Device-assisted transcatheter closure of large secundum atrial septal defects: a novel approach.

Background: Transcatheter closure of large and complex atrial septal defect can pose challenges and complications during device placement. To improve stability, several assistive techniques have been developed.

Methods: This retrospective study evaluated the efficacy of the device-assisted device closure technique for large secundum atrial septal defects.

Diagnostic enigma of pulmonary hypertension: Tale from a series of three patients.

Pulmonary hypertension (PH) is a complex condition with multiple etiological factors. The ability to identify a potential underlying cause is crucial for accurate diagnosis, patient management, and prognostication. This article presents a series of three patient cases to illustrate the enigmatic nature of PH diagnosis.

Aortico right atrial tunnel - Clinical presentation, transcatheter management, and follow-up from a large cohort of patients.

Background: Aortico right atrial tunnel (ARAT) is a rare extracardiac communication between the aorta and the right atrium with two anatomical types. A recent global review identified 59 patients.

Methods: Patients with ARAT from two centers were analyzed for their demographics, symptoms, morphology, management, and follow-up thromboprophylaxis.

PULMOEAST: A Comprehensive Analysis of Pulmonary Hypertension in Eastern India.

Background Pulmonary hypertension (PH) is a debilitating cardiovascular disorder characterized by abnormally elevated blood pressure within the lungs. The diverse range of causes and varied clinical presentations contribute to the complexity of its diagnosis and management. In eastern India and surrounding areas, awareness of PH remains limited, and resources for its management are scarce.

Fenestration: Integrating Wings Into the Atrial Septal Occluder for Navigating a Challenging Terrain.

Background Atrial septal defect (ASD) closure with significant left-to-right shunt and concurrent comorbidities poses challenges for intervention. A fenestrated atrial septal defect (FASD) device is a viable option for patients who cannot undergo complete occlusion due to hemodynamic and medical reasons. This study explores the use of FASD occluders in patients with secundum ASD and associated comorbidities where complete occlusion is difficult.

Unexpected stormy course after uneventful device closure of atrial septal defect - Possibly due to post-COVID-19 inflammatory state.

COVID-19 infection has myriad manifestations from self-limiting illness to stormy multi-organ failure. A 28-year-old woman negative for COVID reverse transcription-polymerase chain reaction underwent an uneventful elective device closure of atrial septal defect on intubation anesthesia. While a brief postprocedural endotracheal bleed was noted, significant hypoxia and respiratory distress ensued after extubation with biventricular dysfunction, pleural effusion, and radiographic evidence of acute respiratory distress syndrome.

Late occurrence of ventricular septal rupture after deep septal myectomy for hypertrophic cardiomyopathy: Causes and management.

Surgical septal myectomy is increasingly utilized for patients with hypertrophic obstructive cardiomyopathy who remain symptomatic despite maximum doses of medical therapy. Deep and extensive septal muscle resections may lead to iatrogenic ventricular septal defects that are detected on transesophageal echocardiography immediately after weaning from cardiopulmonary bypass and immediately corrected in the same surgery. However markedly thinned out ventricular septum after myectomy may be prone to late rupture from high left ventricular systolic pressures causing delayed detection of a ventricular septal defect when the patients present with new onset symptoms.

Cardiac Evaluation in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated With COVID-19.

Multisystem inflammatory syndrome in children (MIS-C) is notorious for its cardiac involvement. We present a single center data of 71 children, of which 57.7% had myocarditis and 26.

Simultaneous balloon aortic valvotomy and patent ductus arteriosus device closure in preterm newborn.

Multiple congenital heart disease in the small preterm newborn such as severe narrowing of aortic valve and patent ductus arteriosus (PDA) is a therapeutic challenge. We report successful transcatheter antegrade balloon dilatation of the aortic valve and device closure of the PDA in a 1700-gram preterm newborn. Meticulous planning and team work aids in such transcatheter intervention.

Challenges in Device Closure of Secundum Atrial Septal Defect in Older Patients in Their Fifth Decade and Beyond.

Objective Transcatheter atrial septal defect (ASD) device closure in the older population presents a greater challenge due to the long-standing effect of atrial left-to-right shunt. This study analyzes the challenges encountered in transcatheter ASD device closure in older patients in their fifth decade and beyond. Methods Adults aged 40 years and above with significant secundum ASD who underwent transcatheter ASD device closure between June 2015 and April 2021 were analyzed.

Cardiac catheterization through ipsilateral radial and ulnar artery access during the same procedure.

We evaluated the safety and feasibility of ipsilateral radial and ulnar artery cannulation during the same catheterization procedure. Crossover from radial to femoral was done in 122 patients. Both ipsilateral radial and ulnar catheterization were performed in 16 patients without any complications, which was further supported by Doppler ultrasonography.

Echocardiographic Classification of Perimembranous Ventricular Septal Defect Guides Selection of the Occluder Design for Their Transcatheter Device Closure.

Background: Perimembranous ventricular septal defects (VSDs) has proximate relation to the aortic and tricuspid valves as well as the conduction tissues. Transcatheter closure utilizes various off-label device designs.

Methods: Perimembranous VSD without aortic margin were classified as group A, with thick aortic margin as group B, with membranous septal aneurysm as group C and defects restricted by tricuspid valve attachments as group D.

Radiofrequency ablation for fascicular ventricular tachycardia causing tachycardiomyopathy and brief literature review.

A 10-years-old boy presented with a history of effort intolerance and palpitations for 4 months. His electrocardiogram showed wide complex tachycardia suggestive of fascicular ventricular tachycardia (VT). The echocardiogram showed moderate-to-severe left ventricular systolic dysfunction without any structural lesion.

Percutaneous closure of large pulmonary artery to left atrial fistula.

Pulmonary artery to the left atrial fistula is a rare anomaly. Two young males presented with effort intolerance and cyanosis and had large pulmonary artery to left atrial fistula from right and left pulmonary artery, respectively. The right-sided fistula was closed with a large duct occluder device in transseptal approach whereas the left-sided fistula was closed with a large muscular ventricular septal device.

Novel use of Konar-multifunctional occluder.

Introduction: Lifetech Konar-multifunctional occluder is a novel device which is primarily used for the closure of ventricular septal defects. Being "multifunctional", the occluder has the potential to be useful in various structural cardiac defects.

Materials And Methods: We share our retrospective review from two centres regarding non-conventional usage of multifunctional occluders in CHD.

Anomalous origin of right coronary artery causing myocardial ischemia in a young patient.

Anomalous right coronary artery from left coronary sinus can have dynamic narrowing and kinking causing symptoms of myocardial ischemia and sudden cardiac death. Surgical repair of the anomaly is required in the symptomatic patient because of risk of ischemia or ventricular arrhythmia. Asymptomatic incidentally diagnosed low-risk patients can be closely followed up with exercise restriction as per present guideline.

A rare case of cardiac tumor in a child.

Pediatric cardiac tumors are rare and usually benign. An infectious etiology like tuberculosis invading myocardium and presenting as infiltrative mass is extremely rare. We present a case of a 15 month old girl with clinical feature of cardiac failure who had infiltrative multiple myocardial masses in echocardiogram.

Unusual method of creation of a transcatheter fenestration in an extracardiac conduit Fontan circulation.

Failing Fontan physiology in univentricular hearts manifest with protein-losing enteropathy, plastic bronchitis, low cardiac output, and recurrent effusions. Transcatheter creation of fenestration in a failing Fontan may be useful in alleviating the symptoms by improving the cardiac output. It is traditionally achieved by puncturing through the conduit from femoral or jugular venous access.

Juxtaposed atrial appendages: A curiosity with some clinical relevance.

If the atrial appendages lie adjacent to each other on same side of the great arteries, instead of encircling their roots, they are referred as juxtaposed. Right juxtaposition of atrial appendages is less common than left juxtaposition. The images demonstrate the classical radiological, echocardiographic, and surgical images of juxtaposed atrial appendages.

A novel method of creation of a fenestration in nitinol occluder devices used in closure of hypertensive patent arterial ducts.

Test occlusion with a balloon is done to predict operability of large hypertensive patent ductus arteriosus (PDA). If the fall in the pulmonary artery pressures is inadequate, a complete closure is not desired. To create a predictable premeasured fenestration in a nitinol occluder device used for closing hypertensive PDA.