Stent migration during transcatheter management of coarctation of aorta.

A 13-year-old girl underwent endovascular stent placement for coarctation of aorta. The fully expanded stent migrated to ascending aorta which could be stabilized, recrimped, and repositioned with a 20-mm goose neck snare. Postdilatation was performed from the left brachial route resulting in a good outcome.

Successful exclusion of large post-surgical pseudoaneurysms of the ascending aorta by a percutaneous approach.

Two patients, aged 60 and 63 years, presented with a pseudoaneurysm of the ascending aorta arising from the cannulation site or suture line after previous cardiac surgery. Successful exclusion of the aneurysm was performed in both patients percutaneously using Amplatzer muscular ventricular septal defect occluders.

Stenting the patent arterial duct to increase pulmonary blood flow.

Background: Use of surgically created aoropulmonary shunt is well-established for improving pulmonary blood flow in infants with critical reduction in pulmonary blood flow. Recently, stenting the patent ductus arteriosus has emerged as an alternative in selected infants with congenital heart disease and reduced pulmonary blood flow.

Methods And Results: We reviewed records of consecutive infants undergoing stenting of patent ductus arteriosus between August 2003 and October 2005 at our institution.

Bioptome-assisted coil closure of large pulmonary arteriovenous malformations.

Large pulmonary arteriovenous malformations (AVMs) with feeding vessels larger than 5 mm cause significant right-to-left shunt resulting in cyanosis and need to be occluded as soon as they are diagnosed. Occlusion of such AVMs by simultaneous delivery of multiple coils was attempted in five patients and was successful in completely occluding the AVM in four of them. One patient had transient chest pain during the procedure, presumably as a result of coronary air embolism.

Cannulation of patent arterial duct in patients with pulmonary atresia and ventricular septal defect.

During cardiac catheterization in patients with pulmonary atresia and ventricular septal defect, cannulation of the arterial duct was attempted in 23 children via antegrade approach. It was successful in all but two children. Injection of contrast through antegradely placed catheter resulted in improved opacification of pulmonary arteries.

Transcatheter management of patent ductus arteriosus in sick ventilated small infants.

Background: Large patent ductus arteriosus can present in infancy with congestive cardiac failure and superadded pulmonary infection can necessitate mechanical ventilation. Surgical intervention is traditionally indicated for this subset of patients. We present our experience of transcatheter coil closure of the patent ductus arteriosus in such infants.

Bioptome-assisted coil occlusion of moderate-large patent ductus arteriosus in infants and small children.

Coil occlusion of patent ductus arteriosus (PDA), although inexpensive, is technically challenging for the moderate-large ducts in small children. Bioptome assistance allows better control and precision. We describe case selection strategies, technique, immediate and short-term results of bioptome-assisted closure of moderate-large (>/= 3 mm) PDA in 86 infants and children View Article and Find Full Text PDF

Transcatheter closure of native pulmonary artery for the elimination of accessory pulmonary blood flow after bidirectional Glenn shunt.

We report a case where excessive accessory pulmonary blood flow via the native pulmonary valve after cavopulmonary anastomosis resulted in pulmonary hypertension and heart failure. This flow was successfully eliminated in the cardiac catheterization laboratory using an Amplazter duct occluder that was placed across the native pulmonary valve.

Long-term outcome of patients operated for large ventricular septal defects with increased pulmonary vascular resistance.

Background: There is a paucity of data regarding the long-term outcome of patients operated for ventricular septal defect with severe pulmonary arterial hypertension and elevated pulmonary vascular resistance.

Methods And Results: We evaluated the long-term follow-up results of a selected cohort of patients with nonrestrictive ventricular septal defect and elevated pulmonary vascular resistance (>6 Wood units). Thirty-eight patients, median age 7.

Transcatheter closure of very large (>or= 25 mm) atrial septal defects using the Amplatzer septal occluder.

Between June 1999 and September 2002, 45 patients (age, 34 +/- 13 years; mean shunt ratio, 2.6 +/- 0.6) underwent transcatheter atrial septal defect (ASD) closure at our institution with the Amplatzer septal occluder (mean device size, 31.

Anomalous left coronary artery from the non-adjacent sinus of the pulmonary trunk.

We report a rare variant of anomalous origin of the left coronary artery from the non-adjacent sinus of the pulmonary trunk. The patient also had the right coronary artery arising from the non-facing sinus of the aorta.

Coexistence of congenital subaortic and sinus of valsalva aneurysms.

We report a rare association of an aneurysm of the sinus of Valsalva and a subaortic aneurysm. Congenital defective union of the aortic wall and ventricular muscle with the fibrous ring is probably the explanation for this condition.