Systemic-to-pulmonary artery collateral vessels and surgical shunts in patients with cyanotic congenital heart disease: perioperative treatment by transcatheter embolization.

Sharma, Sanjiv; Kothari, Shyam Sunder; Krishnakumar, R.; Saxena, Abhinav; Sharma, Rajesh; Taneja, Karuna; Rajani, M; Venugopal, P

doi:10.2214/ajr.164.6.7754902

Cited by 26 publications

(17 citation statements)

References 10 publications

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“…Transcatheter occlusion is currently the preferred method for the management of MAPCA [3]. Most research on the management of MAPCA has focused on occlusion of MAPCA before surgical correction of the primary disease [4]. Occlusion of MAPCA before surgical correction could lead to a further decrease in arterial oxygen saturation [5].…”

Section: Discussionmentioning

confidence: 99%

Initial Research on Postoperative Management of Tetralogy of Fallot with Major Aortopulmonary Collaterals

Cheng

Fan²,

Tang³

et al. 2016

Cardiology

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Objectives: Tetralogy of Fallot (TOF) with major aortopulmonary collaterals (MAPCA) is a well-known but always severe congenital heart disease. This study was designed to explore proper management after radical correction of TOF with MAPCA based on a hierarchical approach. Methods: The following data were collected from 39 patients planned to undergo radical correction of TOF: age, weight, number of aortopulmonary collaterals, total lumen diameter and collateral diameter-to-body weight ratio, transcatheter occlusion and cardiac catheterization findings, mechanical ventilation time, and ICU monitoring time. The patients were divided into 4 groups by collateral diameter-to-body weight ratio as follows: <0.200 mm/kg (group 1), 0.200-0.500 mm/kg (group 2), >0.500 mm/kg (group 3), and no MAPCA (group 4). Data analysis was performed using IBM SPSS Statistics software for Mac version 22.0 (SPSS Inc., Chicago, Ill., USA) with logistic regression and Fisher's exact test. Results: Most of the patients recovered well after radical correction; postoperative complications occurred in 12 patients and included bloody sputum, low cardiac output syndrome, and severe pulmonary infection that led to tracheotomy. By prolonging the mechanical ventilation time of the patients with postoperative complications, the conditions in 3 patients were improved. However, in the remaining patients, the condition worsened until transcatheter occlusions were performed. Transcatheter occlusion was performed in all 7 patients in group 3 (100%). Only 2 of the 8 patients in group 2 required transcatheter occlusion (25%), and none of the 9 patients in group 1 required transcatheter occlusion (0%). Only 1 patient (group 3) died after radical correction. The transcatheter occlusion results showed a strong association with the total lumen diameter and the collateral diameter-to-body weight ratio (p < 0.05) but no obvious association with age, weight, or the number of aortopulmonary collaterals (p > 0.05). Conclusions: Postoperative management of patients with TOF and MAPCA has great significance. To reduce the morbidity and mortality, transcatheter coil embolization or surgical ligation should be performed in patients with a collateral diameter-to-body weight ratio of at least 0.500 mm/kg. In patients with values between approximately 0.200 and 0.500 mm/kg, prolongation of mechanical ventilation should have priority over transcatheter occlusion, and for patients with values below 0.200 mm/kg no additional treatment is needed.

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Section: Discussionmentioning

confidence: 99%

Initial Research on Postoperative Management of Tetralogy of Fallot with Major Aortopulmonary Collaterals

Cheng

Fan²,

Tang³

et al. 2016

Cardiology

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“…Coils can be delivered through small catheters and through tortuous catheter passes, whereas the GGVOD does not permit the same maneuverability. However, multiple coils are required to close vessels of large diameter, and in the setting of an arteriovenous or aortopulmonary communication, the risk of embolization is significant [1][2][3][4]. Consequently, balloon occlusion of flow during coil delivery has been employed to decrease this risk [2,4].…”

Section: Discussionmentioning

confidence: 99%

“…However, as transcatheter techniques continue to evolve, closure of unnecessary vascular structures, such as patent arterial ducts, arteriovenous fistulae, and arterial and venous collaterals, become more commonplace. Reports of transcatheter closure of systemic-pulmonary artery shunts are few [1][2][3][4][5][6], and devices used thus far consist of embolization coils, detachable balloons, and Rashkind ductal occluders (USCI Angiographics). To our knowledge, the following case represents the first use of a Gianturco-Grifka Vascular Occlusion Device for closure of a modified Blalock-Taussig shunt.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter closure of modified Blalock-Taussig shunt with Gianturco-Grifka vascular occlusion device

Hoyer

León

Fricker

1999

Cathet. Cardiovasc. Intervent.

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“…Follow-up angiograms of 25 vessels, a mean of 9.5 months after coil delivery, showed recanalization in 1 of 18 previously completely occluded collaterals, and progression to complete closure in 4 vessels that had trivial flow immediately after embolization. Sharma et al described results of coil embolization of 67 aortopulmonary collaterals [39]. Total occlusion was achieved in 51 vessels (76%), subtotal in 7 (10%), and partial in 4 (6%).…”

Section: Aortopulmonary Collaterals and Sequestrationsmentioning

confidence: 99%

“…Other smaller series of patients with aortopulmonary shunts include 5 coil embolizations attempted by Sharma et al, with 4 successful occlusions and one embolization to a distal pulmonary artery [39]. DeSouza and Reidy described the use of detachable balloons in 4 patients with Blalock-Taussig shunts [8].…”

Section: Surgical Aortopulmonary Shuntsmentioning

confidence: 99%

Pediatric Cardiovascular Embolization Therapy

Rothman

1998

Pediatr Cardiol

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Transcatheter embolization of superfluous vascular structures has assumed an important role in pediatric interventional cardiology. A variety of devices and materials are being used to treat an increasing number of unwanted arterial, venous, and surgically created vascular connections. In general, the occlusion techniques are simple, the results are good, and the complication rates are low. The current indications, devices, materials, methods, applications, and results of pediatric cardiovascular embolization therapy are described.

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Systemic-to-pulmonary artery collateral vessels and surgical shunts in patients with cyanotic congenital heart disease: perioperative treatment by transcatheter embolization.

Cited by 26 publications

References 10 publications

Initial Research on Postoperative Management of Tetralogy of Fallot with Major Aortopulmonary Collaterals

Initial Research on Postoperative Management of Tetralogy of Fallot with Major Aortopulmonary Collaterals

Transcatheter closure of modified Blalock-Taussig shunt with Gianturco-Grifka vascular occlusion device

Pediatric Cardiovascular Embolization Therapy

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