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Atrial septal defect access

In-Chang Hwang, Malouny Sisavanh, Somxay Billamay, Sommanikhone Phangmanixay, Bounleua Oudavong, Jeehoon Kang, Bo Sang Kwon, Gi Beom Kim, Eun Jung Bae, Chung Il Noh, Jung Yun Choi
BACKGROUND: Management of congenital heart disease (CHD) in developing countries is challenging because of limited access to healthcare facilities and socioeconomic limitations. We aimed to describe the recent experience with CHD at Children's Hospital of Lao People's Democratic Republic (PDR), the only pediatric referral hospital in the nation. METHODS: From July 2013 to November 2015, we performed 1,009 echocardiograms of 797 individuals who visited Children's Hospital and identified 213 CHD patients...
September 2, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Joanna Kieliszczyk, Wojciech Baranowski, Wojciech Kosiak
UNLABELLED: Appropriate hydration is a very important prognostic factor for the patient's health. Ultrasonographic assessment of hydration status is rarely used in pediatric medicine and it is not used at all in neonates due to the fact that no reference values have been established for this age group. The aim of the paper was to establish reference values for neonates. MATERIAL AND METHODS: The study included 50 neonates from two hospitals in the Lower Silesia region of Poland; 25 of them were healthy patients (full-term newborns with no perinatal complications) and 25 were sick patients (newborns with heart defects such as ostium secundum atrial septal defect, ventricular septal defect, permanent foramen ovale and patent ductus arteriosus as well as newborns with neonatal jaundice or pneumonia that occurred during the first days of life)...
June 2016: Journal of Ultrasonography
Gianfranco Butera, Nicusor Lovin, Domenica Paola Basile
Secundum atrial septum defect (ASD) is the most common congenital heart disease. It is usually treated by a transcatheter approach using a femoral venous access. In case of bilateral femoral vein occlusion, the internal jugular venous approach for ASD closure is an option, in particular in cases where ASD balloon occlusion test and sizing is needed. Here, we report on a new technique for ASD closure using a venous-arterial circuit from the right internal jugular vein to the femoral artery. Two patients (females, 4 and 10 years of age) had occlusion of both femoral veins because of a previous history of pulmonary atresia and intact ventricular septum, for which they underwent percutaneous radiofrequency perforation and balloon angioplasty...
June 17, 2016: Catheterization and Cardiovascular Interventions
Soujanya Bogarapu, Nelangi M Pinto, Susan P Etheridge, Xiaoming Sheng, Kirk N Liesemer, Paul C Young, Elizabeth V Saarel
Current guidelines recommend that all neonates with Down syndrome (DS) be screened for congenital heart disease (CHD) with an echocardiogram. We sought to determine the effectiveness of a more accessible and less expensive screening strategy consisting of physical examination, electrocardiogram (ECG), and chest X-ray. The Intermountain Healthcare Enterprise Data Warehouse was used to identify infants with a positive karyotype for DS who were born between January 1, 2000, and June 30, 2012. Infants with the results of an echocardiogram, physical examination, ECG, and chest X-ray documented at age ≤6 months were included...
October 2016: Pediatric Cardiology
Takashi Murakami, Yasuo Suehiro, Shinsuke Nishimura, Kenichi Sugioka, Shinichi Iwata, Asahiro Ito, Etsuji Sohgawa, Kazuki Mizutani, Minoru Yoshiyama, Toshihiko Shibata
Because paravalvular leak after mitral valve replacement in highly morbid patients is a troublesome issue, there has been a growing interest in less invasive procedures. We conducted transcatheter paravalvular leak closure of a mitral valve prosthesis through left ventricular apical access. The patient had undergone redo mitral valve replacement through a transatrial septal approach 2 months prior to the procedure; thus, penetration of the atrial septum was considered to be difficult through the ordinary antegrade trans-septal approach...
March 31, 2016: General Thoracic and Cardiovascular Surgery
Yuan Lin, Lingzi Zhuang, Hong Ma, Lixiang Wu, Hailong Huang, Huanhuan Guo
OBJECTIVE: To investigate the effects of arsenic exposure before and during maternal pregnancy on heart development of fetal rats. METHODS: According to body weight, thirty-two female SD rats (30 to 40 days of age) were randomly divided into control group, low dose group, middle dose group and high dose group with 8 rats per group. They were allowed free access to drinking water with 0, 37.5, 75 and 150 mg/L of sodium arsenite (NaAsO2) for 6 weeks, respectively...
January 2016: Wei Sheng Yan Jiu, Journal of Hygiene Research
Tariq Abu-Tair, Christiane M Wiethoff, Jascha Kehr, Wlodzimierz Kuroczynski, Christoph Kampmann
The GORE(®) Septal Occluder (GSO) is a well-evaluated device for interventional ASD closure with closure rates comparable to the Amplatzer(®) Septal Occluder (ASO), but there are no published reports of its use in small children weighing less than 10 kg. This may be due to the necessity of a large-sized introducing sheath of at least 10 Fr and therefore the assumed risk of complications in vascular access. The GSO is an alternative option for interventional ASD closure in children weighing less than 10 kg...
April 2016: Pediatric Cardiology
J D R Thomson, S A Qureshi
Cardiac erosion related to transcatheter atrial septal defect closure devices is of increasing concern. Erosion is reported to have occurred with most of currently available occluder devices. Perhaps due to the very large number of implants worldwide, the Amplatzer (St Jude) occluder is associated with the majority of cardiac erosion events reported in the literature. Best current estimates of the incidence of erosion with the St Jude device are between one and three cases per 1000 implants. Most events occur early after implantation and it is rare, although not unheard of, for events to occur after a year following device insertion...
December 1, 2015: Echo Research and Practice
Mei-Hwan Wu, Hui-Chi Chen, Jou-Kou Wang, Feng-Yu Kao, San-Kuei Huang
BACKGROUND: Secundum atrial septal defect (ASDII) is a common congenital heart defect, but the intervention, either transcatheter or surgical, needs are unclear. This study was to examine the paradigm shift in its intervention in an era of transcatheter closure. METHODS AND RESULTS: The study birth cohort 2000-2008 (2,070,145 live births) with complete postnatal medical data was derived from the national database (2000-2014) of Taiwan, a country with national health insurance and easily accessible high-standard medical care...
December 2015: American Heart Journal
Hiroto Kitahara, Kazuma Okamoto, Mikihiko Kudo, Akihiro Yoshitake, Takahito Ito, Kanako Hayashi, Yu Inaba, Yuta Akamatsu, Hideyuki Shimizu
OBJECTIVES: In cases of cardiac surgery via a minimally invasive right minithoracotomy approach, cardiopulmonary bypass is established with peripheral arterial cannulation, frequently with a single femoral artery. Occasionally, alternative perfusion access is required to prevent perfusion site-related complications. In this study, the feasibility of alternative perfusion strategies was verified by comparing the postoperative outcomes and complications. METHODS: The records of 91 consecutive patients (68 women, 23 men; mean age 40...
March 2016: General Thoracic and Cardiovascular Surgery
O V Sapelnikov, P V Mezentsev, A S Partigulova, D I Cherkashin, I R Grishin, V V Volodzyanovskiy, Zh A Drozd, M A Saidova, R S Akchurin
Catheter radiofrequency ablation of focal atrial fibrillation was successfully performed in a patient after closure of interventricular septal defect with a xeno-pericardial patch and plastic of tricuspid valve. The case demonstrates feasibility of carrying out such interventions under intracardiac echocardiographic guidance in patients with disturbed anatomy and complicated access to the left atrium.
2015: Kardiologiia
Pedro R Cox-Alomar, Pedro Colón-Hernández, Antonio Sotolongo-Fernández, Rafael A Cox
OBJECTIVE: The annual rate of percutaneous transcatheter closure of atrial septal defects (ASDs) and patent foramen ovales (PFO) has markedly increased in the United States over the past decade. This technique has been used at the Cardiovascular Center for Puerto Rico and the Caribbean since 2005. We report on the clinical characteristics and the immediate and short-term follow-up of adult patients who underwent this procedure at this center from 2008 to 2012. METHODS: One hundred and two consecutive medical records of adult Hispanic patients who underwent this procedure at our center from 2008 to 2012 were identified...
September 2015: Puerto Rico Health Sciences Journal
Valeria Cammalleri, Francesco Romeo, Gian Paolo Ussia
Transcatheter edge-to-edge mitral valve repair with MitraClip System (Abbott Vascular, Menlo Park, CA) needs a trans-septal access for positioning the 22-Fr guiding catheter in the left atrium. To the best of our knowledge no data are currently available about the hemodynamic consequences of a congenital atrial septal defect (ASD) after MitraClip repair. We report a case of MitraClip repair in a patient with ostium secundum ASD and ischemic cardiomyopathy, who needed intraprocedural closure of the defect for serious hemodynamic complications, secondary to worsening of the right ventricular function, increased pulmonary pressure and inversion of the interatrial shunt in right-to-left direction...
August 2016: Catheterization and Cardiovascular Interventions
Biljana Putniković, Ivan Stanković, Predrag Miličević, Miloje Marjanović, Aleksandar N Nešković
INTRODUCTION: Echocardiography is a highly operator-dependant technique which requires adequate training and skills that are frequently not present, considering the widespread use of cardiovascular ultrasound. This could particularly be true for hand-held echo devices which made echocardiography more accessible but are frequently used by non-cardiologists and non-experts. OUTLINE OF CASES: We present a 45-year-old female and a 37-year-old male with heart murmurs due to atrial and ventricular septal defect, respectively...
May 2015: Srpski Arhiv za Celokupno Lekarstvo
Michael E Rich, Andrew Tseng, Hae W Lim, Paul J Wang, Wilber W Su
The cryoballoon catheter ablates atrial fibrillation (AF) triggers in the left atrium (LA) and pulmonary veins (PVs) via transseptal access. The typical transseptal puncture site is the fossa ovalis (FO) - the atrial septum's thinnest section. A potentially beneficial transseptal site, for the cryoballoon, is near the inferior limbus (IL). This study examines an alternative transseptal site near the IL, which may decrease the frequency of acute iatrogenic atrial septal defect (IASD). Also, the study evaluates the acute pulmonary vein isolation (PVI) success rate utilizing the IL location...
2015: Journal of Visualized Experiments: JoVE
Giacomo Mugnai, Juan Sieira, Giuseppe Ciconte, Marta Soriano Hervas, Ghazala Irfan, Yukio Saitoh, Burak Hünük, Erwin Ströker, Vedran Velagic, Kristel Wauters, Claudio Tondo, Giulio Molon, Carlo De Asmundis, Pedro Brugada, Gian-Battista Chierchia
BACKGROUND: Transseptal (TS) catheterization is needed to access the left heart during pulmonary vein isolation (PVI) procedures. In the radiofrequency (RF) ablation procedure, left atrial access is commonly achieved with a double TS puncture; cryoballoon (CB) ablation usually requires only a single TS puncture. Our aim was to compare the incidence of iatrogenic septal defect (IASD) between double transseptal conventional RF and CB ablation. METHODS AND RESULTS: Individuals having undergone PVI as index procedure by RF or CB ablation and a subsequent transesophageal echocardiography examination during postablation follow-up in our center were consecutively included...
September 2015: Pacing and Clinical Electrophysiology: PACE
Kisha Beg, Larry A Latson, Gosta Pettersson, Lee Wallace, Athar M Qureshi
Cardiac erosions may occur in a small percentage of patients after device closure of atrial septal defects. These devices have to be explanted. We report an aorta-to-left atrial fistula after surgical explantation of the device eight years after implant for access to mitral valve repair. The importance of realizing the risk of subclinical cardiac erosion and subsequent fistula development after device removal is discussed.
April 2015: World Journal for Pediatric & Congenital Heart Surgery
Twalib O Aliku, Sulaiman Lubega, Peter Lwabi, Michael Oketcho, John O Omagino, Tom Mwambu
BACKGROUND: Heart disease is a disabling condition and necessary surgical intervention is often lacking in many developing countries. Training of the superspecialties abroad is largely limited to observation with little or no opportunity for hands on experience. An approach in which open heart surgeries are conducted locally by visiting teams enabling skills transfer to the local team and helps build to build capacity has been adopted at the Uganda Heart Institute (UHI). OBJECTIVES: We reviewed the progress of open heart surgery at the UHI and evaluated the postoperative outcomes and challenges faced in conducting open heart surgery in a developing country...
December 2014: African Health Sciences
A Haddad, R Bourezak, M Aouiche, R Ait Mohand, A Hamzaoui, S E Bourezak
INTRODUCTION: With advances in recent decades in the field of congenital heart disease both for imaging in medical therapy, a large number of heart disease is diagnosed before birth. Many of them benefit from surgery and reach adulthood, they do not require further action. Some of them develop later in their lives other problems requiring reoperation in adulthood. This sparked the birth of a subspecialty within the department of congenital heart disease: GUCH Unit "grown up congenital heart disease"...
September 2015: Annales de Cardiologie et D'angéiologie
G Coppola, C La Greca, E Corrado, L Ajello, A Nogara, G Ciaramitaro, S Augugliaro, G Novo, S Novo, P Assennato
he right ventricular apex (RVA) has always been the most used pacing site, because it is easily accessible and provides a stable lead position with a low dislodgment rate. However, it is well-known that long-term right ventricular apical pacing may have deleterious effects on left ventricular function by inducing a iatrogenic left bundle branch block, which can have strong influences on the left ventricle hemodynamic performances. More specifically, RVA pacing causes abnormal contraction patterns and the consequent dyssynchrony may cause myocardial perfusion defects, histopathological alterations, left ventricular dilation and both systolic and diastolic left ventricular dysfunction...
April 2015: Minerva Cardioangiologica
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