ABSTRACT
BACKGROUND: There is limited published outcome data on the STARFlex device for transcatheter closure of atrial septal defects (ASD). AIM: To contribute to the long term outcomes of ASD device closure with the STARFlex device. METHODS: Results of a prospective FDA approved clinical trial (1999-2001) from a single institution of the STARFlex device for simple ASD was reviewed. The inclusion criteria included age >or=2 years, isolated secundum ASD, evidence of right ventricular volume overload, and maximum stretched diameter <22 mm. A retrospective review of the original study data with most recent follow-up was performed. Clinical success in the trial was defined as complete closure or residual leak Subject(s)
Cardiac Catheterization/instrumentation
, Heart Septal Defects, Atrial/therapy
, Adolescent
, Adult
, Cardiac Catheterization/adverse effects
, Cardiac Surgical Procedures
, Child
, Child, Preschool
, Device Removal
, Echocardiography, Doppler, Color
, Electrocardiography
, Equipment Design
, Equipment Failure
, Female
, Follow-Up Studies
, Foreign-Body Migration/etiology
, Foreign-Body Migration/surgery
, Heart Septal Defects, Atrial/diagnostic imaging
, Heart Septal Defects, Atrial/physiopathology
, Hemodynamics
, Humans
, Male
, Middle Aged
, Retrospective Studies
, Time Factors
, Treatment Outcome
, Young Adult
ABSTRACT
OBJECTIVE: To determine whether presenting electrocardiography is related to histologic findings and clinical outcomes in children with dilated cardiomyopathy. BACKGROUND: Lymphocytic myocarditis is an important cause of childhood dilated cardiomyopathy, the outcome of which is unclear. The results of non-invasive investigations are often used to infer the presence or absence of lymphocytic myocarditis. METHODS: Thirty-four children, presenting acutely with dilated cardiomyopathy, underwent both early electrocardiography and endomyocardial biopsy. The parameters examined included heart rate, PR, QRS, and corrected QT intervals, R-wave voltages in Leads V(1) and V(6), S-wave voltages in Leads V(1) and V(6), and sum of SV(1) and RV(6). We expressed measurements as Z scores, based on published normal values for age and gender. RESULTS: A total of 15 patients had lymphocytic myocarditis on endomyocardial biopsy (Group I), and 19 had non-specific histologic findings (Group II). We did not distinguish the 2 groups by age, time to endomyocardial biopsy, or duration of follow-up. Group I patients had significantly smaller R-wave Z scores in Leads V(1) and V(6), and combined S in V(1) and R in V(6) Z scores (p < 0.02 for each). The positive and negative predictive values of an R-wave amplitude in V(6) < 5th percentile were 75% and 65%, respectively, for the diagnosis of lymphocytic myocarditis. An R-wave amplitude in V(6) > 95th percentile had a positive and negative predictive value of 80% and 63%, respectively, for the diagnosis of idiopathic dilated cardiomyopathy. Survival and freedom from late cardiac dysfunction were more common among Group I patients compared with Group II (p Subject(s)
Cardiomyopathy, Dilated/pathology
, Cardiomyopathy, Dilated/physiopathology
, Electrocardiography
, Biopsy
, Child, Preschool
, Female
, Humans
, Infant
, Lymphocytes/pathology
, Male
, Myocarditis/pathology
, Myocardium/pathology
ABSTRACT
Persistent cyanosis after successful balloon valvuloplasty for neonatal critical pulmonary valve stenosis is often related to poor right ventricular compliance and right-to-left shunting at the atrial level. A successful catheter closure of an atrial septal defect was performed with a dramatic increase in systemic oxygen saturation alleviating the need for a surgical systemic-to-pulmonary artery shunt.