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Rohit Mathur, Sanjeev Sanghvi, Anil Baroopal
Lutembacher syndrome is a rare cardiac abnormality characterized by a combination of congenital atrial septal defect (ASD) and acquired rheumatic mitral stenosis (MS). Here we report a case of 18-year-old male with Lutembacher syndrome successfully treated percutaneously with transcatheter Accura balloon valvuloplasty and Amplatzer septal occluder device closure.
January 2018: Journal of the Association of Physicians of India
Yoav Hammer, Uri Landes, Oren Zusman, Ran Kornowski, Guy Witberg, Katia Orvin, Amos Levi, Pablo Codner, Hanna Vaknin-Assa, Mithal Nassar, Gideon Shafir, Abid Assali, Ashraf Hamdan
BACKGROUND: Transfemoral Transcatheter Aortic Valve Replacement (TAVR) carries a risk of Vascular Complications (VCs) at the access site. The currently used measures for assessing the risk for VCs are not accurate enough, and sometimes fail to predict them. We therefore aimed to examine whether Iliofemoral artery lumen volume (IFV) assessment with 3-dimensional computed tomography (CT) predicts VCs after transfemoral TAVR. METHODS: We identified 45/560 trans-femoral TAVR patients with VC, then performed nearest neighbor 1:1 matching for patients with no VC, matching for age, sex, TAVR year, valve size and type, closure-device, sheath size and peripheral vascular disease...
October 13, 2018: Journal of Cardiovascular Computed Tomography
Narayana Sarma V Singam, Rakesh Gopinathannair, Jeffrey M Stidam, Naresh K Solankhi, Matthew Bessen, Marcus F Stoddard
The left atrial appendage (LAA) in the setting of non-valvular atrial fibrillation (NVAF) is the predominant location for intracardiac thrombus formation. An absent LAA is a very rare congenital cardiac anomaly. We present a case of a 79-year-old female with NVAF, high CHADS2VASC2 score, and high bleeding risk who presented for elective Watchman™ left atrial appendage closure device implant. A pre-procedural transesophageal echocardiography showed an absent LAA. This finding was confirmed with cardiac computed tomography and a left atrial angiogram...
October 18, 2018: Echocardiography
Bauback Safa, Amir Belson, Carol Meschter, Michelle Kelley, Daren Stewart, Kei Ichiryu, Sandra Biroc, Eric Storne
There remains a lack of understanding of how wound closure methods perform comparatively when exposed to patient-induced movement during healing and how they may contribute to bacterial infiltration in the wound site. The present study attempts to objectively quantify this gap. The study evaluates bacterial penetration and subsequent symptoms of infection of traditional sutures and an emerging tape-based, zip-type wound closure technology under physiologically relevant loading. In an in vivo model to simulate real-world conditions, the latter demonstrates better performance compared to commonly used sutures, holding the wound intact and minimizing bacterial penetration when subjected to simulated patient movement-induced stress...
August 4, 2018: Curēus
Masroor H Sharfi, Jameel Al-Ata, Amjad Al-Kouatli, Haysam Baho, Lamees Al-Ghamdi, Mohammed O Galal
Background: Transcatheter closure of secundum atrial septal defect is routinely performed under general anesthesia and transesophageal echocardiography guidance. If patients have good echo windows, the procedure could be performed under transthoracic echo guidance. Aim of study: To evaluate safety and efficacy of the intervention using fluoroscopy and echo guidance. Methods: In a case control study design, 180 patients underwent atrial septal defect closure between January 2010 and December 2016...
January 2019: Journal of the Saudi Heart Association
Weizhi Zhang, Lei Gao, Wancun Jin, Qin Wu, Shijun Hu, Yifeng Yang, Tianli Zhao
To evaluate the feasibility and safety of device closure of patent ductus arteriosus (PDA) using only venous access under echocardiography guidance alone.
 Methods: A total of 102 consecutive pediatric patients underwent transcatheter PDA closure without arterial access, under the guidance of only echocardiography. The patients were followed up by clinical examination, electrocardiogram, and echocardiogram at 1, 3, 6 12, and 24 months.
 Results: Transvenous PDA closure under echocardiographic guidance was successful in 99 (97...
September 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
F Vigouroux, C Choufani, A Grosset, O Barbier, S Rigal, L Mathieu
The purpose of this report was to analyze sequential management of patients with combat-related hand injuries in the Kabul International Airport Combat Support Hospital and to identify principles of hand damage control orthopedics (DCO). A retrospective study was conducted using the French Opex data system that included all the patients who received sequential treatment for combat-related hand injuries from 2009 to 2013. Demographics, mechanism, injury pattern, reasons for DCO application and surgical procedures performed during initial and definitive treatment were described...
October 14, 2018: Hand Surgery and Rehabilitation
Giovanni Sorropago, Gurbhej Singh, Antonio Sorropago, Andrea Sole, Jessica Rossi, Valerio Stefano Tolva, Eugenio Stabile, Filippo Scalise
AIMS: Success of transfemoral transcatheter aortic valve implantation (TAVI) and thoraco-abdominal aneurysm repair(TAAR) depends on the hemostatic control of access site, which is usually obtained with suture-based closure devices. Our aim was to study the feasibility and safety of a single-ProGlide/Glubran technique for vascular access site closure after TAVI and TAAR. METHODS AND RESULTS: This technique was used in 250 patients from 2012 to 2017. The primary end-point was success of the closure technique defined as access site hemostasis without complications and not requiring any further intervention within 30 days of index procedure...
October 16, 2018: EuroIntervention
Felix J Hüttner, Pascal Probst, Hannes G Kenngott, Phillip Knebel, Thilo Hackert, Alexis Ulrich, Markus W Büchler, Markus K Diener
BACKGROUND: Postoperative pancreatic fistula (POPF) remains a frequent problem especially after distal pancreatectomy. The application of 2-octyl cyanoacrylate showed promising results in the reduction of POPF after pancreatoduodenectomy prompting an expansion of this technique to distal pancreatectomy. Thus, the objective of the current study was to assess safety, feasibility and preliminary efficacy of an intraoperative 2-octyl cyanoacrylate application after distal pancreatectomy. METHODS: Between April 2015 and June 2016 adult patients scheduled for elective distal pancreatectomy were considered eligible for the study...
2018: PloS One
Wolfram Windisch, Sarah Bettina Schwarz, Friederike Sophie Magnet, Michael Dreher, Claudia Schmoor, Jan Hendrik Storre, Verena Knipel
BACKGROUND: Inhalation errors frequently occur in patients receiving inhalation treatment, which can significantly impair treatment success. While this underscores the importance of inhalation training, the role of modern web-based instructional videos has not yet been investigated. METHODS: A randomized controlled trial using standardized checklists (10 items: preparation, N = 3, inhalation routine, N = 6, and closure of inhalation, N = 1) was carried out to determine the relative effects of web-based, device-specific videos versus standard personal instruction on reducing multiple (≥2) inhalation errors in severe COPD patients requiring hospitalisation...
2018: PloS One
S M Koerber, T Loethen, M Turagam, J Payne, R Weachter, G Flaker, M R Gold, S Gautam
PURPOSE: Device infection is a serious complication of cardiac implantable electronic devices (CIED). Ensuring complete pocket closure can be time consuming, but remains vital to prevent infection. The Zip® Surgical Skin Closure (ZIP) is a noninvasive adhesive device applied to the skin as an alternative to subcuticular sutures for skin closure. We hypothesized that using this device would decrease pocket closure times without increasing the risk of pocket infections. This is a single center, retrospective cohort study to compare pocket closure times and infection rates between ZIP and standard suture for CIED pocket closure...
October 15, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Jan A Roth, Fabrice Juchler, Marc Dangel, Friedrich S Eckstein, Manuel Battegay, Andreas F Widmer
Background: Preliminary studies analyzing surrogate markers have suggested that operating room (OR) door openings may be a risk factor for surgical site infection (SSI). We therefore aimed to estimate the effect of OR door openings on SSI risk in patients receiving a cardiac surgery. Methods: This prospective observational study involved consecutive patients receiving a cardiac surgery in two pre-specified ORs equipped with automatic door counting devices from June 2016 to October 2017...
October 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Sabry Omar, Garrison L Morgan, Hemang B Panchal, Vinod Thourani, Charanjit S Rihal, Ruchi Patel, Nisharahmed Kherada, Alexander C Egbe, Nirat Beohar
BACKGROUND: Post-myocardial infarction (MI) ventricular septal defects (PIVSD) are an uncommon but life-threatening complication of acute MI. Although surgical closure has been the standard of care, mortality, and recurrence of VSD remain high even after emergent surgery. Transcatheter VSD closure (TCC) devices have become an alternative or adjunct to surgical closure. METHODS: Online database search was performed for studies that included adults with PIVSD who underwent medical treatment (MT) alone, surgical closure (SC) (early or late), and TCC (early, late, or for post-surgical residual VSD)...
August 28, 2018: Journal of Interventional Cardiology
Jamshid H Karimov, Tomislav Mihaljevic, Shengqiang Gao, Gengo Sunagawa, Patrick Grady, Martin Sinkewich, Kiyotaka Fukamachi
OBJECTIVE: With heart disease increasing worldwide, demand for new minimally invasive techniques and transcatheter technologies to treat structural heart disease is rising. Cardioscopy has long been considered desirable, as it allows direct tissue visualization and intervention to deliver therapy via a closed chest, with real-time fiber-optic imaging of intracardiac structures. Herein, the feasibility of the advanced cardioscopic platform, allowing both transapical and fully percutaneous access is reported...
October 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
Qiang Chen, Han-Fan Qiu, Gui-Can Zhang, Liang-Wan Chen
BACKGROUND: This study compared the safety and effectiveness of intraoperative device closure of a perimembranous ventricular septal defect (pmVSD) using the right-thoracic-minimal-incision-to-right-ventricle and lower-midline-sternotomy-to-right-ventricle approaches. METHODS: We retrospectively analyzed the clinical data of 46 patients who underwent intraoperative device closure of a pmVSD via the right-thoracic-minimal-incision-to-right-ventricle route (group I) and 52 patients who underwent intraoperative device closure of a pmVSD via a minimal incision in the lower sternum (group II) at our hospital from March 2016 to March 2017...
October 9, 2018: Annals of Thoracic Surgery
Amit N Vora, William Schuyler Jones, Adam D DeVore, Adrian Ebner, William Clifton, Manesh R Patel
BACKGROUND: There are limited options for percutaneous mechanical circulatory support (pMCS) in patients requiring high-risk percutaneous coronary intervention. OBJECTIVES: This first-in-human, single-center study aimed to evaluate the safety and feasibility of a novel pMCS device in high-risk percutaneous coronary intervention patients. METHODS: Aortix (Procyrion, Houston, Texas) is a pMCS device deployed in the descending aorta via the femoral artery that uses axial flow to provide cardiac unloading and augment renal and systemic perfusion...
October 11, 2018: Catheterization and Cardiovascular Interventions
Hyojung Park, Jinyoung Song, E Seul Kim, June Huh, I-Seok Kang
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...
September 2018: Journal of cardiovascular imaging
Yoonhee Han, Jae Hyun Kwon, Surin Park
AIM: To report 17-mo experience of femoral artery puncture site closure during angiographic procedures using ExoSeal vascular closure devices (VCDs). METHODS: Between November 2015 and April 2017, we performed 179 diagnostic and interventional angiographic procedures via a common femoral arterial access. The ExoSeal VCD was used at the puncture site to achieve hemostasis in 125 patients. We evaluated the technical and procedural success rates, the complications, and the factors affecting the hemostasis time of the ExoSeal VCDs...
September 28, 2018: World Journal of Radiology
Kensuke Kobayashi, Tadashi Kitamura, Shinzo Torii, Toshiaki Mishima, Hirotoki Ohkubo, Yuki Tanaka, Akihiro Sasahara, Takuma Fukunishi, Yuki Ohtomo, Rihito Horikoshi, Yuta Murai, Kagami Miyaji
Case 1:An 18-year-old male underwent emergent left extracorporeal ventricular assist device(eVAD) implantation for a cardiogenic shock because of dilated cardiomyopathy (DCM). After listing for heart transplant, he underwent a HeartMate II implantation as bridge-to-bridge(BTB) therapy. The omental flap was simultaneously used to prevent device infection that could have been induced by the infected malgranulation around the cannulas of the eVAD. Eventually, he was discharged and waiting for transplantation. Case 2:A 30-year-old male with DCM underwent emergent eVAD implantation for left ventricular support, centrifugal veno-pulmonary artery extracorporeal membrane oxygenation (ECMO) for right ventricular and respiratory support, and mitral valve replacement...
October 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Ruediger Prosst
OTSC Proctology is a minimally invasive sphincter-preserving technique for the surgical treatment of anorectal fistulas. It is based on a super-elastic Nitinol clip which closes the internal fistula opening to allow healing of the fistula tract. A systematic search of the literature was undertaken to identify publications about OTSC Proctology. All studies and reports identified were reviewed and evaluated to determine the feasibility, efficacy and safety of clip surgery. The assessment of all available studies with a total of more than 200 surgical cases strongly suggests that the clip procedure is safe and effective with a low rate of complications...
October 11, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
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