4D flow MRI: impact of region of interest size, angulation and spatial resolution on aortic flow assessment.

In cardiovascular magnetic resonance, the 3D time-resolved phase-contrast technique, also known as 4D flow, is gaining increasing attention due to applications that exploit three-directional velocity encoding throughout the cardiac cycle. Blood flow volume assessment usually requires an expert to draw regions of interest (ROI) around the vessel cross section, whereas the errors involved in this estimation have not been thoroughly investigated. Our objective is to quantify the influence of ROI sizing, angulation and spatial resolution of the reconstructed plane employed in blood flow measurements using 4D flow.

Automatic correction of background phase offset in 4D-flow of great vessels and of the heart in MRI using a third-order surface model.

Objective: To evaluate an automatic correction method for velocity offset errors in cardiac 4D-flow acquisitions.

Materials And Methods: Velocity offset correction was done in a plane-by-plane scheme and compared to a volumetric approach. Stationary regions were automatically detected.

Pediatrics Spanish Registry of Percutaneous Melody Pulmonary Valve Implantation in Patients Younger Than 18 Years.

Introduction And Objectives: A decade has passed since the first Spanish percutaneous pulmonary Melody valve implant (PPVI) in March 2007. Our objective was to analyze its results in terms of valvular function and possible mid-term follow-up complications.

Methods: Spanish retrospective descriptive multicenter analysis of Melody PPVI in patients < 18 years from the first implant in March 2007 until January 1, 2016.

Elective implantation of covered stents for coarctation and recoarctation in adolescents and adults.

Introduction And Objectives: Stent implantation is an effective therapy for aortic coarctation and recoarctation. However, in adolescents and adults, aortic wall rupture and dissection can occur, as well as aneurysms during follow-up. In order to reduce these complications, we electively implant covered stents.

Stent-graft deployment for aortic rupture after stenting for aortic recoarctation.

We present the case of a 62-year-old woman who presented with recoarctation and then experienced rupture of the aorta and severe clinical deterioration after a stent was deployed. She was treated immediately by intrastent deployment of a stent-graft, which resolved the extremely serious situation.

[Percutaneous closure of complex fistula between the internal mammary artery and a lobar branch of a pulmonary artery].

A through review of the literature identified only 20 reported cases of fistula involving the internal mammary (internal thoracic) artery and a lobar branch of a pulmonary artery. Surgical closure was frequently done to avoid complications associated with this anomaly. We report the first patient in whom percutaneous treatment was accomplished with a combined technique involving an Amplatzer Duct Occluder device and coils.

[Occlusion of the first septal branch with microcoils in a patient with hypertrophic obstructive cardiomyopathy].

Nonsurgical septal reduction by induced septal infarction is one of the management options in the treatment of patients with hypertrophic obstructive cardiomyopathy. Good immediate and long-term clinical and hemodynamic results have been reported with this technique for occlusion of the first septal branch of the anterior descending coronary artery followed by ethanol infusion. This is the first report of a case in which nonsurgical septal reduction with microcoils has been attempted.

[Guided transcatheter valvulotomy in pulmonary atresia with intact ventricular septum].

Transcatheter valvulotomy in pulmonary atresia with an intact ventricular septum can be used as a first step to create biventricular circulation and to stimulate further development of the hypoplastic right ventricle. We describe our experience in a case of a neonate with this congenital cardiac defect who underwent successful transcatheter perforation of the atretic pulmonary valve. This report highlights the utility of a special technique based on the use of a gooseneck snare positioned just above the atretic valve to guide the advance of a coronary guidewire.

[Reimplantation edema in the transplanted lung. Reperfusion-ischemia or hydrostatic edema?].

The development of non cardiogenic pulmonary edema or pulmonary reimplantation response after lung transplantation has been well described. The cause is ischemic vascular injury of the allograft, results in increased permeability of the lung after reperfusion, in turn leading to interstitial and alveolar edema. We report two cases of pulmonary reimplantation response after bilateral sequential lung transplantation.

[A 49 year old patient with single left ventricular morphology who underwent surgical repair and good outcome ].

We report a 51-year-old patient, diagnosed with single left ventricle and anterior rudimentary chamber which was corrected by a Fontan procedure in 1997. The echocardiogram, Holter and pulmonary perfusion scintigraphy, isotopic ventriculography, magnetic resonance and blood tests performed during follow-up showed an uncomplicated postoperative course. The patient remains asymptomatic.

[PRIMARY STENT IMPLANTATION IN AORTIC COARCTATION. MID-TERM FOLLOW-UP].

The use of balloon-expandable stents provides an effective alternative therapy in patients with stenotic lesions in congenital heart disease. Stents implantation has served to improve the results and to reduce complications of balloon angioplasty for coarctation and recoarctation of the aorta. AIM: We report our results after primary stents implantation for coarctation and recoarctation of the aorta.

[Primary stent implantation in aortic coarctation: mid-term follow-up].

Background: The use of balloon-expandable stents provides an effective alternative therapy in patients with stenotic lesions in congenital heart disease. Stents implantation has served to improve the results and to reduce complications of balloon angioplasty for coarctation and recoarctation of the aorta.

Objective: We report our results after primary stents implantation for coarctation and recoarctation of the aorta.

Stent implantation in a central aorto-pulmonary shunt.

A 5.5-week-old infant with tricuspid atresia presented with severe hypoxemia not responding to the placement of a central shunt (4 mm polytetrafluorethylene). The infant was taken to the catheterization laboratory, where an AVE stent was successfully implanted in a severe postoperative stenosis, at the pulmonary end of the anastomosis.

[Stent implantation in palliative central aortopulmonary shunt of congenital cardiopathies with pulmonary hypoperfusion. Experience of 2 cases].

We describe the pioneer experience of balloon angioplasty and stent implantation in the central polytetrafluoroethylene aorto-pulmonary shunt. Two infants 1 and 13 month-old, with cyanotic complex congenital cardiopathy and pulmonary hypoperfusion, presented signs of prosthesis dysfunction with severe and critic hypoxemia. The angioplasty and stent implantation were performed through retrograde femoral arterial approach and "freely" (without a guide catheter) in the first case and venous via by using Judkins right coronary guiding catheter in the second one.

[Occlusion of the levoatrial cardinal vein with Gianturco coils after Fontan operation].

We report the case of a 6-year-old girl with mitral atresia, hypoplastic left ventricle with a large right ventricle from which the main vases flow with a normal relationship and pulmonary obstruction, in which a modified fenestrated Fontan procedure with Gore-Tex baffle was performed. In the course of the treatment she developed cyanosis and a significant desaturation related to the presence and development of a levoatrial cardinal vein which was treated effectively using Gianturco coils with a good latter evolution. We discuss the possibilities of right-to-left shunting post Fontan procedure, percutaneous treatment as an alternative to surgery, the technique and angiographic characteristics of this case.

Stent implantation in an adult with coarctation of the aorta in the presence of advanced secondary heart failure.

We report the case of a 56-year-old woman with congenital coarctation of the aorta, who presented in critical clinical condition with advanced secondary cardiomyopathy and heart failure. We successfully applied an unusual technique to pass the aortic obstruction, and then implanted a PALMAZ stent. The procedure resulted in prompt clinical improvement and completely resolved the coarctation.

[An anomalous origin of the left coronary artery in the right pulmonary artery with interventricular communication].

A six-month-old female baby with a left coronary artery of anomalous origin in the right pulmonary artery, associated with a interventricular septal defect and a slight mitral pathology, was operated on direct implantation of the left coronary artery with a small segment of the pulmonary artery in the posterior wall of the ascending aorta and closure of the perimembranous defect was performed. The patient has been asymptomatic for one year since surgery.

[Experience with Palmaz stent in pulmonary branch stenosis].

Introduction And Objectives: Since 1989, the balloon expandable Palmaz stent (Johnson & Johnson Interventional Systems) has been used for the treatment of congenital heart disease. This study reports the results and the technique used for its implantation in native and post surgical retraction pulmonary branch stenosis.

Materials And Methods: From february 1995 to june 1996, we have performed this technique in 11 symptomatic children/adolescents with pulmonary branch stenosis, the mean age was 11 +/- 2 years.

[Late reopening of patent ductus arteriosus after complete closure with the Rashkind prosthesis. Possible traumatic origin].

We report the case of a symptomatic adult with an occluded persistent duct with a transcatheter proceeding using a Rashkind prosthesis. After a month of follow up the color-coded Doppler-flow echocardiogram did not show residual shunt, posteriorly the patient's symptoms disappeared and the left ventricular dimensions were reduced. At the thirteen month of follow-up, the patient had an accident while working, falling down from a scaffold.

[Congenital stenosis of pulmonary veins in the adult].

We report a case of congenital bilateral pulmonary vein stenosis associated with a double-chambered right ventricle, ventricular septal defect and persistence of the ductus arteriosus in a 29 year-old female. The angiographic, echocardiographic and surgical findings are discussed. A precise diagnosis, the utility of the echocardiography and the surgical correction of this type of ostial stenosis is also reported.

[Acquired aortic coarctation after surgical operation of ductus arteriosus in a preterm infant].

The coarctation of the aorta can be acquired or secondary to the surgical correction of congenital anomalies of the great vessels. We report the cases of two newborns operated for patency of the ductus arteriosus (normal aortic arch and a great left-to-right-shunt). During the postoperative period the patients were asymptomatic and the echocardiogram showed no abnormalities.

[Thrombocytosis and coronary disease. Report of a case].

We report the case of a young male with an inferior myocardial infarction who was treated with fibrinolytic agents and displayed a good evolution. The only cardiovascular risk factor that this patient had was an idiopathic thrombocytosis with abnormal platelet hyperreactivity tests. The angiogram showed an eccentric lesion of 60% in the left main coronary artery.