The Experts below are selected from a list of 210 Experts worldwide ranked by ideXlab platform
Chunleung Lau - One of the best experts on this subject based on the ideXlab platform.
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successful percutaneous retrieval of a dislodged left atrial appendage occlusion device with double transseptal sheaths and biopsy Bioptome
Catheterization and Cardiovascular Interventions, 2015Co-Authors: Ngaiyin Chan, Chichung Choy, Chunleung LauAbstract:A 64-year-old woman underwent left atrial appendage occlusion with an Amplatzer Cardiac Plug device. Displacement of the device was detected on day 1 with transesophageal echocardiographic checking. The device became dislodged and flitted in the left atrium after unsuccessful retrieval with a snare and 12 Fr steerable transseptal sheath. A double transseptal sheath technique was then attempted. The flitting device was stabilized by one 12 Fr steerable transseptal sheath and successfully retrieved with a biopsy Bioptome through another similar transseptal sheath. The patient suffered from no long-term sequelae.
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successful percutaneous retrieval of a dislodged left atrial appendage occlusion device with double transseptal sheaths and biopsy Bioptome
Catheterization and Cardiovascular Interventions, 2015Co-Authors: Ngaiyin Chan, Chichung Choy, Chunleung LauAbstract:A 64-year-old woman underwent left atrial appendage occlusion with an Amplatzer Cardiac Plug device. Displacement of the device was detected on day 1 with transesophageal echocardiographic checking. The device became dislodged and flitted in the left atrium after unsuccessful retrieval with a snare and 12 Fr steerable transseptal sheath. A double transseptal sheath technique was then attempted. The flitting device was stabilized by one 12 Fr steerable transseptal sheath and successfully retrieved with a biopsy Bioptome through another similar transseptal sheath. The patient suffered from no long-term sequelae. © 2014 Wiley Periodicals, Inc.
Raman Krishna Kumar - One of the best experts on this subject based on the ideXlab platform.
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transcatheter occlusion of patent ductus arteriosus in pre term infants
Jacc-cardiovascular Interventions, 2010Co-Authors: Edwin Francis, Anil Kumar Singhi, Srinivas Lakshmivenkateshaiah, Raman Krishna KumarAbstract:Objectives The aim of this study was to describe our institutional experience with transcatheter coil occlusion of patent ductus arteriosus (PDA) in symptomatic low birth weight pre-term infants. Background Transcatheter treatment of PDA in very small infants ( Methods Coil occlusion was offered as an option to selected infants with symptomatic PDA. Case selection for the transcatheter procedure was determined by the patient's weight, PDA size, size of ampulla, and the anticipated coil mass required for complete closure (determined through echocardiography). The PDA occlusion was achieved with coils delivered with assistance of a 3-F Bioptome. Arterial access and catheter manipulation within the cardiac chambers were avoided whenever feasible. Results Eight pre-term infants underwent coil occlusion. Gestational age ranged from 27 to 32 weeks (28.7 ± 1.9 weeks). The median birth weight was 1,040 g (range 700 to 1,700 g), and the median weight at the time of procedure was 1,100 g (range 930 to 1,800 g). Three patients were receiving mechanical ventilation before intervention. Duct sizes ranged between 2 and 3.5 mm. Complete occlusion of the duct was instantly achieved in 7 patients, and 1 patient had a small residual flow for 24 h. There were no major procedure or access-related complications; 4 patients were discharged within 72 h; 1 patient was discharged on Day 10. Three patients required prolonged ventilation (34 and 150 days) due to pulmonary pathology. Conclusions It is technically feasible to undertake transcatheter coil closure of PDA in carefully selected symptomatic pre-term infants, and it is a safe alternative to surgical ligation.
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Bioptome assisted coil closure of large pulmonary arteriovenous malformations
Journal of Vascular and Interventional Radiology, 2006Co-Authors: Bhava R J Kannan, Sivadasan Radha Anil, Kotaram Krishnadas Haridas, Raman Krishna KumarAbstract:Large pulmonary arteriovenous malformations (AVMs) with feeding vessels larger than 5 mm cause significant right-to-left shunt resulting in cyanosis and need to be occluded as soon as they are diagnosed. Occlusion of such AVMs by simultaneous delivery of multiple coils was attempted in five patients and was successful in completely occluding the AVM in four of them. One patient had transient chest pain during the procedure, presumably as a result of coronary air embolism. A Bioptome was used to hold the multiple coils together for optimal deployment and controlled release of the coils.
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Bioptome assisted coil occlusion of moderate large patent ductus arteriosus in infants and small children
Catheterization and Cardiovascular Interventions, 2004Co-Authors: Raman Krishna Kumar, Sivadasan Radha Anil, Bhava R J Kannan, Ancil Philip, Kothandam SivakumarAbstract:Coil occlusion of patent ductus arteriosus (PDA), although inexpensive, is technically challenging for the moderate-large ducts in small children. Bioptome assistance allows better control and precision. We describe case selection strategies, technique, immediate and short-term results of Bioptome-assisted closure of moderate-large (>/= 3 mm) PDA in 86 infants and children 6 mm (> 4 mm for children under 5 kg) and/or shallow ampullae (by echocardiography) underwent operation (n = 41). Specific technical modifications included use of long sheaths (5.5-8 Fr) for duct delineation and coil delivery, cutting of coils turns (51 patients) to accommodate the coils in the ampulla, and simultaneous delivery of multiple coils (n = 43). As far as possible, coils were deployed entirely in the ampulla. Median fluoroscopy time was 7.3 min (1.2-42 min). Successful deployment was feasible in all (final pulmonary artery mean pressures, 20 +/- 4.6 mm Hg). Coils embolized in 14 (16%) patients (all retrieved). Complete occlusion occurred immediately in 63 patients (73%) and in 77 patients (89%) at 24 hr. Three patients had new gradients in the left pulmonary artery. Follow-up (62 patients; median duration, 13 months) revealed small residual Doppler flows in 11 patients (18%) at the most recent visit. Bioptome-assisted coil occlusion of moderate-large PDA in selected infants and small children is feasible with encouraging results.
Sivadasan Radha Anil - One of the best experts on this subject based on the ideXlab platform.
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Bioptome assisted coil closure of large pulmonary arteriovenous malformations
Journal of Vascular and Interventional Radiology, 2006Co-Authors: Bhava R J Kannan, Sivadasan Radha Anil, Kotaram Krishnadas Haridas, Raman Krishna KumarAbstract:Large pulmonary arteriovenous malformations (AVMs) with feeding vessels larger than 5 mm cause significant right-to-left shunt resulting in cyanosis and need to be occluded as soon as they are diagnosed. Occlusion of such AVMs by simultaneous delivery of multiple coils was attempted in five patients and was successful in completely occluding the AVM in four of them. One patient had transient chest pain during the procedure, presumably as a result of coronary air embolism. A Bioptome was used to hold the multiple coils together for optimal deployment and controlled release of the coils.
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Bioptome assisted coil occlusion of moderate large patent ductus arteriosus in infants and small children
Catheterization and Cardiovascular Interventions, 2004Co-Authors: Raman Krishna Kumar, Sivadasan Radha Anil, Bhava R J Kannan, Ancil Philip, Kothandam SivakumarAbstract:Coil occlusion of patent ductus arteriosus (PDA), although inexpensive, is technically challenging for the moderate-large ducts in small children. Bioptome assistance allows better control and precision. We describe case selection strategies, technique, immediate and short-term results of Bioptome-assisted closure of moderate-large (>/= 3 mm) PDA in 86 infants and children 6 mm (> 4 mm for children under 5 kg) and/or shallow ampullae (by echocardiography) underwent operation (n = 41). Specific technical modifications included use of long sheaths (5.5-8 Fr) for duct delineation and coil delivery, cutting of coils turns (51 patients) to accommodate the coils in the ampulla, and simultaneous delivery of multiple coils (n = 43). As far as possible, coils were deployed entirely in the ampulla. Median fluoroscopy time was 7.3 min (1.2-42 min). Successful deployment was feasible in all (final pulmonary artery mean pressures, 20 +/- 4.6 mm Hg). Coils embolized in 14 (16%) patients (all retrieved). Complete occlusion occurred immediately in 63 patients (73%) and in 77 patients (89%) at 24 hr. Three patients had new gradients in the left pulmonary artery. Follow-up (62 patients; median duration, 13 months) revealed small residual Doppler flows in 11 patients (18%) at the most recent visit. Bioptome-assisted coil occlusion of moderate-large PDA in selected infants and small children is feasible with encouraging results.
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Bioptome assisted coil occlusion of coronary artery fistula
Indian heart journal, 2002Co-Authors: Sivadasan Radha Anil, Kothandam Sivakumar, Krishna R KumarAbstract:We describe a novel technique that allows controlled and precise delivery of single or multiple coils simultaneously for occlusion of a coronary artery fistula using a Bioptome passed via a long sheath positioned at the distal end of the fistula. The fistula was balloon occluded distal to the take-off of the native branches before, during and after coil delivery in two patients.
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Bioptome assisted simultaneous delivery of multiple coils for occlusion of the large patent ductus arteriosus
Catheterization and Cardiovascular Interventions, 2001Co-Authors: Krishna R Kumar, Madangopal Krishnan, K Venugopal, Kothandam Sivakumar, Sivadasan Radha AnilAbstract:We describe a novel method that allows Bioptome–assisted delivery of multiple Gianturco coils simultaneously for occlusion of the large patent ductus arteriosus (PDA). Two or more coils were intertwined at one end and held by a Bioptome (5.2 Fr) and pulled into a short introducer. The coils were then deployed in the PDA via a long sheath (7–11 Fr) previously placed across the duct via the femoral vein. Twelve patients (6 months to 64 years; median, 10.5 years) with large PDAs (4.7 ± 1.3 mm; range, 3.1–8.4 mm; PA mean pressure, 40 ± 17 mm Hg; pulse pressure 63 ± 18 mm Hg) underwent Bioptome-assisted occlusion with multiple coils at our institutions. The procedure was uneventful in nine patients (fluoroscopy time, 6–23 min) and prolonged in three patients (fluoroscopy time, 26, 72, and 120 min) because of dislodgment of the coil mass and embolization of an additional coil. Successful coil deployment was feasible in all patients. Three patients required repeat coil deployment for flow elimination (hemolysis occurred in two). Flow elimination was demonstrated on the last follow-up evaluation in all except two patients. One infant has developed significant left pulmonary artery stenosis. Bioptome-assisted PDA occlusion using multiple coils delivered simultaneously may be a promising alternative to devices for transcatheter closure of large PDAs. Cathet Cardiovasc Intervent 2001;54:95–100. © 2001 Wiley-Liss, Inc.
Ngaiyin Chan - One of the best experts on this subject based on the ideXlab platform.
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successful percutaneous retrieval of a dislodged left atrial appendage occlusion device with double transseptal sheaths and biopsy Bioptome
Catheterization and Cardiovascular Interventions, 2015Co-Authors: Ngaiyin Chan, Chichung Choy, Chunleung LauAbstract:A 64-year-old woman underwent left atrial appendage occlusion with an Amplatzer Cardiac Plug device. Displacement of the device was detected on day 1 with transesophageal echocardiographic checking. The device became dislodged and flitted in the left atrium after unsuccessful retrieval with a snare and 12 Fr steerable transseptal sheath. A double transseptal sheath technique was then attempted. The flitting device was stabilized by one 12 Fr steerable transseptal sheath and successfully retrieved with a biopsy Bioptome through another similar transseptal sheath. The patient suffered from no long-term sequelae.
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successful percutaneous retrieval of a dislodged left atrial appendage occlusion device with double transseptal sheaths and biopsy Bioptome
Catheterization and Cardiovascular Interventions, 2015Co-Authors: Ngaiyin Chan, Chichung Choy, Chunleung LauAbstract:A 64-year-old woman underwent left atrial appendage occlusion with an Amplatzer Cardiac Plug device. Displacement of the device was detected on day 1 with transesophageal echocardiographic checking. The device became dislodged and flitted in the left atrium after unsuccessful retrieval with a snare and 12 Fr steerable transseptal sheath. A double transseptal sheath technique was then attempted. The flitting device was stabilized by one 12 Fr steerable transseptal sheath and successfully retrieved with a biopsy Bioptome through another similar transseptal sheath. The patient suffered from no long-term sequelae. © 2014 Wiley Periodicals, Inc.
Kothandam Sivakumar - One of the best experts on this subject based on the ideXlab platform.
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Bioptome assisted coil occlusion of moderate large patent ductus arteriosus in infants and small children
Catheterization and Cardiovascular Interventions, 2004Co-Authors: Raman Krishna Kumar, Sivadasan Radha Anil, Bhava R J Kannan, Ancil Philip, Kothandam SivakumarAbstract:Coil occlusion of patent ductus arteriosus (PDA), although inexpensive, is technically challenging for the moderate-large ducts in small children. Bioptome assistance allows better control and precision. We describe case selection strategies, technique, immediate and short-term results of Bioptome-assisted closure of moderate-large (>/= 3 mm) PDA in 86 infants and children 6 mm (> 4 mm for children under 5 kg) and/or shallow ampullae (by echocardiography) underwent operation (n = 41). Specific technical modifications included use of long sheaths (5.5-8 Fr) for duct delineation and coil delivery, cutting of coils turns (51 patients) to accommodate the coils in the ampulla, and simultaneous delivery of multiple coils (n = 43). As far as possible, coils were deployed entirely in the ampulla. Median fluoroscopy time was 7.3 min (1.2-42 min). Successful deployment was feasible in all (final pulmonary artery mean pressures, 20 +/- 4.6 mm Hg). Coils embolized in 14 (16%) patients (all retrieved). Complete occlusion occurred immediately in 63 patients (73%) and in 77 patients (89%) at 24 hr. Three patients had new gradients in the left pulmonary artery. Follow-up (62 patients; median duration, 13 months) revealed small residual Doppler flows in 11 patients (18%) at the most recent visit. Bioptome-assisted coil occlusion of moderate-large PDA in selected infants and small children is feasible with encouraging results.
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Bioptome assisted coil occlusion of coronary artery fistula
Indian heart journal, 2002Co-Authors: Sivadasan Radha Anil, Kothandam Sivakumar, Krishna R KumarAbstract:We describe a novel technique that allows controlled and precise delivery of single or multiple coils simultaneously for occlusion of a coronary artery fistula using a Bioptome passed via a long sheath positioned at the distal end of the fistula. The fistula was balloon occluded distal to the take-off of the native branches before, during and after coil delivery in two patients.
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Bioptome assisted simultaneous delivery of multiple coils for occlusion of the large patent ductus arteriosus
Catheterization and Cardiovascular Interventions, 2001Co-Authors: Krishna R Kumar, Madangopal Krishnan, K Venugopal, Kothandam Sivakumar, Sivadasan Radha AnilAbstract:We describe a novel method that allows Bioptome–assisted delivery of multiple Gianturco coils simultaneously for occlusion of the large patent ductus arteriosus (PDA). Two or more coils were intertwined at one end and held by a Bioptome (5.2 Fr) and pulled into a short introducer. The coils were then deployed in the PDA via a long sheath (7–11 Fr) previously placed across the duct via the femoral vein. Twelve patients (6 months to 64 years; median, 10.5 years) with large PDAs (4.7 ± 1.3 mm; range, 3.1–8.4 mm; PA mean pressure, 40 ± 17 mm Hg; pulse pressure 63 ± 18 mm Hg) underwent Bioptome-assisted occlusion with multiple coils at our institutions. The procedure was uneventful in nine patients (fluoroscopy time, 6–23 min) and prolonged in three patients (fluoroscopy time, 26, 72, and 120 min) because of dislodgment of the coil mass and embolization of an additional coil. Successful coil deployment was feasible in all patients. Three patients required repeat coil deployment for flow elimination (hemolysis occurred in two). Flow elimination was demonstrated on the last follow-up evaluation in all except two patients. One infant has developed significant left pulmonary artery stenosis. Bioptome-assisted PDA occlusion using multiple coils delivered simultaneously may be a promising alternative to devices for transcatheter closure of large PDAs. Cathet Cardiovasc Intervent 2001;54:95–100. © 2001 Wiley-Liss, Inc.