ABSTRACT
OBJECTIVES: The objective of this study was to demonstrate the safety and feasibility of using the new Cardia Ultrasept II™ device with interposed Goretex patch referring to the perforation of polyvinyl alcohol membrane. BACKGROUND: Great advances have been made in the development of devices for closure of atrial septal defect. The Cardia Ultrasept II™ with interposed Goretex patch is the modified last generation of Cardia devices, having the advantage of a super-low profile within the atria and an integral locking delivery-retrieval mechanism that ensures safe deployment. In addition, with the interposition of the Goretex, it has been possible to abolish perforation of Ivalon's membrane as a complication.Methods and resultsPatients with ostium secundum atrial septal defect with surrounding rims with a minimum length of 5 mm and who underwent atrial septal defect closure with the new Ultrasept II™ with Goretex patch were included from two paediatric cardiac centres. Primary end point was to determine perforation of the Goretex membrane at follow-up; secondary end point included right ventricular diastolic diameter. In total, 30 patients underwent atrial septal defect closure at a median age of 6 (1-29) years. At follow-up for 6 (range, 1-15) months, freedom from perforations was 100%. A continuous decrease in right ventricular diastolic diameter was found with an initial median of 30 (25-49) mm and after catheterisation of 27.5 (18-33) mm, p=0.01, and Z-score of 2.6 (1.7-3.6) versus 1.9 (1-2.9) after procedure, p=0.01. CONCLUSIONS: The new modified generation of the Ultrasept II™ device with interposed Goretex patch is a good alternative to achieve atrial septal defect closure safely and feasibly with no membrane perforation at follow-up.
Subject(s)
Heart Septal Defects, Atrial/surgery , Polytetrafluoroethylene , Polyvinyls , Postoperative Complications/epidemiology , Septal Occluder Device , Adolescent , Adult , Child , Child, Preschool , Echocardiography, Doppler, Color , Echocardiography, Transesophageal , Female , Follow-Up Studies , Heart Septal Defects, Atrial/diagnosis , Heart Septal Defects, Atrial/epidemiology , Humans , Incidence , Infant , Male , Mexico/epidemiology , Prosthesis Design , Prosthesis Failure , Retrospective Studies , Time Factors , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Living at high altitude increases the prevalence of patent ductus arteriosus (PDA) and may affect its morphology. AIM: To compare the anatomical and haemodynamic features of isolated PDA in patients living at low and high altitudes (1,500-4,200 metres above sea level - m.a.s.l.). METHODS: We studied retrospectively data from 1,404 consecutive patients - 708 living in lowland areas (group L) and 696 in highland areas (group H), in whom transcatheter closure of PDA was attempted. The mean age of the patients in group L was 9.9 ± 13.5 years and in group H it was 8.2 ± 19.7 years. RESULTS: The diameter of PDA in group L was 2.3 ± 1.3 mm and 4.1 ± 1.2 mm in group H (p < 0.001), while the mean pulmonary artery pressure was 17.9 ± 5.9 mm Hg and 25.5 ± 12.3 mm Hg, respectively (p < 0.001). Angiographic PDA type A was more frequently observed in highland patients. In groups L and H, self expanding nitinol occluders (mostly Amplatzer devices) were used in 25.7% vs 92.2% of patients (p < 0.001), whereas coils were used in 69.2% vs 7.5% (p < 0.001), respectively. Double umbrella systems were used in 4.8% of patients in group L. CONCLUSIONS: In catheterised patients with PDA living at high altitude, larger ductal diameter, anatomic type A and higher pulmonary artery pressure were more frequently observed. This finding has important implications for future strategy regarding transcatheter closure in populations living at different altitudes. Kardiol Pol 2011; 69, 5: 431-436.
Subject(s)
Altitude , Cardiac Catheterization , Ductus Arteriosus, Patent/pathology , Ductus Arteriosus, Patent/physiopathology , Adolescent , Adult , Child , Child, Preschool , Ductus Arteriosus, Patent/surgery , Female , Hemodynamics , Humans , Infant , Infant, Newborn , Male , Retrospective StudiesABSTRACT
Presentamos el caso de una mujer de 47 años de edad, portadora de una comunicación interatrial, con historia de palpitaciones frecuentes. Por este motivo, se realizó estudio electrofisiológico diagnóstico, el cual reveló una taquicardia por reentrada intranodal variedad común. Se decidió realizar ablación con radiofrecuencia transcatéter de la vía lenta, la cual se llevó a cabo en forma exitosa, eliminándose la taquicardia. Durante la misma sesión, se le colocó un dispositivo Amplatzer para cerrar la comunicación interatrial. Los dos procedimientos no tuvieron complicaciones y fueron exitosos. Lo que hace este caso inusual es que ambos procedimientos se realizaron durante la misma sesión.
