Personalized Approach in Transcatheter Palliation of Congenital Heart Disease with Duct-Dependent Pulmonary Circulation: Right Ventricular Outflow Tract Stenting vs. Arterial Duct Stenting.

Despite significant improvements in techniques, the treatment of neonates and infants with congenital heart disease resulting in duct-dependent pulmonary circulation is still significantly challenging. Despite current trends toward early primary surgical repair, temporary palliation is still necessary in those patients who are at high surgical risk for complete correction due to unfavorable clinical or anatomic characteristics. Recent advances in interventional cardiology have led to the emergence of right ventricular outflow tract and arterial duct stenting as cost-effective alternatives to surgical palliation in high-risk surgical candidates or whenever short-term pulmonary blood flow support is anticipated.

Percutaneous closure of 'complex' multi-fenestrated atrial septal aneurysm in visceral situs inversus using a multi-device approach: a case report.

Background: Percutaneous closure is nowadays still deemed challenging in patent forame ovale (PFO) associated to multi-fenestrated atrial septal aneurysm (ASA). This anatomic arrangement is still considered a significant risk factor for recurrence of paradoxical embolism. Theoretically, transcatheter approach could be theoretically even more complex in the case of dextrocardia and visceral situs inversus.

Mid-Term Electrical Remodeling after Percutaneous Atrial Septal Defect Closure with GCO Device in a Pediatric Population.

Background And Aim: The GORE CARDIOFORM (GCO) septal occluder is an atrial septal defect/patent foramen ovale closure device with theoretical advantages over other commercialized devices thanks to its softness and anatomical compliance. Our aim was to evaluate the short- and medium-term electrocardiographic changes after percutaneous ASD closure with GCO in a pediatric population.

Methods: We enrolled 39 patients with isolated ASD submitted to trans-catheter closure from January 2020 to June 2021.

Transcatheter Treatment of Native Idiopathic Multiloculated Aortic Aneurysm Guided by 3D Printing Technology.

Pediatric idiopathic aortic aneurysm is rare. Single saccular malformation can complicate native or recurrent aortic coarctation; however, multiloculated dilatations of the descending thoracic aorta, associated with aortic coarctation, have so far never been described in literature. In our case, printed 3D model technology was crucial in planning transcatheter treatment.

Rescue atrial septal defect closure with the new GORE cardioform atrial septal defect occluder.

Atrioventricular block (AVB) is an infrequent but life-threatening complication of transcatheter closure of atrial septal defect (ASD), accounting for 0.1%-6.2% of cases in large series.

Transcatheter closure of "Surgical" ostium secundum atrial septal defects with GORE® Cardioform ASD Occluder.

Objective: To evaluate the GORE® Cardioform ASD Occluder (GCA)(WL Gore & Associates) device for closure of ostium secundum atrial septal defects (ASDs) with predicted indication for surgical correction.

Background: Closure of large ASD in small children by transcatheter approach is still challenging. This study evaluated the results of GCA in this subset of patients in a tertiary referral center.

Transcatheter Treatment of Ascending Aorta Pseudoaneurysm Guided by 3D-Model Technology.

Ascending aorta pseudoaneurysm is a rare but potentially life-threatening complication of atherosclerosis, infections, chest trauma, transcatheter or surgical interventions. Due to high surgical risk, percutaneous closure is considered a valuable cost-effective therapeutic alternative. In this setting, 3D printing technology is emerging as a powerful tool to plan transcatheter repair.

Novel echocardiographic score to predict duct-dependency after percutaneous relief of critical pulmonary valve stenosis/atresia.

Objectives: This study aimed to identify clinical, hemodynamic, or echocardiographic predictive features of persistent duct-dependency of pulmonary circulation (PDDPC) after effective percutaneous relief of pulmonary atresia with the intact ventricular septum (PA-IVS) or critical pulmonary stenosis (CPS).

Methods: From 2010 to 2021, 55 neonates with PA-IVS or CPS underwent percutaneous right ventricle (RV) decompression at our Institution. After successfully relief of critical obstruction, 27 patients (group I) showed PDDPC, whereas RV was able to support the pulmonary circulation in the remaining 28 patients (group II).

Transcatheter closure of fenestrated atrial septal aneurysm in children: Feasibility and long-term results.

Background: To date, extensive experience in transcatheter closure of fenestrated atrial septal aneurysm (ASA) in the pediatric population is limited.

Methods: To report on procedural feasibility, efficacy, and long-term outcome, we enrolled all children submitted to an attempt of transcatheter closure of fenestrated ASA at two, large volume, pediatric cardiology units (Naples and Massa, Italy) between April 2000 to May 2020.

Results: This retrospective study included 139 patients (median age 9 years [range 2-18] and weight 36 kg [range 10-102]); 19 (13.

Role of cardiac MRI in the prediction of pre-Fontan end-diastolic ventricular pressure.

Background: Growing evidence has emphasised the importance of ventricular performance in functionally single-ventricle patients, particularly concerning diastolic function. Cardiac MRI has been proposed as non-invasive alternative to pre-Fontan cardiac catheterisation in selected patients.

Aim Of The Study: To identify clinical and cardiac magnetic resonance predictors of high pre-Fontan end-diastolic ventricular pressure.

GORE® Cardioform ASD Occluder experience in transcatheter closure of "complex" atrial septal defects.

Objective: To evaluate the GORE® Cardioform ASD Occluder (GCO) (WL Gore & Associates, Flagstaff, AZ) device for "complex" atrial septal defects (ASD) closure.

Background: Transcatheter ASD closure is still challenging in "complex" clinical/anatomic settings. This study evaluated the results of GCO in closure of "complex" ASD in a tertiary referral center.

3D model-guided transcatheter closure of ascending aorta pseudoaneurysm with the novel Amplatzer Trevisio intravascular delivery system.

Ascending aorta pseudoaneurysm (AAP) is a rare but life-threatening complication of atherosclerosis, endocarditis, chest trauma, transcatheter or cardio-thoracic procedures. Since surgical repair is burdened by high morbidity and mortality, percutaneous closure is nowadays considered a valuable cost-effective therapeutic alternative. Due to unpredictability and complexity of local anatomy, no standardized technique and device are advised.

Transcatheter closure of fenestrated atrial septal aneurysm: feasibility and long-term results.

Aim: To report on the feasibility, efficacy and long-term outcome of transcatheter closure of fenestrated Atrial Septal Aneurysm (ASA).

Methods: Between April 2000 and May 2020, 568 patients with fenestrated ASA underwent transcatheter closure at two large-volume Pediatric Cardiology and GUCH Units (Naples and Massa, Italy). Procedural indications were cardiac volume overload in 223 patients (39%) or prophylaxis of paradoxical embolization in 345 patients (61%).

Trans-catheter atrial septal defect closure with the new GORE® Cardioform ASD occluder: First European experience.

Background: This perspective, observational study evaluated safety and efficacy of the GORE® Cardioform ASD Occluder (WL Gore & Associates, Flagstaff, AZ), compliant and potentially innovative prosthesis recently approved for closure of ostium secundum atrial septal defects (ASD).

Methods: Between January and June 2020, 43 unselected patients with -significant ASD were submitted to trans-catheter closure with GORE® Cardioform ASD Occluder at two high-volume Italian Pediatric Cardiology centers. Primary endpoints were procedural success and safety.

Repeat percutaneous recanalizations of a discontinuous pulmonary artery: A very "lucky" vessel.

Pulmonary artery (PA) discontinuity with ductal origin of a major pulmonary branch is a rare congenital anomaly that can be diagnosed as an isolated lesion or in association with major cardiac malformations. Arterial duct (AD) closure results in complete disappearance of the dependent PA, thus leading to the misdiagnosis of "congenital PA absence." Neonatal AD transcatheter recanalization is considered a cost-effective approach in view of later, lower-risk surgical recruitment of the disconnected PA.

Fast track extubation in paediatric cardiothoracic surgery in developing countries.

In recent years, low-dose, short-acting anesthetic agents, which replaced the former high-dose opioid regimens, offer a faster postoperative recovery and decrease the need for mechanical ventilatory support. In this study, the aim was to determine the success rate of fast-track approach in surgical procedures for congenital heart disease. There is some evidence, mostly from retrospective analyses, that fast tracking can be beneficial.

Three-dimensional sensitivity assessment of thoracic aortic aneurysm wall stress: a probabilistic finite-element study.

Objectives: In clinical practice, maximum diameter is used as a criterion to estimate aneurysm-rupture risk; however, it is only a general indicator and its value becomes difficult to estimate in the thoracic segment. Improved understanding of aortic aneurysm complexity and biomechanics is needed to achieve advancements in surgical repair techniques. The objective of this study was to determine the maximum wall stress by using imaging-derived data and a specific probabilistic design integrated into finite element (FE) analysis.

Epicardial radiofrequency ablation and aortic valve replacement through right mini-thoracotomy.

The Cobra Adhere XL (Estech, San Ramon, CA, USA) is a multiple-electrode, temperature-controlled, monopolar radiofrequency probe with a vacuum-assisted stabilization system. We describe a new technique for epicardial ablation of atrial fibrillation in patients undergoing aortic valve replacement through right mini-thoracotomy.

A new vacuum-assisted probe for minimally invasive radiofrequency ablation.

Purpose: The Cobra Adhere XL (Estech, San Ramon, CA) is a multiple-electrode, temperature-controlled, monopolar radiofrequency probe with a vacuum-assisted stabilization system. We evaluated this new technology for epicardial ablation of atrial fibrillation in mitral valve patients through a right mini-thoracotomy.

Description: Between June and August 2008, 12 patients underwent minimal invasive surgery for mitral disease and ablation for atrial fibrillation with the Cobra Adhere XL (Estech).