RESUMO
Patent ductus arteriosus (PDA) is common congenital heart disease which may require treatment as transcatheter percutaneous device closure (PDA device closure) or surgical ligation in symptomatic full-term patients. Surgical ligation is an invasive procedure and has more complications especially in the neonates. Problems in PDA device closure are difficult vascular access, manipulation of catheters and sheath, residual shunts, residual obstruction of major arteries etc and these complications increase in low birth weight babies, but it is a less invasive procedure and has fewer complications than surgery, so should be tried in low birth weight patients also. We are presenting a case of 3 kg infant with large PDA (8 mm) presented with failure to thrive, lower respiratory tract infection and heart failure. He successfully underwent PDA device closure with 10 × 12 mm Cocoon PDA device. To the best of our knowledge, this is the first case of the use of such a large device in a 3 kg child with good results.
RESUMO
The aim of this study was to determine the utility of the mitral leaflet separation index (MLSI), for determining the results of percutaneous mitral commissurotomy (PMC) in the acute setting, in the cardiac catheterization laboratory. Forty-eight patients undergoing PMC were studied and 96 examinations were performed. The overall correlation with the MLSI was 0.95. The mitral valve area (MVA) was determined by 2D echo planimetry (MVAPLM ) and 0.83 of the MVA was derived using Gorlin's formula (MVAGOR ). The MLSI was significantly different in patients with severe mitral stenosis (MS) (MVAPLM <1 cm(2) , MLSI of 0.70 mm) compared with those with mild MS (MVAPLM >1.5 cm(2) , MLSI of 0.92 mm). The MLSI is a simple and effective method for assessment of the MVA. An MLSI >0.92, immediately after PMC, had an excellent sensitivity and specificity for the prediction of an effective MVA of >1.5 cm(2) .
