Cost and efficacy of surgical ligation versus transcatheter coil occlusion of patent ductus arteriosus

Hawkins, John A.; Minich, L. LuAnn; Tani, Lloyd Y.; Sturtevant, Jane E.; Orsmond, Garth S.; McGough, Edwin C.

doi:10.1016/s0022-5223(96)70022-3

Cited by 34 publications

(33 citation statements)

References 25 publications

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“…Thirty-two studies that satisfied the inclusion criteria were included in the analysis (Fig 1). OCEBM levels of evidence varied from level 3 (9 studies) [9][10][11][14][15][16]20,23,26 to level 4 (23 studies) [6][7][8]12,13,[17][18][19]21,22,24,25,[27][28][29][30][31][32][33][34][35][36][37] ( Table 1). Occurrence of UVFP, type of surgery, patient demographics, and vocal fold assessment are reported in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

et al. 2014

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BACKGROUND AND OBJECTIVE: There is variation in the literature in regard to the occurrence of unilateral vocal fold paralysis (UVFP) after congenital cardiothoracic surgery. The objective of this study was to identify and appraise the evidence for the occurrence of UVFP after congenital cardiothoracic surgery in a meta-analysis.METHOD: A comprehensive search strategy in Medline, Embase, and the Cochrane Library was conducted, limited to English publications. Two independent reviewers screened studies for eligibility criteria. Of the 162 identified studies, 32 (20%) met the inclusion criteria. Using the Oxford Centre for Evidence-Based Medicine guidelines, 2 reviewers appraised the level of evidence, extracted data, and resolved discrepancies by consensus. Weighted pooled proportion and 95% confidence intervals (CIs) are reported.

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Section: Resultsmentioning

confidence: 99%

“…7,8,[10][11][12][13][14][15]17,20,21,24,[27][28][29][30][31][34][35][36][37] The weighted pooled proportion was 8.7% (95% CI, 5.4% to 12.6%) (Fig 3). Heterogeneity analysis measured an I 2 of 81.6% (95% CI, 65.0% to 88.4%).…”

Section: Analysis By Type Of Surgerymentioning

confidence: 99%

Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

et al. 2014

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“…The patient was a male child aged 5 years and 6 months, admitted to the outpatient care clinics of the Instituto do Coração of the Faculdade de Medicina of the University of São Paulo with a history of fatigue on physical exertion and repetitive respiratory Surgical Treatment of Coil Embolization to the Pulmonary Artery After an Attempt at Percutaneous Closure of Patent Ductus Arteriosus of complications, and costs similar to those of surgery in select groups of patients 13 . The complications of interventional treatment include the lack of closure of ductus arteriosus, embolization of the device, left pulmonary artery stenosis, lesion or occlusion of the femoral artery, and hemolysis.…”

Section: Case Reportmentioning

confidence: 99%

Tratamento cirúrgico da embolização de coil para artéria pulmonar após tentativa de fechamento percutâneo do canal arterial

Atik¹,

Jatene²,

Costa³

et al. 2004

Arq. Bras. Cardiol.

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0infections. On physical examination, the patient was in good general condition, active, afebrile, acyanotic, eupneic, and his pulses were wide in his 4 limbs. His weight was 22 kg and his height 116 cm. His heart rate was 90 bpm, and his blood pressure was 100/50 mmHg. His precordial area showed no deformities, and the cardiac apex was palpated on the fifth left intercostal space in the midclavicular line. The second cardiac sound on the pulmonary focus had increased intensity. A continuous murmur of great intensity was heard in the high left sternal margin, accompanied by a thrill of equal intensity. The pulmonary auscultation was normal, and no visceromegaly was evidenced.The electrocardiogram showed sinus rhythm with a heart rate of 120 bpm, signs of left ventricular overload and diffuse alterations in ventricular repolarization. A simple chest X-ray showed a mildly enlarged cardiac area, bulging of the middle arch, and accentuation of the pulmonary vasculature, mainly in the hilar region.Doppler 2-dimensional echocardiography confirmed the clinical suspicion of persistent ductus arteriosus with increased pulmonary blood flow and a diameter of 4.5 mm. It was characterized as having moderate hemodynamic repercussion.The percutaneous treatment was chosen to close the ductus arteriosus. Because of the great dimension of the ductus arteriosus, 3 Gianturco coils (William Cook, Europe) were chosen and stacked. The procedure was not successful due to an accident in occluding the ductus arteriosus, with migration of the coils to the left pulmonary tree. In the same procedure, retrieval of 2 coils was possible; the last one became embedded in one branch of the left pulmonary artery, and could not be retrieved ( fig. 1).The patient underwent a complementary investigation to locate the precise site of coil embolization and to determine its repercussion on pulmonary perfusion. Pulmonary perfusion scintigraphy showed a decreased flow to the left lung (34%) as compared with that to the right lung (61%). In addition, chest computed tomography identified the presence of hypoattenuation of metallic density in the projection of the left descending interlobular artery.Because of the impairment of pulmonary perfusion to the left caused by coil embolization, surgical treatment was performed in a programmed and elective manner approximately 6 months after interventional catheterization. Under balanced general anesthesia, the following steps were taken: median sternotomy, longitudinal pericardiotomy, and installation of extracorporeal circulation through the ascending aorta and bicaval cannulation. Section and suture of the ductus arteriosus was performed during the cooling Case Report

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“…Entre estas técnicas estão a secção do canal e sutura dos cotos (17) , toracotomia axilar com ligadura extra pleural (18) e, mais recentemente, com a ligadura do canal por videotoracosco-pia (14,15,19) , fechamento percutâneo proposto por Rashkind com umbrella (8,11) e fechamento com coil de Gianturco (10) . Todas as técnicas propostas buscam menor traumatismo, menor risco para o paciente, menor custo e a mesma efetividade do tratamento cirúrgico convencional, operação com secção e sutura dos cotos com toracotomia clássica.…”

Section: Comentáriosunclassified

“…A permanência no hospital é pequena, em geral ± 24 horas. O custo é baixo, embora GRAY et al (21) em 1993, e HAWKINS et al (18) , em 1996, tenham demonstrado a superioridade cirúrgi-ca do fechamento percutâneo com cateter em relação aos resultados e ao custo.…”

Section: Comentáriosunclassified

Ligadura videotoracoscópica da persistência do canal arterial

Souto

Tinoco

et al. 2000

Rev Bras Cir Cardiovasc

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Cost and efficacy of surgical ligation versus transcatheter coil occlusion of patent ductus arteriosus

Cited by 34 publications

References 25 publications

Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

Tratamento cirúrgico da embolização de coil para artéria pulmonar após tentativa de fechamento percutâneo do canal arterial

Ligadura videotoracoscópica da persistência do canal arterial

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