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Baffle stent

Gareth J Morgan, Damien Kenny, Christopher Duke, Kevin P Walsh, Shakeel A Qureshi
Aims We sought to evaluate the first-in-man use of a new system for implantation of covered stents in patients with complex structural and CHD. Methods and results Retrospective data were collected of the first 13 NuDEL™ delivery systems used in patients. The NuDEL™ comprises a covered Cheatham-Platinum stent mounted on a balloon-in-balloon and pre-loaded in a long delivery sheath. Data were collected from three centres in the United Kingdom and Ireland. A total of 13 covered stents were delivered via 12 NuDEL™ delivery systems in 12 patients...
October 2017: Cardiology in the Young
Dhaval Parekh, Zvonimir Krajcer
No abstract text is available yet for this article.
February 1, 2017: Catheterization and Cardiovascular Interventions
Joseph T Poterucha, Nathaniel W Taggart, Jonathan N Johnson, Bryan C Cannon, Allison K Cabalka, Donald J Hagler, Joseph A Dearani, Frank Cetta
OBJECTIVES: To report our experience with intravascular and hybrid intra-operative stent placement for baffle obstruction in patients with complete transposition of the great arteries (TGA) after the atrial switch (Mustard/Senning) operation. BACKGROUND: Venous baffle obstruction is a challenging complication after atrial switch operation in patients with TGA. Traditional treatment options include intravascular stenting or surgery. METHODS: A retrospective analysis of Mayo Clinic's electronic medical record was completed to identify consecutive pediatric and adult patients with TGA after atrial switch who underwent baffle stent implantation from 1994 to 2015...
February 1, 2017: Catheterization and Cardiovascular Interventions
Federico Migliore, Sonia Ferretto, Biagio Castaldi, Nicola Maschietto, Loira Leoni
: We report a successful combined approach of transvenous mechanical pacing lead extraction and stent angioplasty for superior baffle occlusion in a young woman with D-transposition of great artery after Mustard procedure. After having extracted the pacing leads, the baffle was easily stented, thanks to the channel left by the extracted leads. Eventually, a new pacing lead was implanted into the pulmonic ventricle through the stented baffle. Our report demonstrates the safeness and feasibility of a combined interventional approach in avoiding the need for surgery...
December 2016: Journal of Cardiovascular Medicine
Joseph R Casadonte, David F Wax, Jeffrey G Gossett
Transcatheter Fontan fenestration is a valuable option in situations of prolonged pleural drainage or low cardiac output in patients with failing Fontan circulation. This procedure relies on controlled baffle perforation without separation of the Fontan circuit from the pulmonary venous atrium, and placement of an accurately sized covered stent. We report a novel technique for transcatheter extracardiac Fontan fenestration using the SafeSept transseptal guidewire® and snare-controlled diabolo-shaped covered stent placement...
February 15, 2016: Catheterization and Cardiovascular Interventions
Dhaval R Parekh, Marcelo S Cabrera, Frank F Ing
We report a case of simultaneous transcatheter systemic and pulmonary venous baffle obstruction stenting in a post operative Mustard patient with d-transposition of the great arteries.
October 2015: Catheterization and Cardiovascular Interventions
William M DeCampli, Craig E Fleishman, David G Nykanen
OBJECTIVE: The objective of a hybrid approach to staged palliation of single-ventricle anomalies is designed to minimize the trauma of the first stage. However, the second stage is a complex procedure that may negate the advantages of the first stage. We sought to devise a "hybrid" approach to the second stage when aortic outflow is expected to remain unobstructed. METHODS: The procedure involves a simple incision into the main pulmonary artery, dilation/stenting of the ductal continuation, formation of a stented baffle between the branch pulmonary arteries' orifices, and a bidirectional Glenn connection...
April 2015: Journal of Thoracic and Cardiovascular Surgery
Arda Saygılı, Yusuf Yalçınbaş, Ahmet Arnaz, Tayyar Sarıoğlu
An 8-year-old boy with previous shunt operation for corrected transposition of great arteries, ventricular septal defect, pulmonary stenosis and multiple aortopulmonary collateral arteries underwent corrective surgery. In the early post-operative period, there were clinical findings of superior vena cava obstruction. Cardiac catheterization at 72 h following surgery showed a systemic venous baffle stenosis between the vena cava and right atrium. A stent was successfully implanted in the vena cava percutaneously, and the stenosis was relieved...
September 2014: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Osamah Aldoss, Nicholas Von Bergen, Ian Law, Abhay Divekar
OBJECTIVES: We sought to review our current philosophy that all primary invasive electrophysiologic (EP) studies in patients with atrial switch procedures (ASPs) should undergo hemodynamic evaluation and have interventional expertise available. BACKGROUND: Patients who have undergone an ASP for dextro-transposition of the great arteries have a high incidence of both hemodynamic and EP sequelae. We present our data to support the combined assessment approach for these patients...
March 2015: Congenital Heart Disease
Michael M Ross, Marcus S Schamberger, Mark H Hoyer
We present a patient with a history of Mustard repair for transposition of the great arteries. The patient presented with complete inferior venous baffle obstruction and a large baffle leak after several years of cyanosis. Complete relief of the obstruction and exclusion of the baffle leak were accomplished with the use of a combination of bare metal stenting and the Gore(®) Excluder(®) aortic extender. To our knowledge, this represents the first reported use of the Gore(®) Excluder(®) aortic extender in the setting of inferior venous baffle leak and associated total inferior vena cava obstruction...
January 1, 2016: Catheterization and Cardiovascular Interventions
William Wilson, Mark Osten, Lee Benson, Eric Horlick
As increasing numbers of patients with congenital heart disease enter adulthood, there is a growing need for minimally invasive percutaneous interventions, primarily to minimize the number of repeated surgeries required by these patients. The use of percutaneous devices is commonplace for the treatment of simple lesions, such as atrial septal defect, patent foramen ovale, patent duct arteriosus, and abnormal vascular connections. There is also substantial experience with device closure of membranous and muscular ventricular septal defects, as well as more complex shunts such as baffle leaks after atrial switch repair and ventricular pseudoaneurysms...
January 2014: Canadian Journal of Cardiology
Ronald K Binder, Fabian Nietlispach, Ronald G Carere
We report the innovation of both a partly-covered and completely-covered, variable-diameter, balloon-expandable stent that was custom-designed by NuMed, Inc for percutaneous closure of a baffle leak after total caval pulmonary connection (TCPC). A 50-year-old patient, born with tricuspid atresia, who had undergone TCPC, developed severe persistent cyanosis due to a right-to-left shunt through a TCPC baffle leak. Re-operation was deemed too high risk. Therefore, considering his complex anatomy, a custom-made, partly-covered, tapered, balloon-expandable stent was designed and successfully deployed...
May 2013: Journal of Invasive Cardiology
Joseph M Mets, Lisa Bergersen, John E Mayer, Audrey C Marshall, Doff B McElhinney
BACKGROUND: Factors associated with obstruction of the cavopulmonary pathway in patients with a lateral tunnel (LT) intracardiac Fontan connection and outcomes of percutaneous stent implantation for this complication have not been characterized. METHODS AND RESULTS: Between 1999 and 2011, 51 patients underwent stent implantation for LT pathway stenosis at a median age of 10.2 years and a median of 6.9 years after Fontan completion. Compared with control patients undergoing catheterization for other indications, patients had significantly higher inferior vena cava pressures (15...
February 2013: Circulation. Cardiovascular Interventions
Jan Hinnerk Hansen, Ute Runge, Anselm Uebing, Jens Scheewe, Hans-Heiner Kramer, Gunther Fischer
BACKGROUND: Cardiac catheterization and interventional procedures are an important part of staged surgical palliation for hypoplastic left heart syndrome (HLHS). METHODS: We reviewed our experience of interventional procedures for HLHS patients treated between 01/1996 and 12/2010. RESULTS: Overall, 222 neonates received a Norwood operation. Of them, 181 underwent 554 catheterizations with 243 interventions. Recoarctation was treated by balloon angioplasty (BA) in 46 patients...
November 2012: Congenital Heart Disease
James Bentham, Kate English, Dominic Hares, John Gibbs, John Thomson
The aim of this study was to describe the clinical importance and methods of transcatheter closure of systemic venous baffle leaks after atrial redirection procedures for transposed great vessels. Until the late 1970s, atrial redirection surgery was the principal surgical palliative approach to manage transposed great vessels. Baffle leaks are among the many long-term complications of this type of surgery, and their prevalence increases over time. The clinical consequences of baffle leaks in this population are poorly understood, and the indications for closure are incompletely defined...
October 1, 2012: American Journal of Cardiology
Eun Young Choi, Kyung Suk Lee, Jin-young Song
Intravascular or intracardiac stenosis occurs in various congenital heart diseases or after surgical repair. Although balloon angioplasty is the first option for relieving stenosis, frequently restenosis occurs because of elastic recoil or kingking component. The use of a self-expandable stent and covered stent in congenital heart disease has been reported for selected cases. In general, they have been performed for coarctation of the aorta or aortic aneurysm. We now report successful implantation of a self-expandable stent with a self-expandable covered stent graft in a case of lateral tunnel dehiscence with stenosis after a Fontan operation...
February 2013: Cardiology in the Young
Werner Budts, Filip Rega, Marc Gewillig
A typical scimitar vein was surgically corrected in a female patient of 35 years old. The postoperative course was uneventful and in the first months after the functional capacity normalized. Six months after the correction, the patient developed progressive dyspnea. Kinking and distal stenosis of the intracardiac baffle which connected the scimitar vein to the left atrium were diagnosed. Balloon dilatation and stenting could normalize the blood flow through the baffle. The patient remains symptom-less up to six months after the procedure...
February 2013: Catheterization and Cardiovascular Interventions
Ramón Arreola-Torres, Alberto García-y Otero, Alberto Valencia-Castellanos, Eliseo Portilla-de Buen, Fernando Carrillo-Llamas
A Fontan completion with a hybrid approach was performed on a 27-month-old girl with a univentricular heart. A large covered stent was placed between the inferior vena cava and the cavopulmonary anastomosis through a pericardial patch in the intracardiac fenestrated tunnel, circumventing the need for an occluder device for baffle closure. The child's progress has been good and she displays normal growth and acceptable clinical, ultrasonographic, and laboratory results.
April 2012: Annals of Thoracic Surgery
Kevin D Hill, Gregory Fleming, J Curt Fudge, Erin L Albers, Thomas P Doyle, John F Rhodes
OBJECTIVES: To assess safety, efficacy, and intermediate term outcomes of percutaneous interventions in Mustard patients. BACKGROUND: Baffle leaks and obstruction are present in 20% of Mustard survivors. Surgical reintervention is associated with high mortality. METHODS: Retrospective review of percutaneous interventions performed at three adult congenital catheterization programs. RESULTS: Overall, 26 catheterizations and 29 interventions were performed in 22 patients (mean age 32...
November 15, 2012: Catheterization and Cardiovascular Interventions
Siva K Mulpuru, Victor Pretorius, Ulrika Maria Birgersdotter
No abstract text is available yet for this article.
August 2012: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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