Relief of factitious coarctation following occlusion of large patent ductus arteriosus with Gianturco-Grifka vascular occluder.

We report an infant with a large patent ductus arteriosus (PDA) and a hypoplastic aortic isthmus presenting with factitious coarctation due to high ductal flow. Following transcatheter occlusion of the PDA with a Gianturco-Grifka vascular occluder, the aortic gradient resolved, thereby eliminating the need for surgery on the isthmus.

Displacement of preexisting thrombus by umbilical vein catheterization.

Balloon atrial septostomy is recommended as a standard palliative procedure in neonates with congenital heart defects who are dependent on intracardiac shunting. We describe an unusual and unreported complication associated with "bedside" balloon atrial septostomy. The umbilical venous catheterization resulted in displacement of a thrombus from the ductus venosus or the hepatic vein. We recommend careful two-dimensional echocardiographic monitoring during such procedures.

Accelerated renovascular hypertension following intra-aortic balloon counter-pulsation.

A 62-year-old man developed high serum renin arterial hypertension following thoraco-abdominal dissection which resulted from insertion of an intra-aortic balloon pump (IABP). Nephrectomy resulted in cure of medically unmanageable hypertension.