Septal Defect Closure Research Articles

ATRIAL SEPTAL DEFECT DEVICE RELATED INFECTIVE ENDOCARDITIS IN A 20 WEEK PREGNANT FEMALE

Atrial Septal Defect (ASD) closure device related infective endocarditis a year after implantation in a pregnant woman. 29 year old 20 week pregnant female s/p ASD closure a year ago for primary stroke prevention, presented with fever, and myalgias. She underwent dental cleanings while on

Миниинвазивное закрытие дефектов межжелудочковой перегородки с открытым артериальным протоком у детей до 1 года.

Миниинвазивное закрытие дефектов межжелудочковой перегородки с открытым артериальным протоком у детей до 1 года.

Initial Slovenian experience with MitraClip therapy : Careful selection of patients is crucial for optimal outcome.

MitraClip is a percutaneous mitral repair technology increasingly used for high surgical risk patients with primary or secondary mitral regurgitation. We describe initialSlovenian experiencewith MitraClip and discuss the importance of identifying the suitable candidates for this procedure. We retrospectively analyzed the first 10 patients (mean age 75.6± 6.9 years, logistic Euroscore 28.4± 10.9%) with severe and moderate to severe mitral regurgitation (8secondary, 1primary and 1mixed etiology) who underwent a MitraClip procedure between January 2015 and February 2017. Acute reduction of mitral regurgitation was achieved in all but one patient (90%). There were no periprocedural mortalities and at short to mid-term follow-up (median 12months, interquartile range3-15 months). In eight patients improvement of functional class was observed at discharge. No functional improvement was achieved in apatient with advanced ischemic cardiomyopathy, and in apatient with degenerative mitral disease in whom the MitraClip procedure had failed necessitating mitral valve surgery. One patient experienced late leaflet detachment and was effectively managed with a second MitraClip procedure. There were two vascular complications at the access site and one percutaneous closure of an iatrogenic atrial septal defect. Our initial experiences with asmall number of patients indicate that percutaneous mitral repair with MitraClip is afeasible and safe method in high-risk patients. Special attention should be paid to careful patient selection including detailed echocardiographic evaluation of mitral valve anatomy, technical performance and final result, particularly at the beginning of the learning curve in order to reduce the rate of serious complications.

Landmark lecture on interventional cardiology: interventional cardiac catheterisation for CHD: the past, present, and the future.

CHD affects millions of patients worldwide. Interventional therapies for CHD goes back to the mid-1960s when Bill Rashkind performed balloon atrial septostomy on a cyanotic baby with transposition of the great vessels. This was followed by development of balloon catheters to perform balloon valvuloplasties and angioplasties in the early to late 1980s. Although King and Mills performed the first transcatheter closure of secundum atrial septal defect in the mid-1970s, this procedure was better realised in the mid-1990s. More intracardiac defect closures were performed in the late 1990s and early 2000. This brings us to the current era of percutaneous valve implantation as developed by Bonhoeffer. In this paper, we will discuss the past, present, and future of interventional cardiac catheterisation for CHD patients.

Predictive Factors for Patients Undergoing ASD Device Occlusion Who "Crossover" to Surgery.

The aim of this study was to define characteristics of those patients who are referred for device closure of an Atrial septal defect (ASD), but identified to "crossover" surgery. All patients who underwent surgical and device (Amplatzer or Helex occluder) closures of secundum ASDs from 2001 to 2010 were reviewed and organized into three groups: surgical closure, device closure, and "crossover" group. 369 patients underwent ASD closure (265 device, 104 surgical). 42 of the 265 patients referred for device closure "crossed over" to the surgical group at various stages of the catheterization procedure. The device group had defect size measuring 14.2mm (mean) and an ASD index (Defect Size (mm)/BSA) of 14.0 compared to the corresponding values in the surgical group (20.1mm, ASD index 25.9) (P<0.001) and in the "crossover" group (20.7mm, 22.6 ASD index) (P<0.001). 79 patients in the device group had a deficient rim, and 86% were located in the retroaortic region. 33 patients in the "crossover" group had deficient rims with 70% deficiency in the posterior/inferior rim. The device group with deficient rims had an ASD index of 14.7 compared with the crossover group ASD index of 23.8 (P<0.001). Comparing the device and "crossover" groups, an ASD index greater than 23.7 had a 90% specificity in "crossing over" to surgery. The crossover and surgical groups had statistically larger ASD defect size indexes compared with the device group. Deficient rim in the posterior/inferior rim is associated with a large ASD size index which is a predictive factor for crossing over to surgery. Catheterization did not negatively impact surgical results in the "crossover" group.

Percutaneous Closure of Complex Membranous Ventricular Septal Defect Under Transesophageal Echocardiographic Guidance.

Percutaneous Closure of Complex Membranous Ventricular Septal Defect Under Transesophageal Echocardiographic Guidance.

Assessment of atrial septal defects rims on transesophageal echocardiogram at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Background and Aims: Transcatheter Atrial septal defects (ASD) closure has become the better alternative to surgical closure. Morphological variations of ASD are frequent. We aim to study the rims of ASD in Transesophageal echocardiogram (TEE).Methods: It was a retrospective single center audit done at Shahid Gangalal National Heart Centre, Kathmandu, Nepal. TEE clips of all the patients who underwent TEE evaluation for ASD device closure in our centre between June to August 2017 were studied.Results: During the study period 49 patients underwent TEE to evaluate the rims of ASD for device closure. Atrioventricular rim was good in all patients but it was floppy in one patient. In four chamber view, posterior rim was good in 21(42.8%) patients, floppy in 19 (38.7%) patients and absent in nine (18.5%) patients. Aortic rim was good in 15 (30.6%) patients, floppy in three (6.1%) patients and absent in 31(63.3%) patients. Posterior rim in short axis was good in 17 (34.6%) patients, floppy in 24 (48.9%) patients while it was absent in eight (16.3%) patients. Inferior venacava rim was good in 16 (32.6%) patients, floppy in 23 (46.9%) patients, while absent in ten (20.4%) patients. Superior venacava rim was good in 45 (91.8%) patients, floppy in one (2.1%) patient and absent in three (6.1%) patients. Two (4.1%) patients had two ASDs.Conclusion: Most of the ASD patients have absent rims which makes the procedure more demanding and challenging.Nepalese Heart Journal 2017; 14(2): 35-36

A prospective study of immediate and midterm outcome of patients with transcatheter device closure of congenital ventricular septal defect

A prospective study of immediate and midterm outcome of patients with transcatheter device closure of congenital ventricular septal defect

Transthoracic echocardiography versus transoesophageal echocardiography for assessment and guidance of transcatheter closure of atrial septal defects

Transthoracic echocardiography versus transoesophageal echocardiography for assessment and guidance of transcatheter closure of atrial septal defects

Echocardiographic Evaluation of Cardiac Remodeling After Surgical Closure of Ventricular Septal Defect in Different Age Group

Background: Cardiac remodeling is important issue after surgical closure of ventricular septal defect.Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter during diastole (LVIDd) and left ventricular internal diameter during systole (LVIDs) after surgical closure of ventricular septal defect in different age group. Methodology: This prospective cohort studies was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Dhaka. Patient with surgical closure of VSD were enrolled into this study purposively and were divided into 3 groups according to the age. In group A (n=10), patients were within the age group of 2.0 to 6.0 years; age of group B (n=8) patients were 6.1-18.0 years and the group C (n=6) aged range was 18.1-42.0 years. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd, LVIDs were taken preoperatively and at 1st and 3rd month of postoperative values. Result: A total number of 24 patients was recruited for this study. The mean ages of all groups were 12.60±12.09. After 1 month ejection fraction were decreased by 5.97%, 6.71% and 5.66% in group A, group B and group C respectively. After 3 months ejection fraction were increased by 6.13%, 5.13% and 5.14% in group A, group B and group C respectively. After 1 month fractional shortening were decreased by 13.55%, 9.30% and 9.09% in group A, group B and group C respectively. After 3 months fractional shortening were increased by 7.23%, 7.35% and 4.55% in group A, group B and group C respectively. After 1 month LVIDd were increased by 1.97%, 1.91% and 1.32% in group A, group B and group C respectively. After 3 months LVIDd were decreased by 10.84%, 9.89% and 7.34% in group A, group B and group C respectively. After 1 month LVIDs were increased by 2.19%, 2.86% and 1.98% in group A, group B and group C respectively. After 3 months LVIDs were decreased by 11.68%, 10.97% and 8.87% in group A, group B and group C respectively.Conclusion: Cardiac remodeling occurred after surgical closure of ventricular septal defect and remodeling were more significant in younger age group. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2):69-74

GW28-e0058 Cardiac Mechanics in Children post Percutaneous Transcatheter Closure of Perimembranous Ventricular Septal Defect: Right and Left Ventricular Performance assessed by echocardiography

Percutaneous transcatheter closure of perimembranous ventricular septal defect (pmVSD) with occluder has been most widely used in China. Complications were most focused on aortic insufficiency, complete heart block, and etc. However, whether impaired ventricular performance occurs in pediatric

Midterm follow-up of transthoracic device closure of an atrial septal defect using the very large domestic occluder (44\u201348\xa0mm), a single Chinese cardiac center experience

BackgroundThe purpose of this study was to outline the midterm follow-up results and complications in patients who underwent transthoracic device closure of an atrial septal defect (ASD) with the very large domestic occluder (44–48 mm).MethodsThe data of 35 patients who underwent transthoracic device closure of an ASD with the very large domestic occluder (44–48 mm) at our institution were collected prospectively between January 2010 and January 2015. All patients were invited for an outpatient visit and contrast TTE for 12–70 months after ASD closure.ResultsThirty-four patients were occluded successfully under this approach and 1 patient was transferred for surgical repair for dislodgement of the occluder. The most frequent complication was transient cardiac arrhythmia. A new third degree atrioventricular block occurred in 1 patient who recovered 1 week later. During the follow-up period, we found no recurrence, no thrombosis, no device embolization, no device failure, and no cases of death. The total occlusion rate was 94.1% in the 12 months of follow-up, and the intracardiac structure and cardiac function were significant improved contemporaneously.ConclusionTransthoracic device closure of an atrial septal defect with the very large domestic occluder (44–48 mm) is a safe and feasible technique. However, long-term follow-up is required to better assess the safety and feasibility of this method for the closure of very large ASDs in patients.

Minimally invasive video assisted surgical closure of secundum atrial septal defect

Minimally invasive video assisted surgical closure of secundum atrial septal defect

P1705Relation between right atrial speckle tracking echocardiography and p-wave dispersion in patients with a percutaneous closure of atrial septal defect

P1705Relation between right atrial speckle tracking echocardiography and p-wave dispersion in patients with a percutaneous closure of atrial septal defect

Transjugular closure of atrial septal defect with the steerable delivery system

Transjugular closure of atrial septal defect with the steerable delivery system

Utilizing Hybrid Techniques to Maximize Clinical Outcomes in Congenital Heart Disease.

The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital cardiology. Recent collaborations between interventional cardiologists and cardiac surgeons have sparked novel innovative hybrid procedures that provide potentially safer, faster, and less invasive alternatives to the management of many diseases. This paper will review the most recent advances in hybrid interventions in the field of pediatric and adult congenital cardiology. The earliest experiences with hybrid interventions included intraoperative stenting of pulmonary arteries and perventricular device closure of ventricular septal defects. Newer hybrid interventions have focused on a hybrid approach to stage 1 palliation for infants with hypoplastic left heart syndrome and hybrid approaches to transcatheter pulmonary valve replacement in patients of all ages. Hybrid approaches to complex congenital heart disease are important in the management of congenital heart disease offering a less invasive approach, and novel hybrid procedures will likely be a focus of future research in this field.

Percutaneous Closure of Ventricular Septal Defect Secondary to Aortic Valve Replacement

Percutaneous Closure of Ventricular Septal Defect Secondary to Aortic Valve Replacement

Percutaneous Closure of Ventricular Septal Defect Secondary to Aortic Valve Replacement

Percutaneous Closure of Ventricular Septal Defect Secondary to Aortic Valve Replacement

Congenital Heart Disease in Adults

With advances in medical and surgical care, an increasing number of children with congenital diseases of the heart and vasculature now survive to adulthood. The proportion of adults who are affected by congenital heart disease is expected to continue to increase. Thus, it is important for clinicians to be knowledgeable about the care of these patients. This review examines acyanotic disorders (shunts and valvular lesions), vascular anomalies, cyanotic disorders, and women’s health issues. Figures show the anatomy of atrial septal defects, transcatheter closure of atrial septal defects, an anatomic cross section showing the atrioventricular septum, the anatomic positions of ventricular septal defects, a computed tomography scan of aortic coarctation, angiogram of a persistent left superior vena cava draining into the right atrium, systemic artery-to-pulmonary artery shunts, magnetic resonance image of a patient with repaired tetralogy of Fallot and long-standing pulmonary valve insufficiency, treatment of pulmonary valve regurgitation with a transcatheter pulmonary valve, computed tomographic images of a patient with atrial switch palliation of transposition of the great arteries and multiple baffle obstructions, stages in the repair of functional single ventricles, and echocardiograms of a patient with Ebstein anomaly. Tables list recommendations for pulmonary valve replacement in repaired tetralogy of Fallot, conditions in which pregnancy is high risk, and cardiac indications for fetal echocardiography. This review contains 12 highly rendered figures, 4 tables, and 62 references.

Lutembacher's Syndrome - A Case Report

Lutembacher's Syndrome is a rare heart disease first described by Lutembacher, is a combination of a congenital atrial septal defect (ASD) and acquired mitral stenosis (MS). Traditionally Lutembacher syndrome has been corrected by surgical treatment. If diagnosis could be done earlier, surgical closure of ASD with replacement of mitral valve bears a good prognostic value. Cases were reported where patients treated percutaneouly with a combined Inoue balloon valvuloplasty and septal defect closure using the Amplatzer septal occlusion device. Our patient Mrs. Kohinoor Begum, 26 years old, non diabetic, non hypertensive, admitted in khwaja Yunus Ali Medical College &amp; Hospital (KYAMCH) on 03.04.2013 with the complaints of respiratory distress and chest pain for 3 years. There was history of recurrent attack of fever in childhood. Subsequently she developed MS from Rheumatic carditis. ASD was congenital in origin. After thorough perioperative evaluation pericardial patch closure of ASD with open mitral commissurotomy was done. Postoperative followup 6 months after operation showed no residual shunt with adequately functioning mitral valve.KYAMC Journal Vol. 5, No.-1, Jul 2014, Page 484-487