Transcatheter patent ductus arteriosus closure with echocardiographic guidance: can radiation exposure be reduced?

Objectives: The radiation dose from interventional cardiac catheterization is particularly relevant when treating children because of their greater radiosensitivity compared to adults. The transcatheter closure of patent ductus arteriosus (PDA), as well as other more complex pediatric interventions, have raised concerns regarding radiation exposure, particularly relevant when treating children. The purpose of this study is to show how to perform the transcatheter closure of PDA in children while giving less ionized radiation and to prove that the amount of radiation and contrast material can be reduced.

Treatment of depression in an adolescent with cardiomyopathy and arrhythmia.

Patients with cardiomyopathy have a higher incidence of mood and anxiety disorders, resulting in greater probability for hospitalisation and increased risk for arrhythmia and death. We report a case of a 16-year-old boy with Danon disease, Wolff-Parkinson-White syndrome, and hypertrophic cardiomyopathy, who later developed depression and significant weight loss. The patient was successfully treated for his anxiety and depression with mirtazapine without any adverse cardiac effects.

Radiofrequency resistant pulmonary atresia with intact septum: the use of Conquest Pro 12 coronary guidewire.

Pulmonary valve atresia with intact ventricular septum, which is a rare congenital heart defect, can be treated either surgically or via transcatheter. Nowadays, in many centers, transcatheter treatment options have become the standard of care for pulmonary atresia, with an intact ventricular septum, for eligible patients. More commonly, radiofrequency wires are used for the perforation of the atretic valve, and subsequently, balloon dilatation is performed.

Evaluation rhythm problems in unexplained syncope etiology with implantable loop recorder.

Background: Syncope is a frequent complaint in children and adolescents and may be a significant sign of serious pathology. Although patient history, family history, and physical examination are sufficient to reach a diagnosis in most cases of syncope, the cause of syncope still cannot be determined after initial investigation in one-third to half of all patients. The aim of this study was to evaluate the diagnostic yield of implantable loop recorder (ILR) in children with unexplained syncope.

Possible link between right ventricular coronary sinusoids and noncompaction sinusoids in pulmonary atresia with intact ventricular septum patients that later develop left ventricular noncompaction.

Patients who have pulmonary atresia with intact ventricular septum have been shown to have a number of various myocardium anomalies like ischemia, fibrosis, infarction, rupture, disarray, spongious myocardium and ventricular endocardial fibroelastosis. Multiple connections have been found between right ventricular myocardial sinusoids and small branches of intramural coronary arteries. Noncompation of ventricular myocardium has been shown to be the result of myocardial ischemia or excessive pressure preventing the reduction of embryonic sinusoids.

Efficacy of very low-dose prostaglandin E1 in duct-dependent congenital heart disease.

Aim: The present study aims to define the lowest effective prostaglandin E1 dose in patients with inadequacy of pulmonary blood flow and/or intracardiac blood mixing and those with inadequate systemic blood flow.

Methods: Patients with inadequacy of both pulmonary blood flow and/or blood mixing (Group 1) and those with inadequate systemic blood flow (Group 2) were retrospectively evaluated in two separate groups with regard to the prostaglandin E1 starting dose given in the referring facility, the lowest and the highest dose administered in our centre, treatment duration, adverse effects, and administered treatment.

Results: No difference between the groups could be detected with respect to sex or birth weight (p=0.

The significance of transesophageal echocardiography in assessing congenital heart disease: our experience.

Background: The rapid expansion of pediatric cardiovascular surgery, along with the increase in the number of centers and operations, has also increased the use of intraoperative transesophageal echocardiography (TEE). Preoperative TEE allows for the confirmation of diagnoses established by transthoracic echocardiography and angiography, and also identifies possible additional pathologic conditions. TEE is also used to follow up on surgical repairs, determine the need for reintervention, and evaluate myocardial performance and the need for inotropic treatment.

Prolonged mechanical ventilation associated with hypothyroidism after paediatric cardiac surgery.

Hypothyroidism in patients undergoing congenital heart defect surgery is known to be possible. This generally temporary condition can progress as it involves yet other factors, increasing the patients' time to heal. The case presented here is that of a 5-month-old girl who was dependent in the long term on mechanical ventilation following cardiac surgery.

Evaluation of non-surgical causes of cardiac tamponade in children at a cardiac surgery center.

Background: The aim of this study was to examine the causes of cardiac tamponade in children undergoing percutaneous pericardiocentesis.

Method: Patients who presented with other complaints but were diagnosed with cardiac tamponade based on clinical and echocardiographic findings between January 2010 and January 2013 were retrospectively investigated. Electrocardiography, telecardiography and transthoracic echocardiography were performed.

Percutaneous pulmonary valve implantation using Edwards SAPIEN transcatheter heart valve in different types of conduits: initial results of a single center experience.

Background: Percutaneous pulmonary valve implantation is frequently used as a less invasive method in patients with conduit dysfunction. The common valve type cannot be used in conduits with a diameter larger than 22 mm. There has been limited experience concerning the used of the SAPIEN Transcatheter Heart Valve, produced for use in conduits with a large diameter.

Transcatheter management of neonates with pulmonary atresia with intact ventricular septum: a single center experience from Turkey.

Pulmonary atresia with intact ventricular septum (PAIVS) is characterized by a broad spectrum of heterogeneous morphologies. Perforation of the atretic valve, balloon dilatation, and stenting of the patent ductus arteriosus are the percutaneous techniques that are used with increasing frequency in our clinic as well. They have some advantages over surgery, including short hospital stay and short intensive care unit stay.

Long-term follow-up results of lung perfusion studies after transcatheter closure of patent ductus arteriosus.

Objective: This study presents the long-term follow-up of patients who developed left lung perfusion (LLP) abnormalities following patent ductus arteriosus (PDA) closure with various device types.

Design: The study includes 23 adult and pediatric patients who had undergone transcatheter PDA closure and were shown to have decreased LLP (<40%) by the first scintigraphy performed within the average follow-up period of 14.0 ± 8.

Percutaneous embolization of a caroticoazygous fistula with the Amplatzer Vascular Plug 1.

We present the case of a five-year-old boy with a caroticoazygous fistula, which is an extremely rare congenital vascular malformation. The patient also had patent ductus arteriosus, a common cause of continuous murmur. The murmur continued despite successful coil embolization of the ductus.

Levoatriocardinal vein with normal intracardiac anatomy and pulmonary venous return.

Levoatriocardinal vein (LACV) is characterized by an abnormal connection between pulmonary and systemic venous return. This extremely rare cardiac malformation is usually associated with left-sided obstructive lesions including mitral atresia, hypoplastic left-heart syndrome, and abnormal pulmonary venous connection. Patients may have low systemic cardiac output and pulmonary venous obstruction symptoms.

Multiple transcatheter interventions in the same session in congenital cardiopathies.

Background: To investigate the methods of percutaneous transcatheter interventions for combined congenital heart disease and to evaluate its efficacy in children.

Materials And Methods: Thirty cases (ages 3 days-13.5 years, body weight 3-35 kg) that underwent two multiple transcatheter interventions for combined or solitary congenital heart disease were retrospectively analyzed and presented.

Double outlet right ventricle and aortopulmonary window in a patient with Cornelia de Lange syndrome: a novel association.

We report a patient with Cornelia de Lange syndrome with congenital cardiac malformation; double outlet right ventricle and aortopulmonary window. This is the first report describing this combination of findings for Cornelia de Lange syndrome. Behalf of this report, the pathogenesis of congenital heart disease in Cornelia de Lange syndrome was also revisited.

Stent implantation into the patent ductus arteriosus in cyanotic congenital heart disease with duct-dependent or diminished pulmonary circulation.

We assessed the efficacy and safety of stent implantation into the ductus arteriosus in infants with cyanotic heart disease. Ten patients with duct-dependent or diminished pulmonary circulation underwent cardiac catheterization with the aim of stent implantation. Coronary stents of 3.

Successful transcatheter balloon dilatation of coarctation of aorta and coil occlusion of patent ductus arteriosus in a single catheterization procedure.

Simultaneous transcatheter coil occlusion of patent ductus arteriosus and balloon angioplasty of coarctation of aorta is avoided since intimal tearing after angioplasty is believed to increase the risk for dissection of the aorta during catheter manipulation. We report a 14-month-old boy, with weight of 7.6 kg, with aortic coarctation and patent ductus arteriosus with a large left-to-right shunt who underwent successful simultaneous balloon angioplasty of native coarctation and coil embolization of the patent ductus arteriosus.

Echocardiographic study on the origin of the innocent flow murmurs.

To investigate the origin of the pulmonary systolic ejection innocent flow murmur (IFM), echocardiographic examinations were undertaken in 30 children with IFM and in a control group consisting of 28 healthy children without murmur. Compared to the controls, the diameters of the left ventricular outflow tract (LVOT) and aortic valve annulus and aortic valve area tended to be smaller, whereas stroke volume (SV) and cardiac output were slightly greater in children with IFM, but they were not statistically significant. Mean fractional shortening was significantly higher in children with IFM.

Effect of partial oxygen supply on mitochondrial electron transport system during complete cardiac ischemia.

During complete ischemia we assessed myocardial utilization of the small amount of oxygen available. We also determined whether blood cardioplegia has any advantage over crystalloid cardioplegia in this setting. Patients with preserved left ventricular myocardial function and without anterolateral wall infarct or aneurysm were included to the study.