Transcatheter closure of patent ductus arteriosus using ADO device: retrospective study of 149 patients

Patent ductus arteriosus [PDA] is a common form of congenital heart disease and forms about 5-10% of congenital heart diseases. Surgical closure is safe and effective; however, certain patients may experience some morbidity. Recently, transcatheter closure of PDA using the Amplatzer duct occluder has been shown to be safe and efficacious. To evaluate whether transcatheter closure with this device offers an alternative to surgical closure of PDA. Between July 2006 to July 2008, 149 patients [98 females and 51 males] with PDA underwent cardiac catheterization in an attempt to close their PDA by transcatheter approach using Amplatzer duct occluder device. The patient's age ranged from 4 months to 45 years [median 5 years]. Successful PDA closure was achieved in 136 patients [91.2%] with 100% complete closure rate within 24 hours after the procedure. Thirteen patients [8.7%] had unsuccessful attempts, 11 [7.3%] of them had failure of deployment of the device, while embolization of the device occurred in two of the patients [1.3%]. Amplatzer duct occluder device is safe and effective for closure of different types and sizes of PDA with low rate of complication

Electro cardiographic features of patients with tetralogy of Fallot

For many decades, the ECG was the workhorse of non-invasive cardiac test and today although other techniques provide more details about the structural anomalies in congenital heart diseases, ECG is likely to be part of clinical evaluation of patients with such diseases because it is inexpensive, easy to perform and in certain situations may be both sensitive and specific. This study carried out to identify the pattern of ECG study in patients with TOF. This is a retrospective study of 200 patients with TOF, referred to Ibn Al-Bitar cardiac center from April 1993 to May 1999. The diagnosis of TOF established by echocardiographic, catheterization and angiographic study. For each patient, the ECG tracing had been analyzed for rhythm, p-wave, P-R interval, QRS axis, duration and T-wave in VI and any chamber enlargement. The ECG analysis revealed that all patients had sinus rhythm, normal P-R interval and normal p-wave duration and amplitude, and normal QRS duration. All studied patients had one criteria of RVH and 95% of them had two or more of such criteria. We found that in the absence of RVH criteria, the diagnosis of TOF is unlikely and the present of northwest axis should indicate canal type VSD

Clsnieas features of Iraqi patients with tetralogy of fallot

Tetralogy of Fallot is the most common cyanotic congenital heart disease which represents about 8-10% of all congenital heart diseases. It is characterized by four morphological features, large malalignment ventricular septal defect, Pulmonary stenosis, Overriding of aorta, and Right ventricular hypertrophy. The infant with TOP does 'well for the first few months of life with minimal or no cyanosis. The cyanosis begins to increase with secondary slow increase in polycythemia as well. Hypercyanotic spells are the most common complicating features of TOP This is a retrospective study of 200 patients with Tetralogy of Fallot [TOF] referred to Ibn Al-Bitar Center for Cardiac surgery from April 1993 to May 1999. The diagnosis was established by echocardiography, catheterization and angiographic study. For each patient, clinical history, physical examination, O2 saturation and hematocrit level had been reviewed. The patients' ages ranged from 11 months to 37years. The weight of 42 patients [22%] and the height of 38 patients [20.5%] were below 3[rd] centile. There were 60 patients [30%] were polycythemic [hematocrit above 65%]. Only 7 patients [14%] had low cyanosis [pink TOF] and one third of the patients had history of hyper cyanotic spells. The CNS complications were the most common complications. The study revealed that most of our patients had been delayed in their presentation for proper medical and surgical management. The study showed that most of TOF patients had normal growth pattern and the most important factor affecting the growth was the level of oxygen desatitration and we found high incidence of both infective endocarditis and CNS complications

Catheterization And Angiographic variations in iraqi patients with Tetralogy of fallot

Tetralogy of Fallot [TOF] is the most common form of cyanotic congenital heart disease and the catheterization and angiography still considered [in most centers] as essential preoperative diagnostic step.This retrospective aimed at evaluating the catheterization and angiographic finding in our Iraqi patients with diagnosis of TOF The catheterization and angiographic study of 200 patients with TOF referred to Ibn Al-Bitar Cardiac Center had been reviewed.There were 126 males and 74 females and their ages ranged from 11 months to 37 years. The catheterization data showed that 88% of the patients had equal LV and RV pressure. The evaluation of pulmonary artery pressure showed that all patients had normal pressure. The review of angiographic studies revealed that the perimembraneous VSDs were the most common type [91% of the patients]. 13 patients [6.5%] had coronary anomalies,and the patent ductus arteriosus is the most common associated anomalies.The frequency of doubly committed VSD and single coronary artery were higher than other studies and we showed there was no indication to measure the pulmonary artery pressure during catheterization.