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https://www.readbyqxmd.com/read/28293976/evolution-of-hybrid-interventions-for-congenital-heart-disease
#1
Hitesh Agrawal, Wail Alkashkari, Damien Kenny
Surgical and transcatheter interventions have seen a tremendous evolution in last three decades. Hybrid technology combines the achievements of both disciplines to bring substantial hemodynamic benefit to patients with congenital heart disease (CHD) in a minimally invasive manner. This collaboration between surgeons and interventionalists will continue to grow as the technology evolves to meet the demands of CHD patients, potentially avoiding cardiopulmonary bypass and vascular access complications as well as optimizing immediate technical outcomes with exit angiography...
March 15, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28274523/intraoperative-stenting-of-pulmonary-artery-stenosis-in-children-with-congenital-heart-disease
#2
Mathilde Meot, Bruno Lefort, Jean Marc El Arid, Nathalie Soulé, Julie Lothion-Boulanger, François Lengellé, Alain Chantepie, Paul Neville
BACKGROUND: Branch pulmonary artery (BPA) stenosis is frequently associated with congenital heart disease. Management of BPA stenosis is challenging for surgeons due to a high rate of recurrence. The purpose of this study was to assess the results of intraoperative pulmonary artery stenting associated with or without surgical angioplasty. METHODS: We included 33 children from our center between January 2008 and July 2014. Patients had pulmonary atresia with ventricular septal defect (13), tetralogy of Fallot (10), troncus arteriosus (4), double outlet right ventricle (2), and single left or right ventricle (4)...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28260555/stent-implantation-to-ductus-arteriosus-in-a-patient-with-interrupted-aortic-arch-guided-by-ct-image-overlay
#3
Sebastian Goreczny, Pawel Dryzek, Tomasz Moszura
A 15-day-old premature patient with ventricular septal defect and interrupted aortic arch type B underwent "hybrid" initial treatment consisting of bilateral pulmonary artery banding followed by stenting of the ductus arteriosus. A pre-registered CT scan was re-purposed with a new three-dimensional image fusion software (VesselNavigator) to create a roadmap for stent delivery.
March 6, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28248409/immediate-and-long-term-outcomes-of-percutaneous-transcatheter-pulmonary-valve-implantation
#4
Roland Fiszer, Paweł Dryżek, Małgorzata Szkutnik, Sebastian Góreczny, Alexandra Krawczuk, Jadwiga Moll, Tomasz Moszura, Szymon Pawlak, Jacek Białkowski
BACKGROUND: Transcutaneous pulmonary valve replacement (TPVR) has become an alternative to heart surgery for patients after previous right ventricular outflow tract (RVOT) or pulmonary artery (PA) surgical interventions. The objective was to present immediate and long-term outcomes of transcutaneous pulmonary valve replacement. METHODS: Between 06/2009 and 06/2016, 46 patients underwent TPVR. Initial diagnoses included tetralogy of Fallot, common arterial trunk, transposition of great arteries post Rastelli correction, left ventricle outflow obstruction after Ross operation, pulmonary atresia, and isolated dysplastic pulmonary valve stenosis...
March 1, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28219851/understanding-the-requirements-of-self-expandable-stents-for-heart-valve-replacement-radial-force-hoop-force-and-equilibrium
#5
María Sol Cabrera, Cees W J Oomens, Frank P T Baaijens
A proper interpretation of the forces developed during stent crimping and deployment is of paramount importance for a better understanding of the requirements for successful heart valve replacement. The present study combines experimental and computational methods to assess the performance of a nitinol stent for tissue-engineered heart valve implantation. To validate the stent model, the mechanical response to parallel plate compression and radial crimping was evaluated experimentally. Finite element simulations showed good agreement with the experimental findings...
February 7, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28139455/vascular-anatomy-in-children-with-univentricular-hearts-regarding-transcatheter-bidirectional-glenn-anastomosis
#6
Aleksander Sizarov, Francesca Raimondi, Damien Bonnet, Younes Boudjemline
BACKGROUND: Transcatheter stent-secured Glenn anastomosis, aiming to reduce the invasiveness of palliation in patients with univentricular heart defects, has been reported in large experimental animals. The advent of biodegradable stents and tissue-engineered vascular grafts will make this procedure a reality in human patients. However, the relationship between the superior vena cava (SVC) and the right pulmonary artery (RPA) is different in humans. AIM: To characterise vascular anatomy in children with univentricular hearts, regarding technical aspects and device design for this procedure...
January 27, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28110338/takayasu-s-arteritis-with-isolated-pulmonary-artery-involvement-in-a-middle-aged-asian-woman-with-hepatitis-b-and-latent-tuberculosis-infection
#7
Felix Liebscher, Thomas Pfammatter, Antonios Kolios, Matthias Greutmann, Daniel Franzen
We report a rare case of Takayasu's arteritis with isolated pulmonary artery stenosis in the presence of active hepatitis B and latent Mycobacterium tuberculosis infection in a middle-aged Asian woman who initially presented with severe dyspnea on exertion and recurrent syncope, occasional burning chest pains, and fatigue. Therapy of the active hepatitis B and latent M. tuberculosis infection together with a course of methotrexate led to a slight reversal of the symptoms, as angioplasty with or without stenting was not an option...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28109571/in%C3%A2-vivo-tissue-engineering-of-human%C3%A2-airways
#8
Emmanuel Martinod, Joseph Paquet, Hervé Dutau, Dana M Radu, Morad Bensidhoum, Sébastien Abad, Yurdagül Uzunhan, Eric Vicaut, Hervé Petite
BACKGROUND: Airway transplantation remains a major challenge in thoracic surgery. Based on our previous laboratory work, we developed the techniques required to bioengineer a tracheal substitute in vivo using cryopreserved aortic allografts as biological matrices (Replacement of the Airways and/or the Pulmonary Vessels Using a Cryopreserved Arterial Allograft [TRACHEOBRONCART] Study, NCT01331863). We present here 2 patients who had a definitive tracheostomy for complex laryngotracheal stenoses refractory to conventional therapy...
January 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28100120/hybrid-stage-i-procedure-as-initial-palliation-for-neonate-with-hypoplastic-left-heart-syndrome-and-right-congenital-diaphragmatic-hernia
#9
Draginja Cvetkovic, Joseph Giamelli, Michael Lyew, Markus Erb, Suvro Sett, Youmna DiStefano
During the past decade, a hybrid procedure has emerged and dramatically evolved as an alternative stage I palliation to the conventional Norwood procedure in neonates with hypoplastic left heart syndrome (HLHS). The hybrid approach avoids the need for cardiopulmonary bypass (CPB) utilizing stenting of the arterial duct and bilateral pulmonary artery banding. Cerebral and coronary perfusion pressure is maintained, and the pulmonary vasculature is protected from higher systemic pressure. Elimination of risks associated with CPB gains vital time to stabilize the patient and correct coexisting noncardiac anomalies and allows growth in preparation for the later stages of the Fontan pathway...
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28056476/-advanced-systemic-sclerosis-endovascular-reconstruction-of-the-aortic-bifurcation-for-limb-salvage
#10
Florian Stein, Lars Kamper, Konstantinos Meletiadis, Ulrich Kusenack, Patrick Haage
History and admission findings A 69-year-old patient was initially hospitalized because of a 1.5 cm ulceration at the back of the right foot which had existed for the last year and become increasingly swollen and painful. Medical history revealed PmScl-positive systemic sclerosis presenting with a massive calcinosis cutis, advanced pulmonary fibrosis and peripheral artery disease. Examinations Inflammatory markers were normal. MR-Angiography of the lower extremities revealed a multi-segmental high-grade stenosis of the aortic bifurcation due to extensively calcified plaques...
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28041804/endovascular-treatment-of-the-common-femoral-artery-in-the-vascular-quality-initiative
#11
Jeffrey J Siracuse, Kathryn Van Orden, Jeffrey A Kalish, Mohammad H Eslami, Marc L Schermerhorn, Virendra I Patel, Denis Rybin, Alik Farber
OBJECTIVE: Endovascular interventions of the common femoral (CFA) and deep (DFA) femoral arteries are becoming more common. However, there is very little published data for guidance. Our objective was to analyze practice patterns and outcomes from these interventions. METHODS: The Vascular Quality Initiative (2010-2015) was queried for all endovascular interventions of the CFA and DFA. Cases that were emergent or for acute limb ischemia were excluded. Those with isolated CFA with or without DFA treatment were analyzed...
December 29, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28038838/-interventional-cardiac-catheterization-in-congenital-heart-disease
#12
François Godart, Ali Houeijeh
Interventional cardiac catheterization has a major place in the management of congenital heart disease. Since the Rashkind atrioseptostomy in mid-1960s, many techniques have been developed. For some, it is necessary to close a cardiac or extracardiac shunt using occluder (double disc system, plug, coil…): closure of atrial septal defect, ventricular septal defect or patent arterial duct. For others, it is necessary to treat a valvular or vascular stenosis using a balloon catheter: dilatation of the pulmonary or the aortic valve, dilatation of aortic coarctation...
December 27, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/28033076/a-simplified-technique-for-interventional-extracardiac-fontan
#13
Sudesh Prabhu, Ben Anderson, Cameron Ward, Tom Karl, Nelson Alphonso
PURPOSE: We report a simple technique for an interventional extracardiac Fontan (ECF) procedure. DESCRIPTION: At the preparatory stage along with a bidirectional cavopulmonary connection (BCPC; cardiopulmonary bypass), a short piece of polytetrafluoroethylene (PTFE) tube graft is anastomosed to the inferior surface of the right pulmonary artery. Another longer PTFE graft is anastomosed to the transected inferior vena cava (IVC). A large medial opening in the lower PTFE graft is anastomosed to an atriotomy...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27995292/initial-experience-with-elective-perventricular-melody-valve-placement-in-small-patients
#14
Aamisha Gupta, Damien Kenny, Massimo Caputo, Zahid Amin
Perventricular Melody valve placement has been described as a bailout approach or alternative RVOT approach in patients >30 kg. We present three patients <20 kg and two patients with limited venous access, where we electively performed the perventricular approach. Retrospective analysis of patients <30 kg and vascular access limitation undergoing elective hybrid pulmonary valve replacement were reviewed. The subcostal approach was performed without sternotomy with the sheath introduced through the diaphragmatic surface of the right ventricle...
December 20, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27965298/right-ventricular-outflow-tract-stenting-in-tetralogy-of-fallot-infants-with-risk-factors-for-early-primary-repair
#15
Juan Pablo Sandoval, Rajiv R Chaturvedi, Lee Benson, Gareth Morgan, Glen Van Arsdell, Osami Honjo, Christopher Caldarone, Kyong-Jin Lee
BACKGROUND: Tetralogy of Fallot with cyanosis requiring surgical repair in early infancy reflects poor anatomy and is associated with more clinical instability and longer hospitalization than those who can be electively repaired later. We bridged symptomatic infants with risk factors for early primary repair by right ventricular outflow tract stenting (stent). METHODS AND RESULTS: Four groups of tetralogy of Fallot with confluent central pulmonary arteries were studied: stent group (n=42), primary repair (aged <3 months) with pulmonary stenosis (early-PS group; n=44), primary repair (aged <3 months) with pulmonary atresia (early-PA group; n=49), and primary repair between 3 and 11 months of age (surg>3mo group; n=45)...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27951539/wellens-syndrome-with-syncope-but-not-chest-pain
#16
Omar Z Yasin, Alberto Rubio-Tapia, Maurice E Sarano
We report the case of a woman in her 70s presenting to the emergency department with syncope, troponemia, and an electrocardiogram with deep symmetric T-wave inversions in V2 and V3 and prolonged QTc. Her presentation was concerning for acute coronary syndrome, Wellens syndrome in particular, given the elevated troponin levels, lack of ST segment changes, and characteristic T-wave findings. The diagnosis was confirmed with angiography that showed a critical left anterior descending (LAD) artery occlusion. Since myocardial infarction does not typically present with syncope, we explored the differential diagnoses for T-wave inversions, which include electrolyte abnormalities, medications, intracranial hemorrhage, pulmonary embolism, and other cardiac diseases that were ruled out in our patient...
December 13, 2016: Cardiology
https://www.readbyqxmd.com/read/27938458/unexpected-complication-of-uncovered-aortic-end-in-ductal-stenting
#17
Sasidharan Bijulal, Deepa Sasikumar, Aamir Rashid
A newborn with tricuspid atresia and pulmonary atresia underwent ductal stenting. The aortic end of the ductus was not completely covered and was wide open; the baby was discharged on dual antiplatelets. The baby presented after a month with desaturation, and an angiogram showed extensive thrombus in the stent and the right pulmonary artery. The angle formed by the stent with the uncovered aortic end is likely to have precipitated the thrombus.
December 12, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27931595/transcatheter-closure-of-patent%C3%A2-ductus%C3%A2-arteriosus-in-extremely%C3%A2-premature%C3%A2-newborns-early-results-and-midterm-follow-up
#18
Evan M Zahn, Daniel Peck, Alistair Phillips, Phillip Nevin, Kaylan Basaker, Charles Simmons, Marion E McRae, Tracy Early, Ruchira Garg
OBJECTIVES: The goal of this study was to describe early and midterm outcomes of extremely premature newborns (EPNs) who underwent transcatheter echocardiographically guided patent ductus arteriosus (PDA) closure. BACKGROUND: Surgical ligation of PDA in EPNs confers significant risk for procedural morbidity and adverse long-term outcomes. METHODS: The Amplatzer Vascular Plug II was used in all cases. Post-ligation syndrome was defined using previously published parameters...
December 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27926388/endovascular-stent-graft-placement-in-the-left-main-pulmonary-artery-for-management-of-a-giant-pulmonary-artery-pseudoaneurysm
#19
Andrew J Klobuka, Robert F Short
No abstract text is available yet for this article.
November 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27901322/risk-factors-analysis-of-thromboembolectomy-for-acute-thromboembolic-lower-extremity-ischemia-in-native-arteries
#20
Gabriele Piffaretti, Alessandro Angrisano, Marco Franchin, Massimo Ferrario, Nicola Rivolta, Alessandro Bacuzzi, Patrizio Castelli, Matteo Tozzi
BACKGROUND: Aim of this study is to report the results of thromboembolectomy (ThEmb) for acute thromboembolic lower limb ischemia (ATLI) in native arteries and to create a predictive score for amputation-free survival (AFS) at 30 days. METHODS: It is a single center, retrospective analysis of a four years period. All patients had ThEmb: adjunctive procedures included femoral and/or popliteal endarterectomy in 30 (18.3%) cases, PTA- stent in 24 (14.6%), and femoral endarterectomy plus PTA-stent in 12 (7...
November 30, 2016: Journal of Cardiovascular Surgery
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