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1.
Indian Heart J ; 2005 Nov-Dec; 57(6): 704-8
Artículo en Inglés | IMSEAR | ID: sea-4677

RESUMEN

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. Two of 12 patients underwent patent ductus arteriosus stenting to facilitate preparation of left ventricle for transposition with intact septum. We report the case selection, technique, immediate and short-term follow-up outcome in the remaining 10 patients [median age: 16 days (range 4-290 days): weight 2.7 kg (range 2-6 kg)] with reduced pulmonary blood flow who underwent stenting of patent ductus arteriosus as an alternative to conventional surgical aortopulmonary shunts. Five of the 6 newborns were prostaglandin-dependent and 4 had previously undergone guidewire perforation of the pulmonary valve (n=2) or balloon dilation (n=2). Successful stent implantation was accomplished in all with no major patient-related complication (median fluoroscopy time: 18.6 min; range: 7.7-72 min). The intensive care unit and hospital stays were prolonged in 3 patients because of sepsis (n=2) and pulmonary over-circulation with sepsis (n=1). On follow-up (median 5.5 months; range 1-19 months) all implanted stents were patent. One patient underwent re-dilation of the implanted stent for declining saturations. CONCLUSIONS: The immediate and short-term follow-up results of stenting of the patent arterial duct, as an alternative to the surgical aortopulmonary shunt in carefully selected newborns and infants is encouraging.


Asunto(s)
Velocidad del Flujo Sanguíneo , Preescolar , Estudios de Cohortes , Conducto Arterioso Permeable/diagnóstico , Femenino , Estudios de Seguimiento , Cateterismo Cardíaco/instrumentación , Cardiopatías Congénitas/diagnóstico , Humanos , Lactante , Recién Nacido , Masculino , Circulación Pulmonar/fisiología , Estudios Retrospectivos , Medición de Riesgo , Stents , Resultado del Tratamiento
2.
Indian Heart J ; 2002 May-Jun; 54(3): 309-11
Artículo en Inglés | IMSEAR | ID: sea-5729

RESUMEN

Strokes following cardiac surgery occur in about 5% of patients. Intra-arterial thrombolysis is a good option in such a setting where intravenous thrombolysis is contraindicated, and when in-hospital strokes are detected well within the window for treatment and the chances of complete reperfusion are maximum. On postoperative day 4 after atrial septal defect correction, a 34-year-old woman with paroxysmal atrial fibrillation developed left middle cerebral artery stroke causing severe neurological deficits. Intra-arterial thrombolysis with urokinase led to remarkable recovery.


Asunto(s)
Adulto , Angiografía Cerebral , Femenino , Fibrinolíticos/uso terapéutico , Defectos del Tabique Interatrial/cirugía , Humanos , Complicaciones Posoperatorias/tratamiento farmacológico , Accidente Cerebrovascular/tratamiento farmacológico , Terapia Trombolítica/métodos , Resultado del Tratamiento , Activador de Plasminógeno de Tipo Uroquinasa/uso terapéutico
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