its application and teaching value.In order to lessen the complications of VSD closure, it is necessary to improve the currently available treatment devices using appropriate animal models.In this study, we used 16 healthy adult canines as our models. After anesthesia, the VSD puncture was performed, followed by balloon dilatation of the perforation. VSD was confirmed by angiography. The venous-artery orbit was established, and the VSD was then closed once the catheter and occluder were across the defect.Of the experimental canines, 14 of the 16 canines were successfully modeled, giving a success rate of 87.5%. The canines underwent an immediate creation of a venous-artery orbit for teaching practice and were implanted with an occluder during the procedure. After 4 weeks, 13 canines survived. As per our findings, most VSD types established by the puncture were perimembranous (10 of 13, 77%).The current model has a high success rate. The model can not only avoid the risk of infection and hemodynamic disorders associated with an open thoracotomy, but can also be effectively used in evaluating the impact of occluders. It can also directly measure the parameters of the devices during the procedure, thus having a very high experimental and teaching value.
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Affiliation(s)
- Wei Zhang
- Department of Cardiology, Gongli Hospital of Shanghai Pudong New Area
| | - Ya-Wei Yang
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
| | - Xin-Miao Huang
- Department of Cardiology, Changhai Hospital, The Second Military Medical University
| | - Guo-Jun Chu
- Department of Cardiology, Changhai Hospital, The Second Military Medical University
| | - Tong Kan
- Department of Cardiology, Changhai Hospital, The Second Military Medical University
| | - Ji-de Lu
- Department of Cardiology, Gongli Hospital of Shanghai Pudong New Area
| | - Yong-Wen Qin
- Department of Cardiology, Changhai Hospital, The Second Military Medical University
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5
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Rakhmawati A, Achmad IN, Hartopo AB, Anggrahini DW, Arso IA, Emoto N, Dinarti LK. Exercise Program Improves Functional Capacity and Quality of Life in Uncorrected Atrial Septal Defect-Associated Pulmonary Arterial Hypertension: A Randomized-Control Pilot Study. Ann Rehabil Med 2020; 44:468-480. [PMID: 33440095 PMCID: PMC7808796 DOI: 10.5535/arm.20100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/13/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To assess the effect of combined hospital and home-based exercise programs on functional capacity and quality of life (QoL) among uncorrected atrial septal defect-associated pulmonary arterial hypertension (ASD-PAH) patients. METHODS This study was a randomized controlled trial with uncorrected ASD-PAH patients as the subjects. They were allocated randomly into control and exercise groups. Exercise group subjects performed hospital and home-based exercise programs, completing baseline 6-minute walking test (6MWT) and EQ-5D-3L QoL test (Utility Index and EQ-VAS scores), and were followed up for 12 weeks. The primary outcomes were 6MWT distance and EQ-5D-3L score at week 12. The N-terminal pro B-type natriuretic peptide (NT-proBNP) level was also assessed. A repeated-measure ANOVA was performed to detect endpoint differences over time. RESULTS The exercise group contained 20 subjects and control group contained 19. In total, 19 exercise group subjects and 16 control group subjects completed the protocol. The 6MWT distance, Utility Index score, and EQ-VAS score incrementally improved significantly in the exercise group from baseline until week 12, with mean differences of 76.7 m (p<0.001), 0.137 (p<0.001) and 15.5 (p<0.001), respectively. Compared with the control group, the exercise group had significantly increased 6MWT distance and utility index score at week 12. The EQ-VAS score increased in the exercise group at week 12. The NT-proBNP level decreased at week 12 in the exercise group. CONCLUSION Combined hospital and home-based exercise program added to PAH-targeted therapy, improving functional capacity and QoL in uncorrected ASD-PAH patients.
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Affiliation(s)
- Annis Rakhmawati
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jogjakarta, Indonesia
| | - Indera Noor Achmad
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jogjakarta, Indonesia
| | - Anggoro Budi Hartopo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jogjakarta, Indonesia
| | - Dyah Wulan Anggrahini
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jogjakarta, Indonesia
| | - Irsad Andi Arso
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jogjakarta, Indonesia
| | - Noriaki Emoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.,Laboratory of Clinical Pharmaceutical Science, Kobe Pharmaceutical University, Kobe, Japan
| | - Lucia Kris Dinarti
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jogjakarta, Indonesia
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Lee JH, Shin HJ, Shin JS. Left Hemitruncus Treated Along with Ventricular Septal Defect in a Neonate. Korean J Thorac Cardiovasc Surg 2020; 53:414-416. [PMID: 32919443 PMCID: PMC7721518 DOI: 10.5090/kjtcs.20.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/15/2020] [Accepted: 06/19/2020] [Indexed: 11/24/2022]
Abstract
Hemitruncus arteriosus is a rare cardiovascular malformation in which one of the pulmonary arteries anomalously originates from the aorta. Left hemitruncus arteriosus, defined as the origination of the left pulmonary artery from the aorta, is less common than right hemitruncus arteriosus. In this study, we report the case of a neonate diagnosed with left hemitruncus arteriosus, ventricular septal defect, and atrial septal defect who underwent successful surgical treatment.
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Affiliation(s)
- Jun Hee Lee
- Department of Thoracic and Cardiovascular Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Hong Ju Shin
- Department of Thoracic and Cardiovascular Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Seung Shin
- Department of Thoracic and Cardiovascular Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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7
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Gold BM, Parekh DR, Kearney DL, Silva GV, Fish RD, Stainback RF. Forme Fruste Cor Triatriatum Dexter by Transesophageal Echocardiography and Its Impact on Percutaneous Heart Procedures: A Case Series. ACTA ACUST UNITED AC 2019; 3:189-199. [PMID: 31709369 PMCID: PMC6833460 DOI: 10.1016/j.case.2019.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cor triatriatum dexter (CTD) can complicate percutaneous atrial septal interventions. Clinically silent (forme fruste) CTD is detectable by new echocardiography techniques. Using these techniques could improve patient selection and guide interventions.
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Affiliation(s)
- Benjamin M Gold
- Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
| | - Dhaval R Parekh
- Department of Cardiology, Texas Heart Institute, Houston, Texas.,Department of Cardiology, Baylor St. Luke's Medical Center, Houston, Texas.,Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Debra L Kearney
- Department of Pathology, Texas Children's Hospital, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Guilherme V Silva
- Department of Cardiology, Texas Heart Institute, Houston, Texas.,Department of Cardiology, Baylor St. Luke's Medical Center, Houston, Texas.,Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - R David Fish
- Department of Cardiology, Texas Heart Institute, Houston, Texas.,Department of Cardiology, Baylor St. Luke's Medical Center, Houston, Texas
| | - Raymond F Stainback
- Department of Cardiology, Texas Heart Institute, Houston, Texas.,Department of Cardiology, Baylor St. Luke's Medical Center, Houston, Texas.,Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas
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8
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Kouakou NYN, Song J, Huh J, Kang IS. The experience of transcatheter closure of postoperative ventricular septal defect after total correction. J Cardiothorac Surg 2019; 14:104. [PMID: 31186037 PMCID: PMC6558918 DOI: 10.1186/s13019-019-0933-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to describe our experience with patients who underwent transcatheter closure of a post-operative ventricular septal defect (VSD). METHODS All patients who underwent transcatheter closure of a VSD after total correction of congenital heart disease since 2012 were enrolled. Medical records were retrospectively reviewed to determine the patients' initial diagnosis, closure device used, and final outcome after device closure. RESULTS Six patients with a median age of 17.7 years (range: 7 months-48 years) underwent transcatheter closure of an unresolved VSD. The median time interval from the initial corrective surgery to the percutaneous closure procedure was 10.4 years (range: 0.3-33.0 years). The initial diagnoses included tetralogy of Fallot (one patient), VSD (two patients), double outlet of the right ventricle (two patients), and aortic valve stenosis (one patient). The reasons for unresolved VSD (other than leakage) after corrective surgery included previous fenestration (in two patients), and iatrogenic Gerbode shunt (in one patient). Various devices were used, including the Amplatzer duct occluder I, Amplatzer duct occluder II, Amplatzer vascular plug II, and Cocoon membranous VSD occluder. Only one device was used in each patient. There were no major complications associated with the closure procedures. The immediate results were satisfactory. The median follow-up duration was 2.75 years. All cases were successful, with the exception of minimal leak in one patient. CONCLUSIONS Transcatheter device closure of post-operative VSD can be performed using various device types of devices and is safe and effective. But more experiences are mandatory.
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Affiliation(s)
| | - Jinyoung Song
- Department of Pediatrics, Samsung Medical Center, Heart Vascular Stroke Institute, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - June Huh
- Department of Pediatrics, Samsung Medical Center, Heart Vascular Stroke Institute, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - I-Seok Kang
- Department of Pediatrics, Samsung Medical Center, Heart Vascular Stroke Institute, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
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9
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Park H, Song J, Kim ES, Huh J, Kang IS. Early Experiences Using Cocoon Occluders for Closure of a Ventricular Septal Defect. J Cardiovasc Imaging 2018; 26:165-174. [PMID: 30310884 PMCID: PMC6160808 DOI: 10.4250/jcvi.2018.26.e19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 09/04/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Transcatheter device closure of ventricular septal defect (VSD) has become an attractive alternative to surgery. We report here on our early experiences of transcatheter closure of VSD using Cocoon devices, which are now available in Korea. METHODS We reviewed the medical records and angiographic images of 13 patients who underwent transcatheter closure of VSD with a Cocoon occluder at Samsung Medical Center. The median patient age was 5.8 years, and the median patient weight was 20.3 kg. RESULTS The device was successfully implanted in all patients. The follow-up period was 10 ± 6 months, and no mortality was observed. An immediate residual leak on the next day was detected in 7 patients (including 4 with perimembranous VSD). However, 6 months later, a residual leak was observed only in 2 patients with perimembranous VSD and 1 patient with muscular VSD. Early conduction abnormalities were observed in 3 patients, all of whom had perimembranous VSD, but no significant complete atrioventricular block was observed. One patient experienced newly developed significant aortic regurgitation that decreased spontaneously but still existed at the 6 month follow-up. No hemolysis or embolization was noted on the next day or during the follow-up period. CONCLUSIONS Cocoon devices can be used safely and effectively for VSD closure. However, residual leaks and conduction abnormalities may occur early after implantation, especially in patients with perimembranous VSD. Although normal conduction was recovered, long-term evaluation remains essential.
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Affiliation(s)
- Hyojung Park
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinyoung Song
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - E Seul Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - June Huh
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - I-Seok Kang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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10
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Catton KG, Setty SP. Anomalous left subclavian artery from the pulmonary artery in a neonate. Asian Cardiovasc Thorac Ann 2018; 26:476-478. [PMID: 29860892 DOI: 10.1177/0218492318780798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The presence of an isolated left subclavian artery arising from the pulmonary artery in a patient with d-transposition of the great arteries is exceedingly rare. Prior to undertaking repair of this congenital cardiac anomaly, identification of an isolated left subclavian artery originating from the pulmonary artery is imperative in order to plan the appropriate intervention to prevent the development of subclavian artery steal or vertebrobasilar insufficiency. We describe the case of a 5 day-old girl in whom an isolated left subclavian artery arising from the pulmonary artery was detected after surgical entry for repair of transposition of the great arteries.
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Affiliation(s)
- Kirsti G Catton
- Miller Children's and Women's Hospital, Memorial Heart and Vascular Institute, Long Beach, CA, USA
| | - Shaun P Setty
- Miller Children's and Women's Hospital, Memorial Heart and Vascular Institute, Long Beach, CA, USA
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11
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Thingnam SKS, Mahajan S, Kumar V. Surgical perspective of percutaneous device closure of atrial septal defect. Asian Cardiovasc Thorac Ann 2018; 26:343-346. [PMID: 29719981 DOI: 10.1177/0218492318776568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Percutaneous device closure of an ostium secundum atrial septal defect is associated with excellent outcomes and cosmetic results but at the cost of occasional serious and sometimes fatal complications as well as lifelong follow-up. Surgical intervention is required in cases of device-related complications, which carries a slightly higher risk compared to primary closure of an atrial septal defect. We present a surgical perspective of device closure of atrial septal defect. Methods Our database was searched over 4 years for complications related to percutaneous device closure of atrial septal defect, which required surgical retrieval of the device and closure of the defect. We identified 14 cases that required surgical intervention. Results The median age of the 14 patients was 18 years (range 4-58 years). The size of the defect ranged from 15 to 40 mm (median 30 mm). Device embolization into any part of the cardiovascular system ( n = 8) was the most common complication, followed by malalignment of the device ( n = 5). One patient had left atrial appendage perforation causing pericardial effusion and cardiac tamponade, and underwent surgical repair. The other 13 patients underwent removal of the device and atrial septal defect closure. One patient developed severe mitral regurgitation requiring mitral valve replacement. There was no mortality. Conclusion Although the incidence of device-related complications may be small, they carry a high risk of death or long-term morbidity, even with a small atrial septal defect, unlike primary surgical closure of isolated atrial septal defect.
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Affiliation(s)
- Shyam Kumar Singh Thingnam
- Department of Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sachin Mahajan
- Department of Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Kumar
- Department of Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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12
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Cui HJ, Zhuang J, Chen JM, Cen JZ, Xu G, Wen SS. [Surgical treatment and early-mid follow-up results of complete atrioventricular septal]. Zhonghua Wai Ke Za Zhi 2017; 55:933-7. [PMID: 29224269 DOI: 10.3760/cma.j.issn.0529-5815.2017.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To discuss the surgical treatment and early-mid follow-up results of complete atrioventricular septal defect (CAVSD). Methods: The clinic data of 235 cases of CAVSD underwent surgical treatment at Department of Cardiac Surgery, Guangdong General Hospital from June 2009 to June 2016 was analyzed retrospectively (104 male and 131 female patients). The patients were aged 18 days to 58 years (mid age 8.9 months) at surgery, and 2 cases of newborns (0.9%), 24 cases of 1 to 3 months (10.2%), 56 cases of 4 to 6 months (23.8%), 66 cases of 7 to 12 months (28.1%), 36 cases of 1 to 3 years (15.3%), 37 cases of 4 to 18 years (15.7%), and 14 cases above 18 years (6.0%). There were 129 cases of Rastelli type A (54.89%), 16 cases of type B (6.8%), 25 cases of type C (10.6%) and 65 cases of transitional type (27.7%). The patients were combined with 7 cases of unroofed coronary sinus syndrome, 5 cases of coarctation of aorta, 4 cases of tetralogy of Fallot, 3 cases of double outlet right ventricle, 1 case of transposition of the great arteries, 1 case of multiple ventricular septal defect, 1 case of pulmonary artery sling. The CAVSD correction operations were performed in 199 cases with modified single patch technique (84.7%), 26 cases with two patch technique (11.1%), 10 cases with conventional single patch technique (4.3%), and the corrective surgeries of other anomalies were performed in the meantime. Generalized Estimated Equation was used to statistical analysis of postoperative regurgitation level of mitral valve and tricuspid valve. Results: Followed-up for 1 to 7 years, 18 cases (7.7%) died overall and 15 cases (6.4%) died within 30 days post-operation.The mortality of little infant (operation age ≤3 months) was much highest(26.9%). The mortality of different operation age had significant difference(P=0.007). There was no difference among the mortality with three techniques. Seven cases (3.0%) suffered from the re-operation for severe mitral regurgitation. A total of 217 patients survived more than 1 year after initial surgery, and there were 11 cases (5.1%) with severe mitral regurgitation and 7 cases (3.2%) with severe tricuspid valve regurgitation at 1 year post-operation.The degree of mitral regurgitation after operation decreased at 1 week to 6 months, and slightly higher after 1 year postoperatively.The ratios of severe mitral regurgitation in different operative age group was statistically significant difference(P=0.017), mainly from 3 months group and 1 to 3 years group.The degree of tricuspid regurgitation decreased significantly after operation, and decreased gradually in the follow-up period. The ratio of postoperative residual severe tricuspid regurgitation was the highest in surgical aged >18 years old, less in 3 years group, the lowest in 3 to 18 years group. Conclusions: The mortality and the ratio of patients with serious mitral regurgitation were higher in infants less 3 months than elder patients. The infants need more frequently follow-up and medicine treatment after operation. The modified one patch technique is effective for all age groups.
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Abstract
We describe an unusual case of partial atrioventricular septal defect with malalignment of the septum primum to the left atrium with respect to the ventricular septum, committing the tricuspid valve to both ventricles (double-outlet right atrium). Abnormal attachment of the septum primum to the lateral aspect of mitral annulus resulted in left atrial outflow obstruction. The patient underwent successful surgical correction.
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Affiliation(s)
- Arun Gopalakrishnan
- Department of Cardiology, 29354 Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala, India
| | - Bijulal Sasidharan
- Department of Cardiology, 29354 Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala, India
| | - Jaganmohan Tharakan
- Department of Cardiology, 29354 Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala, India
| | - Ajitkumar Valaparambil
- Department of Cardiology, 29354 Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala, India
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Abstract
Postinfarction ventricular septal rupture is a life-threatening complication of acute myocardial infarction. Although some novel techniques of ventricular septal rupture closure have been introduced, they involve ventriculotomy, a procedure that can cause a degree of impairment of the incised ventricle. We describe a case in which we closed a ventricular septal rupture through the tricuspid valve, without ventriculotomy.
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Affiliation(s)
- Dai Kawashima
- 1 Department of Cardiovascular Surgery, Takeda General Hospital, Fukushima, Japan
| | - Satoru Maeba
- 1 Department of Cardiovascular Surgery, Takeda General Hospital, Fukushima, Japan
| | - Masahiro Saito
- 1 Department of Cardiovascular Surgery, Takeda General Hospital, Fukushima, Japan
| | - Minoru Ono
- 2 Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
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15
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Nassif M, Heuschen CBBC, Lu H, Bouma BJ, van Steenwijk RP, Sterk PJ, Mulder BJM, de Winter RJ. Relationship between atrial septal defects and asthma-like dyspnoea: the impact of transcatheter closure. Neth Heart J 2016; 24:640-646. [PMID: 27561281 PMCID: PMC5065534 DOI: 10.1007/s12471-016-0879-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Patients with atrial septal defects (ASD) are often misdiagnosed as asthma patients and accordingly receive erroneous bronchodilator treatment. In order to characterise their symptoms of dyspnoea to explain this clinical observation, we investigated the prevalence of asthma-like symptoms in patients with secundum ASD who then underwent successful percutaneous closure. METHODS A total of 80 ASD patients (74 % female, mean age 46.7 ± 16.8 years, median follow-up 3.0 [2.0-5.0] years) retrospectively completed dyspnoea questionnaires determining the presence and extent of cough, wheezing, chest tightness, effort dyspnoea and bronchodilator use on a 7-point scale (0 = none, 6 = maximum) before and after ASD closure. The Mini Asthma Quality of Life (Mini-AQLQ) and Asthma Control Questionnaire with bronchodilator use (ACQ6) were administered. RESULTS A total of 48 (60 %) patients reported cough, 27 (34 %) wheezing, 26 (33 %) chest tightness and 62 (78 %) effort dyspnoea. Symptom resolution or reduction was found in 64 (80 %) patients after ASD closure. Asthma symptom scores decreased significantly on the Mini-AQLQ and ACQ6 (both p < 0.001). The number of patients using bronchodilators decreased from 16 (20 %) to 8 (10 %) patients after ASD closure (p = 0.039) with less frequent use of bronchodilators (p = 0.015). CONCLUSIONS A high prevalence of asthma-like symptoms and bronchodilator use is present in ASD patients, which exceeds the low prevalence of bronchial asthma in this study population. Future prospective research is required to confirm this phenomenon. The presence of an ASD should be considered in the differential diagnosis of patients with asthma-like symptoms, after which significant symptom relief can be achieved by ASD closure.
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Affiliation(s)
- M Nassif
- Department of Cardiology, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - C B B C Heuschen
- Department of Cardiology, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - H Lu
- Department of Cardiology, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - B J Bouma
- Department of Cardiology, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - R P van Steenwijk
- Department of Pulmonary Medicine, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - P J Sterk
- Department of Pulmonary Medicine, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - B J M Mulder
- Department of Cardiology, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands.,Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands
| | - R J de Winter
- Department of Cardiology, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands.
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16
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Nassif M, Abdelghani M, Bouma BJ, Straver B, Blom NA, Koch KT, Tijssen JGP, Mulder BJM, de Winter RJ. Historical developments of atrial septal defect closure devices: what we learn from the past. Expert Rev Med Devices 2016; 13:555-68. [PMID: 27112301 DOI: 10.1080/17434440.2016.1182860] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Since King and Mills' pioneering work in percutaneous closure devices of secundum atrial septal defects (ASD) four decades ago, developments in device shape, material and implantation technique led to adoption of percutaneous ASD closure as current treatment of choice. Not only was the feasibility of such a percutaneous procedure tested altogether, but pursuing the ideal device in terms of safety and efficacy became priority. AREAS COVERED In this review we present the historical development of ASD devices in design, material and technique with clinical data, and provide the future perspectives in percutaneous ASD closures. EXPERT OPINION An 'ideal device' requires complete defect closure with negligible risk of complications using a safe, straightforward delivery technique with repositioning and retrieving properties. Some of the devices currently at hand come close to fulfilling these criteria, however none seem to provide those prerequisites completely. By understanding how challenges in device development were overcome in the past, new insights into future improvements are given.
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Affiliation(s)
- Martina Nassif
- a Department of Cardiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Mohammad Abdelghani
- a Department of Cardiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Berto J Bouma
- a Department of Cardiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Bart Straver
- b Department of Pediatric Cardiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Nico A Blom
- b Department of Pediatric Cardiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Karel T Koch
- a Department of Cardiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Jan G P Tijssen
- a Department of Cardiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Barbara J M Mulder
- a Department of Cardiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands.,c Interuniversity Cardiology Institute of the Netherlands (ICIN) , Utrecht , The Netherlands
| | - Robbert J de Winter
- a Department of Cardiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
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17
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Tocharoenchok T, Sriyoschati S, Tongcharoen P, Tantiwongkosri K, Subtaweesin T. Midterm results of anatomic repair in a subgroup of corrected transposition. Asian Cardiovasc Thorac Ann 2016; 24:428-34. [PMID: 27095702 DOI: 10.1177/0218492316645749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Anatomic repair has become the preferred option in the subgroup of patients with congenitally corrected transposition of the great arteries with ventricular septal defect and pulmonary obstruction. We report our 14-year experience with this approach. METHODS From April 2001 to February 2014, 22 patients with congenitally corrected transposition with ventricular septal defect and pulmonary obstruction underwent anatomic repair. Nineteen patients had a modified Senning-Rastelli procedure, 2 had a Mustard-Rastelli procedure, and one had a hemi-Mustard-Glenn-Rastelli procedure. The mean age was 10.9 years, and 8 (36.4%) patients were male. RESULTS There were 2 early deaths from sepsis and ventricular failure at 18 and 81 days postoperatively, and 3 late deaths from ventricular failure at 4, 33, and 113 months postoperatively. Left ventricular failure with mitral valve regurgitation was present in 3 of the 5 patients who died. Among the survivors, 3 underwent 4 transcatheter interventions for right ventricular outflow tract obstruction and 3 underwent 4 reoperations for atrial pathway obstruction, left and right ventricular outflow tract obstruction, or residual shunt. At a median follow-up of 64 months (range 14-167 months), 15 of 17 survivors were in functional class I. One patient had severe mitral valve regurgitation and was awaiting valve replacement. Another patient had right ventricular outflow conduit obstruction and was scheduled for reoperation. CONCLUSIONS Results of atrial switch-Rastelli procedures in this subgroup of patients with corrected transposition are satisfactory but still imperfect. Mitral regurgitation might predict a poor outcome. Long-term follow-up is necessary.
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Affiliation(s)
- Teerapong Tocharoenchok
- Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Somchai Sriyoschati
- Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Punnarerk Tongcharoen
- Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kriangkrai Tantiwongkosri
- Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thaworn Subtaweesin
- Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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18
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Abstract
Biatrial drainage of the right superior vena cava resulting from a sinus venosus defect is a rare congenital malformation. It can result in severe desaturation although a sinus venosus defect usually presents as a left-to-right shunt. A male baby was noted to have cyanosis while nursing and was referred to us for medical treatment on his second day of life. Echocardiography showed that most of the blood flowing through the superior vena cava drained into the left atrium. He underwent successful surgery to correct this defect at the age of 2 years.
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Affiliation(s)
- Yusuke Iwata
- 1 Department of Pediatric Cardiac Surgery, Children's Medical Center, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Ai Kojima
- 1 Department of Pediatric Cardiac Surgery, Children's Medical Center, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Yuki Nakayama
- 1 Department of Pediatric Cardiac Surgery, Children's Medical Center, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Kentaro Omoya
- 2 Department of Pediatric Cardiology, Children's Medical Center, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Takashi Kuwahara
- 2 Department of Pediatric Cardiology, Children's Medical Center, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Takamasa Takeuchi
- 1 Department of Pediatric Cardiac Surgery, Children's Medical Center, Gifu Prefectural General Medical Center, Gifu, Japan
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19
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El-Rassi I, Charafedine F, Majdalani M, Arabi M, Khater D, Bitar F. Surgical repair of partial atrioventricular defect. Multimed Man Cardiothorac Surg 2015; 2015:mmv037. [PMID: 26685152 DOI: 10.1093/mmcts/mmv037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 11/13/2015] [Indexed: 11/12/2022]
Abstract
Long-term survival rate of patients operated for partial atrioventricular (AV) canal is lower than that of the general population, and late complications are relatively significant: between 10 and 30% of operated patients present with left AV valve regurgitation, and up to 25% have to be reoperated for valve repair or replacement, left ventricular outflow tract obstruction or residual atrial septal defect. Because the left AV valve regurgitation is the most common complication following surgery, technical details in the surgical management of the mitral valve are the most important aspects of this procedure; for example, the decision to close the cleft and to perform an annuloplasty. The presence of mitral valve anomalies in 7-28% of the cases complicates further the surgical management of these valves. This article will describe in detail the operative technique of partial AV canal repair, and review the relevant literature.
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Affiliation(s)
- Issam El-Rassi
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fatimah Charafedine
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariane Majdalani
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariam Arabi
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Daniele Khater
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Bitar
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
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20
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El-Rassi I, Charafeddine F, Tabbakh A, Aboutaka M, Khater D, Arabi M, Bitar F. Surgical repair of complete atrioventricular defect (Nunn technique). Multimed Man Cardiothorac Surg 2015; 2015:mmv023. [PMID: 26443542 DOI: 10.1093/mmcts/mmv023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 08/09/2015] [Indexed: 06/05/2023]
Abstract
Two procedures have been traditionally used for the surgical repair of complete atrioventricular canal. The single-patch technique includes the division of valve leaflets, and the use of one patch to close the ventricular and the atrial septal defects, whereas the double-patch technique uses two separate patches, without the division of the bridging leaflets. Between 1997 and 2007, another technique emerged, the modified single-patch technique, or the 'Australian' technique, whereby the ventricular septal defect (VSD) is closed by the direct apposition of the bridging leaflets against the crest of the defect. Because of the absence of the ventricular septal patch, concerns have been raised about the possible left ventricular outflow tract obstruction (LVOTO), or atrioventricular valve (AVV) distortion, especially in case of a deep VSD, or if the defect extends superiorly. The results of the modified single-patch technique in terms of mortality, immediate and long-term AVV function and LVOTO have been similar to the standard techniques in most reports. This article will describe in detail the operative technique and review the relevant literature.
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Affiliation(s)
- Issam El-Rassi
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Anas Tabbakh
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohammad Aboutaka
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Daniele Khater
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariam Arabi
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Bitar
- Cardiac Surgery, American University of Beirut Medical Center, Beirut, Lebanon
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21
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Lakhotia S, Kumawat M, Mathur SK, Kinge BK. Tuberculous constrictive pericarditis and atrial septal defect: Surgical challenge. Asian Cardiovasc Thorac Ann 2015; 24:888-892. [PMID: 26124431 DOI: 10.1177/0218492315593226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tuberculous constrictive pericarditis with atrial septal defect is very rare. A 23-year-old man required pericardiectomy and atrial septal defect closure under cardiopulmonary bypass by cannulating the aorta and right atrium because femoral cannulation was not possible and the venae cavae could not be visualized. He was discharged in a satisfactory condition on the 15th postoperative day, but returned one month later with swelling all over his body and dyspnea on exertion. Echocardiography showed atrial septal defect patch dehiscence and a bidirectional shunt with a collection or mass compressing the right ventricle. Subxiphoid exploration was carried out, and the swelling subsided.
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Affiliation(s)
- Siddharth Lakhotia
- Department of Cardiothoracic and Vascular Surgery, Institute of Medical Sciences and Associated SS Hospital BHU, Varanasi, India
| | - Mukesh Kumawat
- Department of Vascular Surgery, Institute of Medical Sciences and Associated SS Hospital BHU, Varanasi, India
| | - Sharad Kumar Mathur
- Department of Anesthesia, Institute of Medical Sciences and Associated SS Hospital BHU, Varanasi, India
| | - Bhushan Kumar Kinge
- Department of Anesthesia, Institute of Medical Sciences and Associated SS Hospital BHU, Varanasi, India
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22
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Hemati N, Poormotaabed A, Dabiri S, Sabzi F. Acute Left Atrial Thrombus Formation on Resected Residual Cribriform Septum after Atrial Septal Defect Surgery. J Tehran Heart Cent 2015; 10:109-12. [PMID: 26110012 PMCID: PMC4477086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 07/10/2014] [Indexed: 10/28/2022] Open
Abstract
Acute left atrial thrombosis at the site of the resection of the primary cribriform septum is an exceedingly rare and important complication after atrial septal defect (ASD) closure with a pericardial or synthetic patch. This case report presents a mobile thrombus noted on the left atrium at the raw surface site of a resected cribriform primary septum that was not caught in the suture line with the pericardial patch for the closure of the ASD in a 30-year-old woman with an uncomplicated ASD surgery. The patient had no symptoms in the postoperative period, and routine postoperative transesophageal echocardiography revealed a large pedunculated and mobile mass (thrombosis) at the left atrial side of the interatrial septum at the level of the implanted pericardial patch. The thrombus was successfully treated with surgery. The patient had an uneventful recovery in the postoperative period and was discharged from the hospital 15 days after admission. One-year follow-up showed no evidence of clot recurrence in the left or right atrium.
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Affiliation(s)
| | | | | | - Feridoun Sabzi
- Corresponding Author: Feridoun Sabzi, Professor of Cardiac Surgery, Kermanshah University of Medical Sciences, Imam Ali Hospital, Shaheed Beheshti Ave, Kermanshah, Iran. 6715847134. Tel: +98 918 1311896. Fax: +98 833 8360043.
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23
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Reshmi LJ, Gadhinglajkar S, Mathew T, Venkateshwaran S, Sreedhar R, Dharan B. Pulmonary valvuloplasty for pulmonary atresia-restrictive ventricular septal defect. Asian Cardiovasc Thorac Ann 2014; 24:190-4. [PMID: 25293418 DOI: 10.1177/0218492314553995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pulmonary atresia with restrictive ventricular septal defect is a rare congenital cardiac anomaly. A Blalock-Taussig shunt and surgical perforation of the atretic pulmonary valve is often performed as the initial palliation. We present our experience of utilizing both transesophageal and epicardial echocardiography during surgical pulmonary valvuloplasty in a 22-day-old neonate with pulmonary atresia with restrictive ventricular septal defect. The atretic pulmonary valve was perforated using a sheath introduced through the pulmonary artery.
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Affiliation(s)
- Liza Jose Reshmi
- Department of Anesthesia, Sree Chitra Tirunal Institute For Medical Sciences and Technology, Trivandrum, India
| | - Shrinivas Gadhinglajkar
- Department of Anesthesia, Sree Chitra Tirunal Institute For Medical Sciences and Technology, Trivandrum, India
| | - Thomas Mathew
- Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute For Medical Sciences and Technology, Trivandrum, India
| | - Subramanian Venkateshwaran
- Department of Cardiology, Sree Chitra Tirunal Institute For Medical Sciences and Technology, Trivandrum, India
| | - Rupa Sreedhar
- Department of Anesthesia, Sree Chitra Tirunal Institute For Medical Sciences and Technology, Trivandrum, India
| | - Baiju Dharan
- Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute For Medical Sciences and Technology, Trivandrum, India
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24
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Abstract
A 3-year-old boy with pulmonary atresia with ventricular septal defect, who had undergone placement of a modified Blalock-Taussig shunt, presented with a 1-week history of high fever. Computed tomography showed a pseudoaneurysm at the anastomosis between the right brachiocephalic artery and the graft. After intravenous antibiotic therapy, the pseudoaneurysm and infected graft were resected through a median sternotomy. This report describes successful management of a potentially fatal complication following placement of a modified Blalock-Taussig shunt.
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Affiliation(s)
- Yosuke Nakai
- Department of Cardiovascular Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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25
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Ryu IH, Kim WH, Ryu AJ, Kim MG, Jeon JW, Kim JS, Lee JJ, Choi JH. Percutaneous closure of an iatrogenic ventricular septal defect following concomitant septal myectomy at the time of aortic valve replacement. Korean Circ J 2014; 44:45-8. [PMID: 24497890 PMCID: PMC3905116 DOI: 10.4070/kcj.2014.44.1.45] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 09/04/2013] [Accepted: 09/10/2013] [Indexed: 11/11/2022] Open
Abstract
A 77-year-old female patient underwent aortic valve replacement (AVR) with concomitant septal myectomy and tricuspid annuloplasty. Her symptoms did not improve after a successful operation. Echocardiogram demonstrated the presence of an iatrogenic ventricular septal defect (VSD). It was muscular in location and not the usual AVR with membraneous type of VSD, suggesting a complication from the myectomy. Percutaneous closure of the VSD remained the only feasible option due to her poor overall medical status. A 14-mm Amplazter VSD occluder was deployed successfully, by means of the trans-septal technique. She has improved very well postoperatively.
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Affiliation(s)
- Il Hwan Ryu
- Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Won Ho Kim
- Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Ah Jeong Ryu
- Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Min Gyu Kim
- Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Jae Woong Jeon
- Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Joo Seok Kim
- Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Jae Joon Lee
- Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Jin Ho Choi
- Division of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
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26
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Disli OM, Erdil N, Akca B, Otlu YO, Battaloglu B. Large thrombus formation from right atrial incision site after closure of atrial septal defect. Korean Circ J 2014; 43:842-4. [PMID: 24385998 PMCID: PMC3875703 DOI: 10.4070/kcj.2013.43.12.842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 05/16/2013] [Accepted: 07/26/2013] [Indexed: 11/25/2022] Open
Abstract
Atrial septal defect (ASD) is the common congenital anomaly which requires surgical interventions. Right atrial thrombus formations after primary suture repairs of the ASD and evidences of thromboembolic complications are extremely rare. Specifically, the cases of thromboembolic complications have high mortality and morbidity risks. Two cases of giant intra-atrial thrombus formation detected in the late stage after primary repairs of ASDs are being discussed.
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Affiliation(s)
- Olcay Murat Disli
- Department of Cardiovascular Surgery, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Nevzat Erdil
- Department of Cardiovascular Surgery, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Barıs Akca
- Department of Cardiovascular Surgery, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Yılmaz Omur Otlu
- Department of Cardiology, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Bektas Battaloglu
- Department of Cardiovascular Surgery, Inonu University Faculty of Medicine, Malatya, Turkey
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27
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Affiliation(s)
- Liselotte M Klitsie
- Department of Paediatric Cardiology, Leiden University Medical Center, Leiden, Netherlands
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28
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Koestenberger M, Ravekes W. Impairment of tricuspid annular plane systolic excursion and tricuspid annular peak systolic velocity after ventricular septal defect correction. Eur J Cardiothorac Surg 2013; 44:1158. [PMID: 23671206 DOI: 10.1093/ejcts/ezt270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Martin Koestenberger
- Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria
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29
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Kim JE, Jung SH, Kim GS, Kim JB, Choo SJ, Chung CH, Lee JW. Surgical Outcomes of Congenital Atrial Septal Defect Using da VinciTM Surgical Robot System. Korean J Thorac Cardiovasc Surg 2013; 46:93-7. [PMID: 23614093 PMCID: PMC3631797 DOI: 10.5090/kjtcs.2013.46.2.93] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 10/09/2012] [Accepted: 10/09/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Minimally invasive cardiac surgery has emerged as an alternative to conventional open surgery. This report reviews our experience with atrial septal defect using the da VinciTM surgical robot system. MATERIALS AND METHODS This retrospective study included 50 consecutive patients who underwent atrial septal defect repair using the da VinciTM surgical robot system between October 2007 and May 2011. Among these, 13 patients (26%) were approached through a totally endoscopic approach and the others by mini-thoracotomy. Nineteen patients had concomitant procedures including tricuspid annuloplasty (n=10), mitral valvuloplasty (n=9), and maze procedure (n=4). The mean follow-up duration was 16.9±10.4 months. RESULTS No remnant interatrial shunt was detected by intraoperative or postoperative echocardiography. The atrial septal defects were mainly repaired by Gore-Tex patch closure (80%). There was no operative mortality or serious surgical complications. The aortic cross clamping time and cardiopulmonary bypass time were 74.1±32.2 and 157.6±49.7 minutes, respectively. The postoperative hospital stay was 5.5±3.3 days. CONCLUSION The atrial septal defect repair with concomitant procedures like mitral valve repair or tricuspid valve repair using the da VinciTM system is a feasible method. In addition, in selected patients, complete port access can be helpful for better cosmetic results and less musculoskeletal injury.
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Affiliation(s)
- Ji Eon Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea
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Lovisolo SM, Aiello VD, de Campos FPF. An inferior sinus venosus interatrial communication associated with a secundum atrial septal defect, clinically presenting in an adult patient: autopsy report. Autops Case Rep 2011; 1:21-27. [PMID: 31528549 PMCID: PMC6735558 DOI: 10.4322/acr.2011.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 11/21/2011] [Indexed: 11/30/2022] Open
Abstract
Atrial septal defects (ASD) are the most common congenital cardiac lesion in adults, representing up to 40% of acyanotic shunt lesions in patients older than 40 years. Secundum ASD comprises defects in the area of the oval fossa, and may be associated with other types of interatrial communications. We present a case of a 25 year-old female patient who was asymptomatic until the age 22 when she started presenting exertion dyspnea and lower limbs edema, during her third pregnancy. The patient was admitted in the emergency department because of a febrile respiratory distress syndrome dying in less than 36 hours after her arrival. The autopsy examination revealed pneumonia and a secundum ASD, associated with a rare form of interatrial communication, the inferior sinus venosus defect, which is characterized by an anomalous connection of the right pulmonary veins to the inferior caval vein at its opening in the right atrial cavity, while retaining partially their connection to the left atrium. A dysplastic and thickened mitral valve was also present. Signs of pulmonary hypertension confirm the Eisenmenger syndrome in this adult patient.
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Affiliation(s)
- Silvana Maria Lovisolo
- Anatomic Pathology Service - Hospital Universitário, Universidade de São Paulo, São Paulo/SP - Brazil
| | - Vera Demarchi Aiello
- Laboratory of Pathology - Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP - Brasil
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Cho MJ, Song J, Kim SJ, Choi EY, Lee SY, Shim WS. Transcatheter closure of multiple atrial septal defects with the amplatzer device. Korean Circ J 2011; 41:549-51. [PMID: 22022332 PMCID: PMC3193048 DOI: 10.4070/kcj.2011.41.9.549] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 10/25/2010] [Accepted: 12/21/2010] [Indexed: 11/11/2022] Open
Abstract
Percutaneous device occlusion of secundum atrial septal defect (ASD) has become an accepted alternative to surgical repair. A variety of devices have been used successfully. However, all of them have limitations. We report our experience with two devices used to close multiple ASDs.
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Affiliation(s)
- Mi Jin Cho
- Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea
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Behjati M, Rafiei M, Soltani MH, Emami M, Dehghani M. Transcatheter closure of atrial septal defect with amplatzer septal occluder in adults: immediate, short, and intermediate-term results. J Tehran Heart Cent 2011; 6:79-84. [PMID: 23074610 PMCID: PMC3466875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Accepted: 02/05/2011] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The transcatheter closure of the atrial septal defect (ASD) has become an alternative technique to surgical procedures. The aim of this study was to assess the immediate, short, and intermediate-term results of the transcatheter closure of the secundum ASD with the Amplatzer Septal Occluder (ASO) in adult Iranian patients. METHODS Between December 2004 and July 2008, the transcatheter closure of the ASD using the ASO was attempted in 58 consecutive, adult patients. The mean age of the patients was 37.1 ± 12.7 years (range = 19 - 75 years). All the procedures were performed under local anesthesia with transthoracic or transesophageal echocardiography and fluoroscopic guidance. The stretched diameter of the ASD was determined with a balloon sizing catheter, and device selection was based on and matched to the stretched diameter of the septal defect. Transthoracic echocardiography was performed immediately after the release of the device and before discharge. Further follow-up at one month, six months, and yearly thereafter included physical examination, electrocardiography, and transthoracic echocardiography. RESULTS The mean ASD diameter, as measured by esophageal echocardiography, was 24.8 ± 5.4 mm (range = 13 - 34 mm). The mean stretched diameter, as measured by the balloon catheter, was 27.1 ± 6.4 mm (range = 12.5 - 39 mm). Deployment of the ASO was successful in 52 (89.6%) patients and failed in 6 (10.4%). Four patients experienced severe complications, 1 had tamponade requiring drainage, 2 had device embolization to the left atrium and right ventricular outflow tract, and 1 had late wire fracture (surgical removal and repair of the ASD). The position of two large devices (34 mm and 36 mm) was considered unsuitable and unstable after implantation and resulted in the removal of these devices. Minor complications included transient complete atrioventricular block in 1 patient, paroxysmal supra tachycardia in 3 patients, atrial flutter in 1 patient, and angina pectoris with transient ST elevation in 2 patients. The mean follow-up period was 32.5 ± 18.5 months. Echocardiography at 24 hours, 1 month, 6 months, and 12 months after the procedure showed residual shunts in 11 (21%), 3 (5.8%), 2 (3.8%), and 2 (3.8%) patients, respectively. At follow-up (12.8 months to 48.5 months, mean ± SD = 32.5 ± 18.5 months), complete closure was documented in 50 (96.2 %) of the 52 cases. At the end of the follow-up, 2 (3.8%) patients had residual shunts: The shunt was moderate in 1 (1.9%) patient and small in the other (1.9%). The overall success rate of the transcatheter closure of the ASD was 86% (50 of 58 cases). CONCLUSION The transcatheter closure of the secundum ASD in our adult patient population using the ASO was associated with high degrees of success, minimal procedural complication rates, and excellent short and midterm results. The use of this device, however, requires thorough attention in that the procedure may be ineffective or the device may embolize. Further experience and long-term follow-up are required before a widespread clinical use can be recommended.
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Affiliation(s)
- Mostafa Behjati
- Corresponding Author: Mostafa Behjati, Associate Professor of Pediatric Cardiology, Division of Pediatric Cardiology, Shahid Sadoughi University of Medical Science, Afshar Hospital, Jomhouri Boulevard, Yazd, Iran. 8917945556. Tel: +98 351 5231421. Fax: +98 351 5253335.
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McCarthy KP, Ho SY, Anderson RH. Ventricular septal defects: morphology of the doubly committed juxtaarterial and muscular variants. Images Paediatr Cardiol 2000; 2:5-23. [PMID: 22368583 PMCID: PMC3232488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
In our previous review of the phenotypic features of ventricular septal defects, we concentrated on the perimembranous variant, showing how its distinguishing feature, as viewed from the right ventricle, was fibrous continuity in its postero-inferior rim between the leaflets of the aortic and tricuspid valves. In this second review, we focus on the morphology of those defects which have exclusively muscular rims when viewed from their right side, and the variant with the phenotypic feature of fibrous continuity between the leaflets of the two arterial valves. As with the defects described as being perimembranous, once they have been characterised, it is the position of the defect relative to the components of the morphologically right ventricle that is the primary determinant of the options and strategies for treatment. Therefore, clarification of the morphology is the key to establishing the related risks for each particular defect.
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Affiliation(s)
- KP McCarthy
- Senior Research Technician, Institute of Child Health, University College London, Cardiac Unit, 30 Guilford Street, London WC1N 1EH
| | - SY Ho
- Reader in Cardiac Morphology, National Heart & Lung Institute, Imperial College, Paediatric Cardiac Morphology, Dovehouse Street, London SW3 6LY
| | - RH Anderson
- Joseph Levy Professor of Paediatric Cardiac Morphology, Institute of Child Health, University College London, Cardiac Unit, 30 Guilford Street, London WC1 1EH
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McCarthy KP, Ho SY, Anderson RH. Categorisation of ventricular septal defects: review of the perimembranous morphology. Images Paediatr Cardiol 2000; 2:24-40. [PMID: 22368580 PMCID: PMC3232482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The Association for European Paediatric Cardiology, the Society of Thoracic Surgeons, and the European Association for Cardiothoracic Surgery, have recently published detailed hierarchical listings for the description of ventricular septal defects. This review details the anatomic basis for the European codes, illustrating the phenotypic features of the various holes that can be described as perimembranous ventricular septal defects.
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Affiliation(s)
- KP McCarthy
- Senior Research Technician, Institute of Child Health, University College London, Cardiac Unit, 30 Guilford Street, London WC1N 1EH,Contact information: Ms. Karen McCarthy, Senior Research Technician, Institute of Child Health, University College London, Cardiac Unit, 30 Guilford Street, London WC1N 1EH - UK
| | - SY Ho
- Reader in Cardiac Morphology, National Heart & Lung Institute, Imperial College, Paediatric Cardiac Morphology, Dovehouse Street, London SW3 6LY
| | - RH Anderson
- Professor Robert H Anderson, Joseph Levy Professor of Paediatric Cardiac Morphology, Institute of Child Health, University College London, Cardiac Unit, 30 Guilford Street, London WC1 1EH
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