Septal Defect Closure Research Articles

Transcatheter closure of atrial septal defect associated with arrhythmogenic right ventricular cardiomyopathy: a case report and literature review

Arrhythmogenic right ventricular cardiomyopathy is characterised by progressive, fibrofatty replacement of myocardium, and ventricular arrhythmias, and its prognosis is usually poor. Arrhythmogenic right ventricular cardiomyopathy associated with atrial septal defect is very rare, and this combination may make the diagnosis, treatment, and prognosis difficult. We present a case of a patient with this association who underwent interventional treatment with a septal defect occluder. Transcatheter closure of atrial septal defect in a patient with arrhythmogenic right ventricular cardiomyopathy is hitherto unreported. During a 3-year follow-up he remained relatively stable. We also review the cases reported in the medical literature describing this uncommon association between arrhythmogenic right ventricular cardiomyopathy and atrial septal defect or patent foramen ovale.

TCT-161 Transcatheter Closure of Atrial Septal Defect with Inferior Vena Cava Rim Deficiency: Reconsideration of anatomical indication

TCT-161 Transcatheter Closure of Atrial Septal Defect with Inferior Vena Cava Rim Deficiency: Reconsideration of anatomical indication

Fluoroscopic anatomy of left-sided heart structures for transcatheter interventions: insightfrom multislice computed tomography.

With the introduction of transcatheter structural heart therapies, cardiologists are increasingly aware of the importance of understanding anatomical details of left-sided heart structures. Understanding fluoroscopic cardiac anatomy can facilitate optimal positioning and deployment of prostheses during transcatheter valve repair/replacement, left atrial appendage occlusion, septal defect closure, and paravalvular leak closure. It is possible to use multislice computed tomography to determine optimal fluoroscopic viewing angles for such transcatheter therapies. The purpose of this paper is to describe how optimal fluoroscopic viewing angles of left-sided heart structures can be obtained using computed tomography. Two- and 3-chamber views are described and may become standard in the context of transcatheter structural heart interventions.

Perventricular Device Closure of Ventricular Septal Defect Using a Video-Assisted Thoracoscopic Approach

We describe a new technique of perventricular closure of a perimembranous ventricular septal defect on a beating heart using transesophageal echocardiography guidance and video-assisted thoracoscopy. Ventricular septal defects were closed successfully, and no shunts, rhythm disorders, or valve incompetence developed during the short hospital stay. This procedure is safe and effective for selected patients. These early and mid-term results encourage further evaluation.

RADICAL CORRECTION OF COMBINED CONGENITAL HEART DISEASE IN PATIENT WITH EXTRAHEPATIC PORTAL HYPERTENSION

Aim . To present rare clinical observation of successful surgical treatment of the patient with double-chamber right ventricle in combination with ventricular septal defect, subaortic fi brosis and muscular stenosis, insufficiency of the aortic valve and extrahepatic portal hypertension. Description . Patient F., 15 years old, was diagnosed with Congenital Heart Disease – double-chambered right ventricle, ventricular septal defect. Fibromuscular subaortic stenosis. Aortic valve insuffi ciency II. Circulatory failure II A., functional class III. Extrahepatic portal hypertension. Splenomegaly. Thrombocytopenia. The state after the imposition of splenorenal anastomosis in September 1998 and the imposition of mesocaval H-shaped anastomosis in 1998. Non-functioning anastomoses. Patient indicated for surgical correction of CHD, however, given the low level of platelets, expressed splenomegaly, leucopenia, the patient was referred for a preliminary treatment to Rogachev’s Pediatric Hematology, Oncology and Immunology Center. The treatment (stimulating thrombopoiesis using romiplostim) gave no signifi cant effect. Platelet count reached 70–90 A~ 10 9 . Seeing of frequent bleeding from esophageal varices, the patient underwent varix sclerosis. At the time of hospitalization – no esophageal varices. The patient appealed to V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs where he was recommended for surgical treatment. Result . The patient performed surgery: radical correction of CHD: resection of the stenosis of the outfl ow tract of the right ventricle, subaortic stenosis resection, closure of ventricular septal defect, AV plasty under cardiopulmonary bypass. The early postoperative period was uneventful. Leukopenia was observed to 1,2 A~ 10 9 , thrombocytopenia 70–90 A~ 10 9 . Despite the low level of platelets bleeding in pre-and postoperative period was not registered. Antibiotic therapy with tienam. Good postoperative results were obtained. Liver function was not affected. Conclusion . Presented clinical case demonstrates the possibility of surgical intervention of combined heart disease with cardiopulmonary bypass in patient with extrahepatic portal hypertension.

AV block after flutter ablations?

A 68-year-old, otherwise healthy male, presented at the emergency department with dizziness and near-syncope 4 days after a redo catheter ablation procedure for atypical right atrial flutter. In 1980 he underwent surgical closure of an atrial septal defect. One year prior to the current problem, a catheter ablation procedure in the right atrium was performed because of an atypical isthmus-dependent atrial flutter. During this procedure the cavotricuspid isthmus was blocked. Four days before presentation at the emergency department, a redo procedure was performed because of another postincisional atrial flutter. This time the flutter circuit was located in the septum and was successfully ablated. The earlier ablation lines were well recognisable and still formed block. Physical examination and laboratory tests did not demonstrate any abnormalities.

Large Amplatzer atrial septal occluder in growing children: an echographic study.

Lesions of adjacent structures have been reported after closure of large atrial septal defects with the Amplatzer septal occluder. In children, growth of the heart should modify the initial relationship between the device and surrounding structures. To compare the relationship between large Amplatzer septal occluder and adjacent cardiac structures at short-, mid-, and long-term follow-up in at-risk paediatric population using echocardiography. A total of 25 children (4.6±2.9 years old, 18 girls) with the largest atrial septal defect devices implanted between 1997 and 2002 were enrolled prospectively for complete echocardiogram 17.8±10.5 months (mid-term follow-up) and 8.8±0.9 years (long-term follow-up) after the procedure. RESULTS were compared with the echocardiogram carried out 2.1±3.4 days after the procedure (short-term follow-up). The minimal distance between the left disk and the mitral valve increased: 1.4±2.0 mm at short-term and 5.1±2.3 mm at long-term follow-up (p<0.05), leading to less contact between the disk and the anterior leaflet and less mitral regurgitation (10 at short-term, 4 at long-term follow-up, p<0.05). The number of devices straddling the aorta decreased from 17 to 12 at long-term follow-up (p<0.05). There was protrusion of disk in the venous structure in seven patients on the first echocardiogram, which disappeared at long-term follow-up. Although frequently in close contact with the aortic root, mitral valve, or venous returns, large devices tend to centre and move away from the surrounding structures, with decreased risk for long-term distortion.

Anesthetic efficacy of different doses of dexmedetomidine combined with ketamine in pediatric patients undergoing closure of ventricular septal defect

Objective To evaluate the anesthetic efficacy of different doses of dexmedetomidine combined with ketamine in the pediatric patients undergoing closure of ventricular septal defect.Methods Ninety pediatric patients with ventricular septal defect requiring interventional treatment,aged 4-11 yr,weighing 12-47 kg,of ASA physical status Ⅰ or Ⅱ,were randomly divided into D1-3 groups (n =30 each) using a random number table.After admission to operating room,anesthesia was induced with iv atropine 0.02 mg/kg and ketamine 1.0 mg/kg,followed by administration of a loading dose of dexmedetonidine 0.5 μg/kg which was infused over 10 min.In D1,D2 and D3 groups,dexmedetomidine 0.7,1.0 and 1.2 μg· kg 1 · h-1 were infused intravenously,respectively,until the end of operation.After the pediatric patients lost consciousness,the femoral artery was punctured to perform interventional treatment.Additional ketamine 0.5 mg/kg was given when the depth of anesthesia was inadequate.BIS,BP,HR and SpO2 were recorded after admission to the operating room (T0),at 1 and 5 min after ketamine administration (T1,2),at the end of loading dose of dexmedetomidine infusion (T3),at 15 min after maintenance dose of dexmedetomidine infusion (T4),immediately after operation (T5),and immediately after emergence (T6).The total consumption of ketamine,cases who needed additional ketamine and atropine,operation time,emergence time and development of adverse effects such as respiratory depression and postoperative agitation were recorded.Results Compared with the baseline value at T0,BIS value was significantly decreased at T4,5 in the three groups,HR was decreased at T4,5 in D2,3 groups,and no significant change was found in BP and SpO2 at each time point in the three groups.Compared with D1 group,the requirement for additional atropine was significantly increased,the total consumption of ketamine was reduced,and the requirement for additional ketamine and incidence of respiratory depression were decreased in D2 and D3 groups.No patients needed additional ketamine in D2 and D3 groups.The requirement for additional atropine was significantly higher in D3 group than in D2 group.There was no significant difference in the operation time and emergence time among the three groups.No pediatric patients developed agitation during emergence from anesthesia.Conclusion Ketamine 1.0 mg/kg (for induction of anesthesia) combined with a loading dose of dexmedetomidine 0.5 μg/kg and maintenance dose of dexmedetomidine 1.0 μg·kg-1 · h-1 (for maintenance of anesthesia) can produce good anesthetic efficacy,which is an optimum combination of anesthesia in pediatric patients undergoing closure of ventricular septal defect. Key words: Dexmedetomidine ; Ketamine ; Child ; Heart septal defects, ventricular

TCTAP A-061 Factors Which Determine Compression of Surrounding Structures in Amplatzer Septal Occluder Following Transcatheter Closure of Atrial Septal Defects

TCTAP A-061 Factors Which Determine Compression of Surrounding Structures in Amplatzer Septal Occluder Following Transcatheter Closure of Atrial Septal Defects

TCTAP A-054 Long-term Clinical Outcomes After Transcatheter Closure of Atrial Septal Defect in Adult: Influence of Age Procedure

TCTAP A-054 Long-term Clinical Outcomes After Transcatheter Closure of Atrial Septal Defect in Adult: Influence of Age Procedure

TCTAP C-228 Successful Closure of Post-myocardial Infarction Ventricular Septal Defect with Transcatheter Occluder

TCTAP C-228 Successful Closure of Post-myocardial Infarction Ventricular Septal Defect with Transcatheter Occluder

OP-086 New Modified Balloon-Assisted Technique to Provide Appropriate Deployment in the Closure of Large Secundum Atrial Septal Defect Using Amplatzer Septal Occluder

OP-086 New Modified Balloon-Assisted Technique to Provide Appropriate Deployment in the Closure of Large Secundum Atrial Septal Defect Using Amplatzer Septal Occluder

Succesful transcatheter closure of perimembranous ventricular septal defect with inlet extension using ADOI

Introduction Transcatheter closure of perimembranous ventricular septal defect (PM VSD) is abandoned in many center and in some became restricted to certain age and criteria because of the risk of complete heart block (CHB). The risk of damaging the tricuspid valve (TV) in the presence of inlet extension is another risk. I am presenting successful closure of such defect using Amplatzer occlude device for PDA with reasonable follow up period in Prince Sultan Cardiac Center PSCC. Method Through 2011 4 patients underwent transcatheter closure of PM VSD with inlet extension , all patients were consented and procedure were done under general anesthesia , Transesophageal echocardiography was done in all, one has 3D assessment Hemodynamics were assessed pre procedural, A-V loop was applied in 2 patients, ADOI were used in all, heparin and antibiotics were giving during and 24 hr post procedure, 3 patients were extubated same day and one the following day, all patients were kept on aspirin for 6 months. Result Median age 17 kg , 3 female and 1 male , median age 7 year, Median ventilatory duration is one day, Median hospital stay is 2 days, Median Follow up is 10 months, No immediate or early complication or deaths, normal ECG immediately and during follow up period , normal Echocardiography with no residual leak during follow up period. Conclusion In selected patients with PM VSD and inlet extension ADOI device can be used safely and effectively to close the defect with no immediate or early complications.

PW349 Percutaneous Closure of Atrial Septal Defect When Surgery Is Not Advisable

PW349 Percutaneous Closure of Atrial Septal Defect When Surgery Is Not Advisable

PFO and ASD Closure in Adulthood: Where Do We Stand?

Ever since the observation was made linking a higher prevalence of a patent foramen ovale (PFO) in younger individuals with cryptogenic stroke (CS), there has been a vigorous debate as to the role the PFO plays and a search for the optimal management strategy to prevent recurrent CS. Data from observational studies from the past two decades have demonstrated the superiority of percutaneous device closure over medical therapy. The recent publication of three randomized controlled trials (RCTs), which failed to demonstrate the superiority of percutaneous closure has reignited the controversy as to how best treat these patients. In this article, we will review the contemporary literature from the past three years including the results from new meta-analyses of medical therapy and device closure. In addition, we will review the three published randomized control trials to date (ie, CLOSURE I, the PC trial, and RESPECT) along with a meta-analysis of their results. While on primary intention-to-treat analysis, the three RCTs failed to demonstrate a superiority of percutaneous PFO closure vs medical therapy, a closer look at the data seems to suggest a trend toward benefit. We come to the conclusion that the issue of optimal treatment of PFO in patients with CS is far from settled and is unlikely to be a "one size fits all" approach due to the heterogeneity of this condition. In our opinion, based on the entirety of available data, both observational and randomized, there is likely a role for percutaneous device closure in select patients with CS in whom a PFO is the likely cause of their first stroke and will remain a significant risk for recurrent neurologic events. The article will go on to review current indications for atrial septal defect (ASD) closure and will highlight safety, efficacy and caveats regarding this technique.

New-onset migraine following closure of atrial septal defects in children

New-onset migraine following closure of atrial septal defects in children

Ball Thrombus in the Right Atrium after Patch Closure of Atrial Septal Defect

An 18 year-old woman who underwent secundum atrial septal defect (ASD) closure with a dacron patch 10 months prior returned for follow-up examinations. She received no anticoagulation therapy and remained asymptomatic after surgery. The patient was in normal sinus rhythm and there was no abnormality in physical examination or coagulation testing. Transthoracic echocardiograms (TTE) showed a globular, moderate echoic, homogenous mass (2 cm 2 cm) attached to the anterolateral wall of the right atrium by a narrow stalk, moving back and forth during the cardiac cycle without changing shape or protruding into the right ventricle (Fig. 1A, Video 1). Delayed gadolinium-enhanced

Percutaneous Closure of a Perimembranous Ventricular Septal Defect Through Arm Approach (Radial Artery and Basilic Vein)

We report a case of percutaneous closure of a congenital perimembranous ventricular septal defect (VSD) performed via a radial artery and basilic vein accesses. We further discuss the technique, advantages, and limitation of this innovative approach for perimembranous VSD closure.

Successful use of a cryoablation sheath for closure of problematic atrial septal defect

Successful use of a cryoablation sheath for closure of problematic atrial septal defect

Multimodality imaging for interventional planning and device closure of an atypical ventricular septal defect occurring late after myocardial infarction

A 75-year-old male was transferred to our clinic with suspected ventricular septal defect (VSD) and acute decompensated chronic heart failure New York Heart Association (NYHA) Class IV. He had a history of posterior STEMI 1 month prior to the actual admission with implantation of three drug-eluting stents (DESs) in the right coronary artery (RCA). Three-dimensional (3D) transoesophageal echocardiography (TOE) revealed a medium-sized VSD in the pars membranacea of the ventricular septum with a continuous left-to-right shunt ( Panel A ). Cardiac catheterization showed patent DESs in RCA, post-capillary pulmonary hypertension, …