RESUMO
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 Assuntos
Cateterismo Cardíaco/instrumentação
, Comunicação Interatrial/terapia
, Adolescente
, Adulto
, Cateterismo Cardíaco/efeitos adversos
, Procedimentos Cirúrgicos Cardíacos
, Criança
, Pré-Escolar
, Remoção de Dispositivo
, Ecocardiografia Doppler em Cores
, Eletrocardiografia
, Desenho de Equipamento
, Falha de Equipamento
, Feminino
, Seguimentos
, Migração de Corpo Estranho/etiologia
, Migração de Corpo Estranho/cirurgia
, Comunicação Interatrial/diagnóstico por imagem
, Comunicação Interatrial/fisiopatologia
, Hemodinâmica
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Estudos Retrospectivos
, Fatores de Tempo
, Resultado do Tratamento
, Adulto Jovem
RESUMO
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 Assuntos
Cardiomiopatia Dilatada/patologia
, Cardiomiopatia Dilatada/fisiopatologia
, Eletrocardiografia
, Biópsia
, Pré-Escolar
, Feminino
, Humanos
, Lactente
, Linfócitos/patologia
, Masculino
, Miocardite/patologia
, Miocárdio/patologia
RESUMO
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.