Transcatheter coil closure of pulmonary arteriovenous malformations in children.

Pulmonary arteriovenous fistula (PAVF) is a rare vascular malformation of the lung that may lead to cyanosis, epistaxis, hemoptysis, and neurological deficits or cerebral abscess. The purpose of this study is to assess the effectiveness of percutaneous transcatheter embolization of PAVF in pediatric patients. Transcatheter embolization of PAVF using spring coils was performed in three patients (two males and one female) who presented between 1989 and 1999.

Life-saving balloon mitral valvuloplasty in patient with cardiogenic shock after cardiac arrest.

Balloon mitral valvuloplasty is the procedure of choice in a selected group of patients with significant mitral stenosis and suitable valve morphology. Experience in patients with cardiogenic shock is very limited. We report the case of a dying patient in cardiogenic shock, with pulmonary edema and severe hepatic damage after cardiac arrest caused by mitral restenosis.

Late massive haemoptyses from bronchopulmonary collaterals in infarcted segments following pulmonary embolism.

Massive, recurrent haemoptyses requiring blood transfusions occurred in a patient who had been diagnosed as having pulmonary thromboembolism 3 months earlier. To the authors' knowledge this is the first case report of this kind, in which massive haemoptyses were proved to be caused by large bronchopulmonary collaterals that had developed in the infarcted lung segments affected by embolism. Selective embolization of the collaterals proved to be therapeutic and life saving.

Percutaneous pericardial biopsy: technique, efficacy, safety, and value in the management of pericardial effusion in children and adolescents.

This study describes our technique of nonsurgical percutaneous pericardial biopsy (PPB), its efficacy and safety, and its diagnostic and therapeutic usefulness in the management of pericardial effusion (PE) in children and adolescents. In an 8-year period, 19 selected patients, aged 2 to 20 years, had PPB for evaluation and treatment of PE. Using this procedure we procured multiple biopsy specimens from various areas of the thickened parietal pericardium, and also procured pericardial fluid for investigation.

Comparison of bronchopulmonary collaterals and collateral blood flow in patients with chronic thromboembolic and primary pulmonary hypertension.

Objective: To compare the visualisation of bronchopulmonary collaterals and bronchopulmonary collateral blood flow in patients with chronic thromboembolic pulmonary hypertension 2nd primary pulmonary hypertension.

Setting: Referral centre for cardiology at an academic hospital.

Patients: Nine patients with chronic thromboembolic pulmonary hypertension and 17 with primary pulmonary hypertension.

Mitral balloon valvuloplasty by Inoue technique without echocardiographic standby.

Mitral balloon valvuloplasty (MBV) by Inoue technique was performed in 85 patients with symptomatic rheumatic mitral stenosis (MS). Twenty-eight patients were male and 57 patients were female. The age range was nine to 59 years (mean 28).

Bronchial arteries in experimental pulmonary infarction: angiographic and morphometric study.

Objectives: The aim was to investigate (1) whether collateral bronchopulmonary circulation developing due to chronic pulmonary embolism could prevent the evolution of pulmonary infarction after induction of pulmonary venous outflow impairment; and (2) how collateral bronchopulmonary circulation developed after acute embolisation of the lung with impaired pulmonary venous outflow.

Methods: Fifty two mongrel dogs were studied. Thirty six dogs were experimental animals and 16 were in a control group.

Iliofemoral venous thrombectomy followed by percutaneous closure of the temporary arteriovenous fistula.

Iliofemoral venous thrombosis treated by anticoagulants alone almost invariably results in postthrombotic sequelae with deep venous reflux alone or combined with an outflow obstruction. This study evaluates the result of iliofemoral venous thrombectomy with temporary proximal arteriovenous fistula (AVF) performed on 48 consecutive patients. In 10 patients the thrombus extended in the inferior vena cava, and the thrombectomy was combined with inferior vena cava interruption.

Collateral bronchopulmonary circulation after spontaneous recanalisation of pulmonary thromboemboli in the dog.

Study Objective: The aim was to study the fate of enlarged bronchial arteries after resolution of experimental pulmonary embolism.

Design: Embolisation of the pulmonary arteries of both lungs was performed with intravenous gelfoam. Pulmonary pressure and pulmonary arteriolar resistance were measured 1 h, 40 d and 80 d after embolisation.

The bronchial arteries of the dog after selective embolization of the pulmonary artery with emboli of various size. A morphological study.

The aim of the study was to investigate whether the development of collateral broncho-pulmonary circulation depends on the size of obliterated branches of the pulmonary artery. Massive embolization of the pulmonary arterial bed was performed with sterile plastic spheres of known size from 0.08 to 1.

Percutaneous balloon occlusion of surgical arteriovenous fistulae following venous thrombectomy.

We describe a percutaneous method of balloon occlusion of surgically created femoral arteriovenous fistulae (AVF) after thrombectomy for acute iliofemoral venous thrombosis. The technique was successful in permanent obliteration of the AVF in 25 of 27 patients. Complications were few, minor, and limited to the developmental period of the procedure.

New nonsurgical technique for multiple pericardial biopsies.

We report a new, nonsurgical technique for obtaining multiple pericardial biopsies in patients with pericardial effusion. A short catheter is introduced by the Seldinger technique under fluoroscopy through the subxiphoid approach. The pericardial fluid is aspirated and the catheter replaced by an 8F teflon sheath with a curved tip.

Assessment of the severity of aortic stenosis: comparison of gradient and valve area.

Hemodynamic data, including simultaneously measured left ventricular pressure, aortic pressure, and cardiac output, were obtained in 17 patients with isolated valvar aortic stenosis, before and during infusion of dobutamine, isoprenaline, dopamine, and pacing. Infusion of sympathomimetic drugs resulted in a significant increase of both mean and peak systolic aortic valve gradient, cardiac output, heart rate, and systolic aortic valve flow per second. On the other hand, the calculated aortic valve area did not change significantly in spite of variable alterations of all values used for calculating aortic valve area and different causes of hemodynamic changes induced.

Percutaneous retrieval of foreign bodies from the cardiovascular system.

The authors retrieved percutaneously an iatrogenic foreign body from the cardiovascular system in 10 patients without any complications. The Dormia basket catcher commonly used for stone extraction from the urinary tract was used in 9 out of 10 patients. The foreign body was extracted 6 times from the right atrium and once each from the pulmonary artery, the right ventricle, the iliac vein and the iliac artery.