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Ventricular shunt

Cezar Octavian Morosanu, Gabriela Adriana Filip, Liviu Nicolae, Ioan Stefan Florian
Hydrocephalus represents the pathological elevation of cerebrospinal fluid (CSF) levels as a consequence of various embryological or acquired defects. Although the classic method of treatment is by means of diverting the CSF from the ventricular system towards the peritoneum, there are other sites of diversion that have proven their efficiency through time, in the context of complications related to the more common option of intraperitoneal insertion. The aim of the review is to assess and organize a database of all the types of shunt locations from the oldest shunt attempts until present, using Pubmed and Medline and to underline the particularities related to technique, indications, complications and associated epidemiological background...
October 18, 2018: Neurosurgical Review
Chawannuch Ruaengsri, Matthew R Schill, Timothy S Lancaster, Ali J Khiabani, Joshua L Manghelli, Daniel I Carter, Jason W Greenberg, Spencer J Melby, Richard B Schuessler, Ralph J Damiano
OBJECTIVE: The purpose of this study was to determine the effects of chronic left atrial volume overload on atrial anatomy, hemodynamics, and electrophysiology using a titratable left ventriculoatrial shunt in a canine model. METHODS: Canines (n = 16) underwent implantation of a shunt between the left ventricle and the left atrium. Sham animals (n = 8) underwent a median sternotomy without a shunt. Atrial activation times and effective refractory periods were determined using 250-bipolar epicardial electrodes...
November 2018: Journal of Thoracic and Cardiovascular Surgery
S Tripathi, V K Ajit Kumar
BACKGROUND: Studies on dextrocardia have been limited by low numbers. Hence, it is very difficult to find the most common diagnosis in patients with dextrocardia, who are seeking medical attention in tertiary care center. AIMS AND OBJECTIVE: To identify the most common diagnostic pattern in patients with dextrocardia with different situs. METHODS: It is a retrospective study with records dating back to up to last 21 years from a major tertiary care center in south India...
October 17, 2018: Pediatric Cardiology
Rahul Norawat, Deepa Sarkar, Marc O Maybauer
Rhabdomyoma is the most common cardiac tumor in infancy and commonly located in the ventricles causing outflow obstruction or arrhythmias. We report a rare pediatric (7 month old) case of a right atrial rhabdomyoma presenting with severe cyanosis and low cardiac output from significant tricuspid inflow obstruction with right to left shunt across a stretched patent foramen ovale. We present an emergency cardiac surgery for right atrial tumor resection, and the management of separating the patient with failing right ventricle from cardiopulmonary bypass using a Glenn shunt, since extracorporeal membrane oxygenation (ECMO) or nitric oxide was not available...
October 2018: Annals of Cardiac Anaesthesia
James J Zhou, Michael A Mooney, S Harrison Farber, Michael A Bohl, Andrew S Little, Peter Nakaji
OBJECTIVE: Patients with hydrocephalus secondary to third ventricular colloid cysts may require bilateral external ventricular drain (EVD) placement while awaiting surgery. However, some patients may develop auto-fenestration of the septum pellucidum (AFSP) and only require 1 EVD. We evaluated our experience with bedside iohexol ventriculography and staged EVD placement for patients with obstructive hydrocephalus. METHODS: We retrospectively identified 34 patients treated for third ventricular colloid cysts (2013-2016)...
October 12, 2018: World Neurosurgery
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
Aodhnait S Fahy, Stephanie Tung, Maria Lamberti-Pasculli, James Drake, Abhaya Kulkarni, Justin T Gerstle
INTRODUCTION: Ventriculoperitoneal shunts (VPSs) are the mainstay of treatment of hydrocephalus but frequently need revision. We sought to directly compare the impact of laparoscopic versus open peritoneal shunt revision on the need for subsequent VPS revisions in pediatric patients. MATERIALS AND METHODS: A prospectively maintained, externally validated database of pediatric patients who underwent a first peritoneal VPS revision at a single center between 2008 and 2016 was reviewed...
October 12, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
David M Kaye, Mark C Petrie, Scott McKenzie, Gerd Hasenfuβ, Filip Malek, Martijn Post, Robert N Doughty, Jean-Noël Trochu, Finn Gustafsson, Irene Lang, Adam Kolodziej, Ralf Westenfeld, Martin Penicka, Mark Rosenberg, Jörg Hausleiter, Philip Raake, Guillaume Jondeau, Martin W Bergmann, Tim Spelman, Huseyin Aytug, Piotr Ponikowski, Chris Hayward
AIMS: Impaired left ventricular diastolic function leading to elevated left atrial pressures, particularly during exertion, is a key driver of symptoms and outcomes in heart failure with preserved ejection fraction (HFpEF). Insertion of an interatrial shunt device (IASD) to reduce left atrial pressure in HFpEF has been shown to be associated with short-term haemodynamic and symptomatic benefit. We aimed to investigate the potential effects of IASD placement on HFpEF survival and heart failure hospitalization (HFH)...
October 11, 2018: ESC Heart Failure
Mohamed Kasem, James Bentham, John Thomson
OBJECTIVES: The objectives of this study were to describe the approach to stenting arterial shunts in adult congenital patients with single-ventricle physiology and to assess the medium-term clinical and haemodynamic outcomes following stent insertion. BACKGROUND: Adult patients with single-ventricle physiology and pulmonary blood flow dependent on a surgically placed arterial shunt who did not progress to venous palliation are extremely challenging to manage. Progressive cyanosis secondary to narrowing of the shunt has a marked impact on exercise tolerance and results in intolerable well-being for these patients...
October 12, 2018: Cardiology in the Young
JianPing Zeng, LiPing Qin, DuanBu Wang, JiangBiao Gong, JianWei Pan, Yu Zhu, TianFu Sun, KangLi Xu, RenYa Zhan
BACKGROUND: This meta-analysis aimed to evaluate the risk of shunt-dependent hydrocephalus among patients with ruptured intracranial aneurysms treated with either coil placement or clipping. METHODS: A systematic literature search of EMBASE, PubMed, Web of Science, and the Cochrane Library was performed to confirm relevant studies. The scientific literature was screened in accordance with the predetermined inclusion and exclusion criteria. After quality assessment and data extraction from the eligible studies, a meta-analysis was conducted using Stata SE 12...
October 8, 2018: World Neurosurgery
Charlène Bredy, François-Pierre Mongeon, Line Leduc, Annie Dore, Paul Khairy
Atrial septal defect (ASD) is the most common form of congenital heart disease. Left-to-right shunting leads to right ventricular (RV) volume overload with excessive pulmonary blood flow. Complications include exercise intolerance, pulmonary vascular disease, RV dysfunction, paradoxical thromboemboli, and atrial arrhythmias. Women with coexisting severe pulmonary hypertension should be counselled against pregnancy due to high incidence of maternal and fetal morbidity and mortality. In the absence of pulmonary hypertension, pregnancy is generally well tolerated in the setting of an ASD...
September 2018: Journal of Thoracic Disease
Alejandro Javier Torres
Atrial septal defect (ASD) is one of the most common congenital cardiac anomalies. ASD can present as an isolated lesion in an otherwise normal heart or in association with other congenital heart conditions. Regardless of the type of ASD, the direction and degree of shunting across the communication is mainly determined by the difference in compliance between the right and left ventricle. Hemodynamics in children is characterized by left-to-right shunting, dilated right heart structures and normal pulmonary artery pressures (PAP)...
September 2018: Journal of Thoracic Disease
Pascal Amedro, Sophie Guillaumont, Charlene Bredy, Stefan Matecki, Arthur Gavotto
Nearly four decades ago, the World Health Organization stated that functional capacity explorations best reflected the impact of a chronic disease on quality of life. Today, cardio-pulmonary exercise test (CPET) is recommended in the follow-up of patients with congenital heart diseases (CHDs). Indeed, the maximum oxygen uptake (VO2max ) and the ventilatory efficiency (VE/VCO2 slope) correlate with both the prognosis and the quality of life in this population. Atrial septal defects (ASDs) represent the second most frequent CHD and are usually considered as simple CHDs...
September 2018: Journal of Thoracic Disease
Xiaosong Hu, Bangtian Peng, Yanwei Zhang, Feng Ai, Jiayong Zheng
This retrospective, single-center study evaluated short-term and mid-term results of minimally invasive surgery to occlude ventricular septal defects (VSDs) using a subaxillary approach. The procedure was performed on 429 children (224 boys, 205 girls; age 2.4 ± 2.5 years; mean weight 12.7 ± 10.1 kg) between January 2014 and December 2016 at the Children's Heart Center of Henan Province People's Hospital. An approximately 2-cm subaxillary incision was made between the third and fifth ribs, and the appropriate right atrium or ventricle was punctured under the guidance of transencephalographic echocardiography (TEE)...
October 8, 2018: Pediatric Cardiology
Kang Yi, Tao You, Zhao-Hong Ding, Xiao-Dong Hou, Xing-Guang Liu, Xin-Kuan Wang, Jin-Hui Tian
OBJECTIVE: Our study was aimed to comprehensively compare the relative efficacy, safety, and the cost of transcatheter closure, mini-invasive closure, and open-heart surgical repair to treat perimembranous ventricular septal defects (pmVSDs) in children using network meta-analysis method. METHODS: Five databases were systematically searched including Chinese Biomedical Literature Database, China National Knowledge Infrastructure, PubMed,, and the Cochrane Central Register of Controlled Trials from the starting date of each database to February 2017...
October 2018: Medicine (Baltimore)
Homare Okamura, Mamoru Arakawa, Taro Takeuchi, Hideo Adachi
Ventricular septal rupture is an uncommon fatal complication of acute myocardial infarction. In rare cases, the rupture can extend into the right ventricular free wall and cause intramyocardial dissection. We describe the case of a patient who developed postinfarction right ventricular free wall dissection with left-to-right shunting and successfully underwent patch repair.
October 4, 2018: Interactive Cardiovascular and Thoracic Surgery
Courtney Suzanne Lewis, Ki-Eun Chang, Joshua Bakhsheshian, Ben Allen Strickland, Martin Huy Pham
Isolated fourth ventricle syndrome is an uncommon entity due to obstruction of both inlet and outflow foramina. The resulting mass effect from the progressively expanding fourth ventricle may cause symptoms from both cerebellar and brainstem compression. Although a variety of treatment modalities have been advocated for this condition, an in-depth description of placement of a fourth ventriculopleural (VPL) shunt from a single-stage prone approach has not yet been published in the literature. We describe here a case of successful placement of a fourth VPL shunt in a 22-year-old female with a history of a prior posterior fossa pilocytic astrocytoma resection who presented with symptomatic isolated fourth ventricular hydrocephalus...
July 2018: Asian Journal of Neurosurgery
Deepak Kumar Jha, Mukul Jain, Ishita Pant, Rima Kumari, Renu Goyal, Arvind Arya, Suman Kushwaha
Context: Neuroendoscopic surgeries need specialized equipments, unavailable in neurosurgical departments of majority of public healthcare institutions of India. Aims: Neuroendoscopic treatment of hydrocephalus in the setting of minimal resources using utilization of available resources, inter-departmental co-ordination and indigenous innovations. Methods: Study was carried out at a public sector institute of India with scarce resources. Senior author (DKJ) used indigenously designed stainless steel working sheath along with equipments of 'awake endoscopic intubation system' of department of neuroanesthesia and 18 cm, 4 mm, 0° rigid telescope for neuroendoscopic surgeries for various intraventricular pathologies...
July 2018: Asian Journal of Neurosurgery
Barun Kumar, Anupam Singh, Mohamad Akram, Manish Singh
It is unusual for a moderate-size ventricular septal defect (VSD) to remain asymptomatic and complication-free until the age of 45 years. Similarly, infective endocarditis of anatomically normal pulmonary valve is also rare. Here we report a case in which nature created a protection for VSD, i.e. right ventricular outflow tract (RVOT) obstruction, which led to a complication, i.e. pulmonary valve endocarditis. A 45-year-old sick-looking man presented in medical emergency with fever and progressively increasing breathlessness for the previous 2 weeks...
March 2018: Journal of Cardiology Cases
Luke M Wiggins, Winfield J Wells, Vaughn A Starnes, S Ram Kumar
BACKGROUND: A subset of neonates with single ventricle (SV) physiology has antegrade pulmonary blood flow that is deemed unlikely to be reliable until Glenn. We have used systemic to pulmonary shunt (SPS) with pulmonary artery banding (PAB) to optimize pulmonary blood flow while maintaining reserve antegrade flow. We hypothesize that this is an effective strategy that can be accomplished without the routine need for cardiopulmonary bypass (CPB). METHODS: We retrospectively reviewed the records of 60 neonates who underwent combined SPS+PAB between 2004-2015...
September 29, 2018: Seminars in Thoracic and Cardiovascular Surgery
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