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Arterial ductal stenting

Abhishek Raval, Bhavesh Thakkar, Tarun Madan, Nilesh Oswal, Rajiv Garg, Rhshikesh Umalkar, Komal Shah, Bhumika Maheriya
OBJECTIVES: We aimed to study the feasibility and outcomes of ductal stenting in patients with duct-dependent pulmonary blood flow (PBF). METHODS: Duct-dependent hypoxic patients with confluent pulmonary artery (PA) branches were enrolled for ductal stenting and followed regularly. RESULTS: Sixty patients, with a median age of 12 (1-1095) days and weight of 2.8 (2.2-8.9) kg, were enrolled. Median right PA (RPA) and left PA (LPA) Z-scores were -1...
October 13, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Stephan Schubert, Björn Peters, Felix Berger
We report interventional re-opening of a PDA for reverse Potts shunt circulation 12 months after closure in a 3.8 year old child, suffering from right ventricular (RV) failure due to suprasystemic pulmonary artery hypertension (PAH) after ADO I implantation. After ex vivo simulation, perforation through the mesh of the ADO I with the use of transseptal needle, wire looping (AO-PA), balloon dilatation, stent implantation (Palmaz 6 mm) and post dilatation, a reverse Pott-shunt circulation was established. A follow-up period of 11 months was achieved with preserved RV function and reverse Pott shunt circulation maintained a post ductal saturation of 94-88%...
August 12, 2016: Catheterization and Cardiovascular Interventions
E Girard, J Abba, N Cristiano, M Siebert, S Barbois, C Létoublon, C Arvieux
The spleen and pancreas are at risk for injury during abdominal trauma. The spleen is more commonly injured because of its fragile structure and its position immediately beneath the ribs. Injury to the more deeply placed pancreas is classically characterized by discordance between the severity of pancreatic injury and its initial clinical expression. For the patient who presents with hemorrhagic shock and ultrasound evidence of major hemoperitoneum, urgent "damage control" laparotomy is essential; if splenic injury is the cause, prompt "hemostatic" splenectomy should be performed...
August 2016: Journal of Visceral Surgery
Sushrut Trakroo, Kamran Qureshi
Hepatic arterial flow is paramount in preserving biliary integrity. We present an interesting clinical scenario of a liver transplant recipient with biliary anastomotic stricture who developed biliary abscess and sepsis after Endoscopic Retrograde Cholangiopancreatography. The abscess did not respond to maximal medical management, percutaneous drainage, and adequate endoscopic biliary drainage. Clinically, patient continued to deteriorate and imaging identified hepatic artery stenosis which was treated with percutaneous intra-arterial stenting...
2016: Case Reports in Transplantation
Masaki Kakimoto, Takuya Nakata, Ken Imaizumi, Takayuki Hirano, Tomohiro Murata, Keisuke Okuno, Mayumi Hoshino, Takatoshi Matsuyama, Hiroshi Goto, Haruya Koshiishi, Tetsunori Yoshimura, Takayuki Osanai, Keisuke Suzuki
A 53-year-old woman underwent breast-conserving surgery for right breast cancer (invasive ductal carcinoma, T1cN0M0, ly+, stage ⅠA, ER+, PR+, HER2-) 5 years previously. During treatment with tamoxifen, massive recurrence in the axillary lymph nodes was found. First- through fourth-line chemotherapy were tried, but they all failed. Everolimus and exemestane were administered, resulting in rapid shrinking of the tumor, but the patient developed sudden severe bleeding from the subclavian artery. Hemostasis was achieved with artery stenting...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Swati Choudhry, David Balzer, Joshua Murphy, Ramzi Nicolas, Shabana Shahanavaz
BACKGROUND: Carotid artery access in infants with congenital heart disease undergoing cardiac catheterization via a surgical cut down has been well described. There is a paucity of information regarding percutaneous carotid artery (CA) access in infants <3 months. METHODS: A retrospective review of infants <3 months of age undergoing cardiac catheterization via percutaneous CA approach was performed after IRB approval. Between January 2012 and May 2015, 18 patients underwent 20 procedures; median age 13 days (2-77); median weight 3...
March 2016: Catheterization and Cardiovascular Interventions
Carlos D Miranda, Damien Kenny
We report our experience with stenting a right ductus arteriosus in a neonate with ductal origin of the right pulmonary artery (PA), who subsequently developed severe pulmonary hypertension in the left PA requiring decompression of the right ventricle with stenting of the left ductus. © 2015 Wiley Periodicals, Inc.
November 25, 2015: Catheterization and Cardiovascular Interventions
Anas Taqatqa, Karim A Diab, Christopher Stuart, Louis Fogg, Michel Ilbawi, Sawsan Awad, Massimo Caputo, Zahid Amin, Ra-Id Abdulla, Damien Kenny, Ziyad M Hijazi
The hybrid approach to management of hypoplastic left heart syndrome (HLHS) was developed as an alternative to neonatal Norwood surgery, providing a less invasive initial palliation for HLHS. We describe our experience in extending the concept of the hybrid procedure to palliate neonates with anatomically compromised systemic arterial blood flow in a variety of congenital cardiac anomalies and supporting its application as first-line palliation in centers developing their HLHS programs. Retrospective review of patients undergoing therapy for HLHS at a single institution from June 2008 to December 2014 was performed...
March 2016: Pediatric Cardiology
Michael O Murphy, Hannah Bellsham-Revell, Gareth J Morgan, Thomas Krasemann, Eric Rosenthal, Shakeel A Qureshi, Caner Salih, Conal B Austin, David R Anderson
BACKGROUND: Hybrid procedure offers patients with severe congenital heart disease an alternative initial procedure to conventional surgical reconstruction. We report the midterm outcomes of a cohort of neonates who had a hybrid procedure for variants of hypoplastic left heart syndrome because they were at high risk for the Norwood procedure. METHODS: Between December 2005 and January 2013, 41 neonates underwent bilateral pulmonary artery banding followed by ductal stenting by means of a sternotomy at a median age of 6 days (range, 2 to 18 days) and weight of 2...
December 2015: Annals of Thoracic Surgery
Masataka Kitano, Satoshi Yazaki, Koji Kagisaki
For high-risk neonates with hypoplastic left heart syndrome (HLHS) undergoing Norwood operation, the strategy of bilateral pulmonary artery banding and ductal stenting is risky in case of coarctation of the aorta (CoA), often resulting in death. Therefore, we devised a new method of ductal stenting with side-branch cell dilation, which could overcome the constriction of the ductal arch with CoA in two HLHS patients. This is the first report that presents this method and the results. © 2015 Wiley Periodicals, Inc...
January 1, 2016: Catheterization and Cardiovascular Interventions
Ali Dodge-Khatami, William Z Chancellor, Bhawna Gupta, Samantha R Seals, Makram R Ebeid, Sarosh P Batlivala, Mary B Taylor, Jorge D Salazar
BACKGROUND: Results of surgical management of hypoplastic left heart syndrome (HLHS) and related anomalies are often compared to published benchmark data which reflect the use of a variety of surgical and hybrid protocols. We report encouraging results achieved in an emerging program, despite a learning curve at all care levels. Rather than relying on a single preferred protocol, surgical management was based on matching surgical strategy to individual patient factors. METHODS: From 2010 to 2014, a total of 47 consecutive patients with HLHS or related anomalies with ductal-dependent systemic circulation underwent initial surgical palliation, including 30 Norwood stage I, 8 hybrid stage I, and 9 salvage-to-Norwood procedures...
July 2015: World Journal for Pediatric & Congenital Heart Surgery
Hasan Tahsin Tola, Yakup Ergul, Murat Saygi, Isa Ozyilmaz, Alper Guzeltas, Ender Odemis
Stenting of patent ductus arteriosus is an alternative to palliative cardiac surgery in newborns with duct-dependent or decreased pulmonary circulation; however, the use of this technique in patients with an aortic arch abnormality presents a challenge. Tetralogy of Fallot is a congenital heart defect that is frequently associated with anomalies of the aortic arch and its branches. The association is even more common in patients with chromosome 22q11 deletion. We present the case of an 18-day-old male infant who had cyanosis and a heart murmur...
June 2015: Texas Heart Institute Journal
Juan-Miguel Gil-Jaurena, José-Luis Zunzunegui, Ramón Pérez-Caballero, Ana Pita, María-Teresa González-López, Fernando Ballesteros, Alejandro Rodríguez, Constancio Medrano
Complex cases undergo step surgical and percutaneous procedures, including stent deployment. Concerns arise on stent removal at latest surgery. Our initial experience is presented. Forty-six stents in 35 patients were partially or totally removed at surgery. Univentricular heart was diagnosed in 20 patients. Stents were previously deployed in: ductus (6), right ventricle outflow tract (12), atrial septal defect (4), right pulmonary artery (4), left pulmonary artery (16), inferior vena cava (2), superior vena cava (1) and ascending aorta (1)...
December 2015: Pediatric Cardiology
Kok W Soo, Ming C Leong, Faizah Khalid
We describe the case of an infant who was a late presenter of transposition of the great arteries where we proceeded with ductal stenting to improve oxygenation and left ventricle training. Stenting improved the infant's saturation while keeping the left ventricle well trained for 4 months after the procedure. This report demonstrates that intermediate-term left ventricle training can be achieved via ductal stenting.
February 2016: Cardiology in the Young
Jannika Dodge-Khatami, Ali Dodge-Khatami, Jarrod D Knudson, Samantha R Seals, Avichal Aggarwal, Mary B Taylor, Jorge D Salazar
INTRODUCTION: Debilitating patient-related non-cardiac co-morbidity cumulatively increases risk for congenital heart surgery. At our emerging programme, flexible surgical strategies were used in high-risk neonates and infants generally considered in-operable, in an attempt to make them surgical candidates and achieve excellent outcomes. MATERIALS AND METHODS: Between April, 2010 and November, 2013, all referred neonates (142) and infants (300) (average scores: RACHS 2...
March 2016: Cardiology in the Young
Osman Baspinar, Derya Aydin Sahin
Bilateral ductal stenting should be performed in cases of discontinuity of the pulmonary branches and pulmonary atresia. Performing this procedure via the carotid artery in small infants can be very difficult and challenging. We present a case of bilateral ductal stenting via both the femoral and carotid arteries in a little child with tetralogy of Fallot with pulmonary atresia and a nonconfluent pulmonary artery and bilateral ductus arteriosus.
2015: Case Reports in Cardiology
Giuseppe Santoro, Gianpiero Gaio, Luca Giugno, Cristina Capogrosso, Maria Teresa Palladino, Carola Iacono, Giuseppe Caianiello, Maria Giovanna Russo
OBJECTIVES: To evaluate early results, learning-curve changes, and mid-term outcome of arterial duct (AD) stenting in congenital heart disease with duct-dependent pulmonary circulation (CHD-DPC) in a high-volume, tertiary referral center. BACKGROUND: In spite of wide acceptance as cost-effective alternative to surgical palliation, AD stenting indications, results and mid-term outcome still largely depend on small series, experiences in particular subsets of patients or multicenter series with different approaches and interventional philosophy...
August 2015: Catheterization and Cardiovascular Interventions
Sharon Borik, Sabina Volodina, Rajiv Chaturvedi, Kyong Jin Lee, Lee N Benson
The aim of the study was to examine the role of three-dimensional rotational angiography (3DRA) in assessing vascular and airway narrowing in children with a bidirectional cavopulmonary anastomosis (BCPA). The course of children with single ventricle physiology is often complicated by left pulmonary artery (LPA) and/or bronchial stenosis and may be related to aortic compression. 3DRA may be useful in evaluating this complex anatomy and possible mechanisms for the observed obstruction. Clinical data and imaging (2D angiography and 3DRA) of children with a BCPA were reviewed retrospectively...
June 2015: Pediatric Cardiology
Kiran Mallula, Gabrielle Vaughn, Howaida El-Said, John J Lamberti, John W Moore
OBJECTIVES: We sought to compare ductal stenting (DS) to systemic-pulmonary artery shunt (SPS) in a contemporary cohort of patients having pulmonary atresia with intact ventricular septum (PAIVS). BACKGROUND: Alternative palliative strategies (interventional versus surgical) are currently available for initial palliation of ductal dependent patients with various forms of congenital heart disease. There is little data available to guide strategy selection. METHODS: A retrospective review of patients with PAIVS at our institution from Jan 2006 to Dec 2013 was performed...
June 2015: Catheterization and Cardiovascular Interventions
Sebastian Goreczny, Shakeel Qureshi, Eric Rosenthal, Thomas Krasemann, Radwa Bedair, Caner Salih, Conal Austin, David Anderson, Gareth J Morgan
AIMS: The lack of a specifically designed stent for the arterial duct has led to the off-label use of stents during hybrid palliation of hypoplastic left heart syndrome (HLHS). We evaluated the implantation and performance of a specially designed self-expanding stent in hybrid palliation of HLHS. METHODS AND RESULTS: We implanted 39 sinus-SuperFlex (SSF) stents in 24 patients at a median age of seven days (range 2-27 days) and median weight of 2.85 kg (range 1.3-3...
March 2015: EuroIntervention
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