Transcatheter closure of a non-restrictive patent ductus arteriosus with an Amplatzer muscular ventricular septal defect occluder

Eicken, Andreas; Balling, Gunter; Gildein, Hans Peter; Genz, T.; Kaemmerer, Harald; Hess, John

doi:10.1016/j.ijcard.2006.10.023

Cited by 41 publications

(32 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the case of patients with large VSDs, for example, the drop in pulmonary vascular resistance induced by such therapies leads to an increase in flow and shear stress in the pulmonary circulation, while high pressures through the defect persist. 20 There is potential conversion of Eisenmenger physiology to iPAH physiology with worse long-term outcome and high perioperative risk, but experience is very limited and no long-term data are available. There are serious concerns when taking into consideration closure of cardiac defects in patients with established PAH.…”

Section: Corrective Interventionsmentioning

confidence: 99%

Eisenmenger Syndrome: Not Always Inoperable

Liang

Zhou

2012

Respir Care

View full text Add to dashboard Cite

Recently, advanced therapies for pulmonary arterial hypertension have become available, and have been effective in reducing pulmonary vascular resistance and symptoms in patients with Eisenmenger syndrome, previously thought to be inoperable. This review summarizes the current knowledge on the pathophysiology and treatment of Eisenmenger syndrome. The recent introduction of targeted therapies in pulmonary arterial hypertension has led to a renewed insight in the pathophysiology and treatment of Eisenmenger syndrome. Patients with Eisenmenger syndrome using a diagnostic-treatment-and-repair strategy are amenable to surgery after successful treatment with advanced therapy. With continued improvements in the diagnosis, preoperative management, refinement of surgical techniques and intra-and postoperative management strategies, the patients with Eisenmenger syndrome selected using a diagnostic-treatment-and-repair strategy are operable with safety and efficacy in the current era with advanced pulmonary arterial hypertension therapy. Future directions of Eisenmenger syndrome may be the combination of reversal of pulmonary vascular remodeling and correction.

show abstract

Section: Corrective Interventionsmentioning

confidence: 99%

Eisenmenger Syndrome: Not Always Inoperable

Liang

Zhou

2012

Respir Care

View full text Add to dashboard Cite

show abstract

“…The current rise in adult patients with complex CHD-PH makes the debate about intervention increasingly relevant. In the past, similar case reports have been published concerning invasive interventions in patients with pulmonary hypertension and various forms of CHD, which contribute to the statement that tailored interventions can improve clinical status when guidelines are inconclusive [24,25]. More publications of individual experiences are warranted to further enhance insight into outcomes after intervention.…”

Section: Discussionmentioning

confidence: 79%

Tailored circulatory intervention in adults with pulmonary hypertension due to congenital heart disease

et al. 2016

View full text Add to dashboard Cite

Background Adults with pulmonary hypertension associated with congenital heart disease (PH-CHD) often have residual shunts. Invasive interventions aim to optimise pulmonary flow and prevent right ventricular failure. However, eligibility for procedures strongly depends on the adaptation potential of the pulmonary vasculature and right ventricle to resultant circulatory changes. Current guidelines are not sufficiently applicable to individual patients, who exhibit great diversity and complexity in cardiac anomalies. Methods and ResultsWe present four complex adult PH-CHD patients with impaired pulmonary flow, including detailed graphics of the cardiopulmonary circulation. All these patients had an ambiguous indication for shunt intervention. Our local multidisciplinary Grown-Ups with Congenital Heart Disease team reached consensus regarding a patient-tailored invasive treatment strategy, adjacent to relevant guidelines. Interventions improved pulmonary haemodynamics and short-term clinical functioning in all cases. Conclusions Individual evaluation of disease characteristics is mandatory for tailored interventional treatment in PH-CHD patients, adjacent to relevant guidelines. Both strict

show abstract

“…For lager PDAs, the Amplatzer mVSD occluder is an effective choice yet, particularly for those complicated with severe pulmonary arterial hypertension. [7][8][9][10][11] The mVSD occluder manufactured in China is similar to the Amplatzer occluder. We choose the mVSD occluder because the duct in our case was large and the pulmonary pressure was high.…”

Section: Discussionmentioning

confidence: 99%

An Infectious Pseudoaneurysm Caused by Ventricular Septal Defect Occluder in Patent Ductus Arteriosus Closure in a Two-Year-Old Child

Qiu

Jin

et al. 2017

Int. Heart J.

View full text Add to dashboard Cite

SummaryWe present a case of an infectious pseudoaneurysm after patent ductus arteriosus (PDA) closure with a ventricular septal defect (VSD) occluder in a two-year-old child. The aneurysm grew rapidly but was successfully removed in time and the patient survived. To our knowledge, this is the first report of an infectious pseudoaneurysm caused by VSD occluder in PDA closure.(Int Heart J 2017; 58: 1017-1019) Key words: Aneurysmal dilatation, Infectious endocarditis, Transcatheter A neurysmal dilatation of ductus arteriosus has been considered a rare but potentially fatal abnormality. It can be either congenital or acquired as a complication of surgical ligation of patent ductus arteriosus (PDA) or after a ductal infection. And the congenital ones were much commoner than the acquired ones. In the early days, the surgical method for PDA was excision, which was replaced by occluder nowadays. There were case reports on ductus arteriosus aneurysm in PDA excision.1,2) However, to our knowledge, this is the first report of pseudoaneurysm caused by PDA occluder. Case ReportA two-year-old girl (weighing 10.5 kg) presented with a week history of cough. A physical examination revealed a continuous murmur at the second left intercostal space. Transthoracic echocardiogram revealed a PDA (Figure 1).The patient underwent right heart catheterization. A 5 French (Fr) sheath was inserted into the right femoral vein, followed by a 5-Fr MPA1 catheter, and right-sided pressures were recorded. The catheter was removed, flushed, and then inserted into the right femoral artery. The left-sided pressures were then recorded.The patient was found to have a funnel-shaped PDA (5 mm pulmonary end diameter, 13 mm aortic end diameter and 8 mm length) with preprocedural shunt and Qp:Qs of 4.1:1 (Figure 2). Right heart catheterization demonstrated a pulmonary arterial pressure of 90 mmHg/50 mmHg (mean 63 mmHg) with a mean pulmonary capillary wedge pressure of 7 mmHg. The pulmonary vessel resistance was 459 dynes sec cm-5.A 14 mm muscular ventricular septal defect (mVSD) occluder (Starway Medical Technology, China) was advanced to the site of the PDA through a 9 Fr delivery system. Its subsequent deployment closed the PDA. Postprocedural pulmonary arterial pressure was recorded as 50 mmHg/30 mmHg (mean 37 mmHg). Postoperative transthoracic echocardiogram (TTE) found no residual shunt. 0.5 g Cefazolin was given prophylactically 40 minutes before the procedure and 11.5 hours after the procedure. The postoperative examinations were normal and the patient was discharged. However, the patient came down with a fever of 40 15 days after the procedure and was transferred from a local hospital to ours. The high fever has been lasting and no response for medicines with Vancomycin and Meropenem for 2 weeks at local hospital. TTE showed that the occluder seemed to drop into the main pulmonary artery. The cardiac computed tomographic angiography revealed an aneurysmal dilatation of the ductus arteriosus with a maximum diameter of 30 mm (Figure 3, 28*30 mm). The...

show abstract

Transcatheter closure of a non-restrictive patent ductus arteriosus with an Amplatzer muscular ventricular septal defect occluder

Cited by 41 publications

References 8 publications

Eisenmenger Syndrome: Not Always Inoperable

Eisenmenger Syndrome: Not Always Inoperable

Tailored circulatory intervention in adults with pulmonary hypertension due to congenital heart disease

An Infectious Pseudoaneurysm Caused by Ventricular Septal Defect Occluder in Patent Ductus Arteriosus Closure in a Two-Year-Old Child

Contact Info

Product

Resources

About