A Novel Technique to Reduce Branch Pulmonary Artery Diameter During Transcatheter Pulmonary Valve Replacement Utilizing Side-by-Side Transcatheter Valves in a Superior-Inferior Orientation.

Introduction: Transcatheter pulmonary valve replacement (TPVR) is increasingly used to treat complications related to dysfunctional right ventricular outflow tracts (RVOT). Candidacy is limited by RVOT diameter and coronary artery anatomy. We present the case of a branch pulmonary artery (BPA) that was too large to accommodate a single TPVR and underwent placement of 2 TPVR.

Restrictive tunnel patent foramen ovale and left atrial hypertension in single-ventricle physiology: implications for stent placement across the atrial septum.

Our objective is to describe our approach to the management of patients with single-ventricle physiology and restrictive tunnel patent foramen ovale (TPFO) with unfavorable atrial septal morphology. We describe a series of five patients with single-ventricle physiology and restrictive TPFO and our experience with radiofrequency perforation (RFP), static balloon atrial septostomy (BAS), and stent implantation to create an alternative pathway for left atrial decompression. Between July 4, 2006, and July 10, 2007, five patients with single-ventricle physiology and restrictive TPFO were brought to the cardiac catheterization laboratory for decompression of a hypertensive left atrium.

Cardiopulmonary stress testing in children with sickle cell disease who are on long-term erythrocytapheresis.

The purpose of the study was to assess the feasibility and safety of symptom-limited cardiopulmonary stress testing (CPST) in children with sickle cell disease (SCD), who are on long-term erythrocytapheresis. Maximal symptom-limited CPST was performed in 16 children with SCD who were maintained on long-term erythrocytapheresis and the exercise response in this patient cohort was compared with those of a healthy control population. All patients completed the CPST without any complications.

Rare case of persistent left superior vena cava to left upper pulmonary vein: pathway for paradoxical embolization and development of transient ischemic attack and subsequent occlusion with an amplatzer vascular plug.

We report the successful transcatheter closure of a large persistent left superior vena cava draining into a left upper pulmonary vein in a patient who suffered 2 transient ischemic attacks after intravenous (IV) injection of saline flush solution into a left arm peripheral IV line utilizing an Amplatzer Vascular Plug.

Transcatheter fenestration of autologous pericardial extracardiac Fontan via the transhepatic approach.

We describe a case of a patient with hypoplastic left heart syndrome (HLHS) who developed protein-losing enteropathy (PLE) following autologous pericardial extracardiac Fontan (APEF) operation with successful resolution of PLE following transcatheter fenestration via the transhepatic approach.

Quantitative assessment of ventricular function in sickle cell disease: effect of long-term erythrocytapheresis.

Background: Previous studies on cardiac function in patients with sickle cell disease (SCD) demonstrated abnormalities of systolic and diastolic function including elevated left ventricular myocardial performance index (LVMPI) on chronic transfusion protocols. LVMPI has been validated as a useful and easy non-invasive measure of overall cardiac function. Up to now, there are no reported studies on cardiac function in patients with SCD maintained on long-term erythrocytapheresis (LTE).

Seven-year clinical experience with the extracardiac pedicled pericardial Fontan operation.

Background: Although improved perioperative outcomes with growth potential of the extracardiac pedicled pericardial Fontan (EPPF) operation have been suggested, no advantage has been demonstrated.

Methods: We retrospectively reviewed our institutional experience of 54 consecutive patients undergoing EPPF between June 1996 and August 2003. Clinical and echocardiographic follow-up was obtained yearly with a mean follow-up of 2.

Transcatheter ablation of supraventricular tachycardia and closure of a large secundum ASD in a Jehovah's Witness.

This report describes successful radiofrequency ablation of typical atrioventricular (AV) node reentrant tachycardiafollowed by transcatheter closure of a large secundum atrial septal defect in a patient of the Jehovah's Witness faith. Both procedures were performed successfully during the same catheterization, without complication or need for blood transfusion.

Left atrial thrombus formation on a CardioSeal Septal Occlusion device in a patient with elevated factor VIII: resolution with medical therapy.

We describe a case of thrombus formation on the left atrial disc of a CardioSeal Septal Occlusion device 14 days after transcatheter closure of a patent foramen ovale in a patient with a history of multiple cryptogenic strokes. Work-up to rule out the presence of a hypercoagulable state prior to device closure demonstrated an elevated factor VIII level. Medical therapy with heparin and aspirin was initiated, with subsequent clot resolution.

Catheter closure of autologous pericardial extracardiac Fontan fenestration.

We describe two patients who required fenestration of an autologous pericardial extracardiac Fontan (APEF), short-medium term angiographic follow-up, and subsequent successful transcatheter closure of the fenestration.

A novel technique to prevent displacement of inferior vena cava filter during cardiac catheterization with subsequent transcatheter closure of a patent foramen ovale in a patient with cryptogenic shock.

We describe a novel technique to prevent displacement of a previously implanted inferior vena cava filter in a patient with cryptogenic stroke who underwent transcatheter closure of a patent foramen ovale. This technique may be of use to patients with cryptogenic stroke who might benefit from transcatheter closure of their patent foramen ovale but would otherwise not be candidates for the procedure because of risk of dislodgement of previously implanted inferior vena cava filter.