RESUMO
A 7-month-old boy was admitted for the device closure of symptomatic patent ductus arteriosus (PDA) with moderate pulmonary hypertension. The PDA measured 4.2 mm with adequate ampulla. It was closed with an 8-6 mm Heart R device from pulmonary artery (PA) end. Post extubation, the device embolized to proximal descending thoracic aorta just distal to PDA ampulla. While attempting to snare from the venous side, the device self-repositioned to PDA. It was stable thereafter and patient was discharged after 2 days. We report a complication, which got self-corrected.
Assuntos
Permeabilidade do Canal Arterial/terapia , Falha de Prótese , Radiografia Intervencionista/métodos , Remissão Espontânea , Dispositivo para Oclusão Septal/efeitos adversos , Cateterismo Cardíaco/métodos , Permeabilidade do Canal Arterial/diagnóstico por imagem , Seguimentos , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/terapia , Lactente , Masculino , Desenho de Prótese , Índice de Gravidade de DoençaRESUMO
An eight-year-old boy was evaluated for unexplained hemoptysis and cyanosis. A contrast echocardiogram was suggestive of pulmonary arteriovenous fistula. Further evaluation revealed persistent ductus venosus (PDV) and aortopulmonary collaterals. Both the PDV and aortopulmonary collaterals were closed percutaneously. PDV is amenable for device closure after detailed anatomical evaluation. Prior to closure, it is important to ensure adequate portal vein arborization into the liver and normal portal pressure after test balloon occlusion.
RESUMO
Long-term survival is rare in patients not undergoing surgery after post-myocardial infarction ventricular septal rupture. We report our experience of seven patients out of 27, who did not undergo surgery and were followed up for a mean period of 2.8 years. They were evaluated after a mean period of 2.2 months after infarction in our centre. The septal defects measured 9.8 mms on average and the mean left-to-right shunt ratio was 1.98: 1. The mean pulmonary artery, right atrial and left ventricular end diastolic pressures were 28.3 +/- 10.6, 4 +/- 3 and 15.8 +/- 4.8 mm Hg, respectively. Only three out of seven patients had LV aneurysm and all patients had single-vessel disease. Smaller defect size, minimal left-to-right shunt and preserved right ventricular function may be the factors responsible for long-term survival.
