The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Tomaž Podnar - One of the best experts on this subject based on the ideXlab platform.
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percutaneous management of cyanosis in fontan patients using amplatzer Occluders
Catheterization and Cardiovascular Interventions, 2008Co-Authors: Jozef Masura, Lucia Borodacova, Peter Tittel, Pavel Berden, Tomaž PodnarAbstract:OBJECTIVES: To determine causes of cyanosis and to evaluate percutaneous management of cyanosis in a group of consecutive Fontan patients. BACKGROUND: A variety of communications allow a right-to-left shunt in Fontan circulation causing cyanosis and these communications are amenable to percutaneous closure. METHODS: Between November 1997 and November 2007, 45 consecutive patients ranging in age from 2.5 to 26 years (median 8 years) with Fontan circulation and cyanosis underwent cardiac catheterization and percutaneous closure of superfluous communications using different types of Amplatzer Occluders. RESULTS: Altogether, 51 communications were detected and 50 of them were closed. In 5 patients (11.1%), multiple communications were present and were closed. Fenestration was detected in 37 of 41 patients (90.2%) after total cavopulmonary connection and all were closed by Amplatzer septal Occluders. Five venous collaterals were revealed in 3 of 41 patients (7.3%) with total cavopulmonary anastomosis and were closed by Amplatzer vascular plugs. In 3 patients, lateral tunnel leaks were detected and were closed by Amplatzer PFO Occluders. In 4 patients after Kawashima operation, 3 major pulmonary arterio-venous malformations and single venous collateral contributed to the cyanosis and all were closed using Amplatzer vascular plugs. CONCLUSIONS: Different communications cause cyanosis in Fontan patients. Progressive decline of percutaneous oxygen saturation is suggestive of development of venous collaterals or pulmonary arteriovenous malformations. Superfluous communications are amenable to percutaneous closure using various types of Amplatzer Occluders. A novel use of an Amplatzer PFO occluder for the percutaneous closure of a lateral tunnel leak is described.
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percutaneous management of cyanosis in fontan patients using amplatzer Occluders
Catheterization and Cardiovascular Interventions, 2008Co-Authors: Jozef Masura, Lucia Borodacova, Peter Tittel, Pavel Berden, Tomaž PodnarAbstract:OBJECTIVES: To determine causes of cyanosis and to evaluate percutaneous management of cyanosis in a group of consecutive Fontan patients. BACKGROUND: A variety of communications allow a right-to-left shunt in Fontan circulation causing cyanosis and these communications are amenable to percutaneous closure. METHODS: Between November 1997 and November 2007, 45 consecutive patients ranging in age from 2.5 to 26 years (median 8 years) with Fontan circulation and cyanosis underwent cardiac catheterization and percutaneous closure of superfluous communications using different types of Amplatzer Occluders. RESULTS: Altogether, 51 communications were detected and 50 of them were closed. In 5 patients (11.1%), multiple communications were present and were closed. Fenestration was detected in 37 of 41 patients (90.2%) after total cavopulmonary connection and all were closed by Amplatzer septal Occluders. Five venous collaterals were revealed in 3 of 41 patients (7.3%) with total cavopulmonary anastomosis and were closed by Amplatzer vascular plugs. In 3 patients, lateral tunnel leaks were detected and were closed by Amplatzer PFO Occluders. In 4 patients after Kawashima operation, 3 major pulmonary arterio-venous malformations and single venous collateral contributed to the cyanosis and all were closed using Amplatzer vascular plugs. CONCLUSIONS: Different communications cause cyanosis in Fontan patients. Progressive decline of percutaneous oxygen saturation is suggestive of development of venous collaterals or pulmonary arteriovenous malformations. Superfluous communications are amenable to percutaneous closure using various types of Amplatzer Occluders. A novel use of an Amplatzer PFO occluder for the percutaneous closure of a lateral tunnel leak is described.
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percutaneous management of cyanosis in fontan patients using amplatzer Occluders
Catheterization and Cardiovascular Interventions, 2008Co-Authors: Jozef Masura, Lucia Borodacova, Peter Tittel, Pavel Berden, Tomaž PodnarAbstract:Objectives: To determine causes of cyanosis and to evaluate percutaneous management of cyanosis in a group of consecutive Fontan patients. Background: A variety of communications allow a right-to-left shunt in Fontan circulation causing cyanosis and these communications are amenable to percutaneous closure. Methods: Between November 1997 and November 2007, 45 consecutive patients ranging in age from 2.5 to 26 years (median 8 years) with Fontan circulation and cyanosis underwent cardiac catheterization and percutaneous closure of superfluous communications using different types of Amplatzer Occluders. Results: Altogether, 51 communications were detected and 50 of them were closed. In 5 patients (11.1%), multiple communications were present and were closed. Fenestration was detected in 37 of 41 patients (90.2%) after total cavopulmonary connection and all were closed by Amplatzer septal Occluders. Five venous collaterals were revealed in 3 of 41 patients (7.3%) with total cavopulmonary anastomosis and were closed by Amplatzer vascular plugs. In 3 patients, lateral tunnel leaks were detected and were closed by Amplatzer PFO Occluders. In 4 patients after Kawashima operation, 3 major pulmonary arterio-venous malformations and single venous collateral contributed to the cyanosis and all were closed using Amplatzer vascular plugs. Conclusions: Different communications cause cyanosis in Fontan patients. Progressive decline of percutaneous oxygen saturation is suggestive of development of venous collaterals or pulmonary arteriovenous malformations. Superfluous communications are amenable to percutaneous closure using various types of Amplatzer Occluders. A novel use of an Amplatzer PFO occluder for the percutaneous closure of a lateral tunnel leak is described. © 2008 Wiley-Liss, Inc.
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long term outcome of transcatheter patent ductus arteriosus closure using amplatzer duct Occluders
American Heart Journal, 2006Co-Authors: Jozef Masura, Peter Tittel, Pavol Gavora, Tomaž PodnarAbstract:Background Immediate-, short-, and intermediate-term results of percutaneous patent ductus arteriosus (PDA) closure using Amplatzer duct Occluders are excellent. However, long-term results have not yet been reported to date. Methods Between September 1996 and April 2002, 64 consecutive patients having isolated PDA with minimal diameter of ≥2 mm underwent percutaneous closure using Amplatzer duct Occluders. All patients were included in this study and have been followed up until September 2005. Results Patients have been followed up from 40 to 108 months (median 58 months). The mean PDA diameter was 3.5 ± 1.6 mm. There were no deaths or significant complications during the study period. At a 1-month follow-up, all PDA were completely closed and remained closed thereafter. Conclusions Since the initial clinical experience in September 1996, the Amplatzer duct occluder has been proven as a safe and effective device for transcatheter PDA closure. Based on our experience, we believe that in patients having completely closed PDA with laminar blood flow pattern in the descending thoracic aorta and left pulmonary artery at a 1-year follow-up, there is no need for further evaluations. In contrast, few remaining patients need a careful follow-up until a complete normalization of all findings.
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long term outcome of transcatheter secundum type atrial septal defect closure using amplatzer septal Occluders
Journal of the American College of Cardiology, 2005Co-Authors: Jozef Masura, Pavol Gavora, Tomaž PodnarAbstract:Objectives The aim of this study was to assess long-term results of percutaneous closure of secundum-type atrial septal defect (ASD II) using Amplatzer septal Occluders (ASO). Background Only immediate-, short-, and intermediate-term results of ASO implantation are known so far. Methods Between September 1995 and January 2000, 151 patients underwent a successful percutaneous closure of ASD II in our institution. All were included in the present study and were followed up until September 2004. Results This group of patients was followed up from 56 to 108 months (median 78 months). The mean stretched defect diameter was 15.9 ± 4.8 mm. There were no deaths or significant complications during the study. At three years of follow-up, all defects were completely closed and remained closed thereafter. Conclusions Since the first human implantations in September 1995, the Amplatzer septal occluder proved as a safe and effective device for percutaneous closure of ASD II.
Jozef Masura - One of the best experts on this subject based on the ideXlab platform.
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percutaneous management of cyanosis in fontan patients using amplatzer Occluders
Catheterization and Cardiovascular Interventions, 2008Co-Authors: Jozef Masura, Lucia Borodacova, Peter Tittel, Pavel Berden, Tomaž PodnarAbstract:OBJECTIVES: To determine causes of cyanosis and to evaluate percutaneous management of cyanosis in a group of consecutive Fontan patients. BACKGROUND: A variety of communications allow a right-to-left shunt in Fontan circulation causing cyanosis and these communications are amenable to percutaneous closure. METHODS: Between November 1997 and November 2007, 45 consecutive patients ranging in age from 2.5 to 26 years (median 8 years) with Fontan circulation and cyanosis underwent cardiac catheterization and percutaneous closure of superfluous communications using different types of Amplatzer Occluders. RESULTS: Altogether, 51 communications were detected and 50 of them were closed. In 5 patients (11.1%), multiple communications were present and were closed. Fenestration was detected in 37 of 41 patients (90.2%) after total cavopulmonary connection and all were closed by Amplatzer septal Occluders. Five venous collaterals were revealed in 3 of 41 patients (7.3%) with total cavopulmonary anastomosis and were closed by Amplatzer vascular plugs. In 3 patients, lateral tunnel leaks were detected and were closed by Amplatzer PFO Occluders. In 4 patients after Kawashima operation, 3 major pulmonary arterio-venous malformations and single venous collateral contributed to the cyanosis and all were closed using Amplatzer vascular plugs. CONCLUSIONS: Different communications cause cyanosis in Fontan patients. Progressive decline of percutaneous oxygen saturation is suggestive of development of venous collaterals or pulmonary arteriovenous malformations. Superfluous communications are amenable to percutaneous closure using various types of Amplatzer Occluders. A novel use of an Amplatzer PFO occluder for the percutaneous closure of a lateral tunnel leak is described.
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percutaneous management of cyanosis in fontan patients using amplatzer Occluders
Catheterization and Cardiovascular Interventions, 2008Co-Authors: Jozef Masura, Lucia Borodacova, Peter Tittel, Pavel Berden, Tomaž PodnarAbstract:OBJECTIVES: To determine causes of cyanosis and to evaluate percutaneous management of cyanosis in a group of consecutive Fontan patients. BACKGROUND: A variety of communications allow a right-to-left shunt in Fontan circulation causing cyanosis and these communications are amenable to percutaneous closure. METHODS: Between November 1997 and November 2007, 45 consecutive patients ranging in age from 2.5 to 26 years (median 8 years) with Fontan circulation and cyanosis underwent cardiac catheterization and percutaneous closure of superfluous communications using different types of Amplatzer Occluders. RESULTS: Altogether, 51 communications were detected and 50 of them were closed. In 5 patients (11.1%), multiple communications were present and were closed. Fenestration was detected in 37 of 41 patients (90.2%) after total cavopulmonary connection and all were closed by Amplatzer septal Occluders. Five venous collaterals were revealed in 3 of 41 patients (7.3%) with total cavopulmonary anastomosis and were closed by Amplatzer vascular plugs. In 3 patients, lateral tunnel leaks were detected and were closed by Amplatzer PFO Occluders. In 4 patients after Kawashima operation, 3 major pulmonary arterio-venous malformations and single venous collateral contributed to the cyanosis and all were closed using Amplatzer vascular plugs. CONCLUSIONS: Different communications cause cyanosis in Fontan patients. Progressive decline of percutaneous oxygen saturation is suggestive of development of venous collaterals or pulmonary arteriovenous malformations. Superfluous communications are amenable to percutaneous closure using various types of Amplatzer Occluders. A novel use of an Amplatzer PFO occluder for the percutaneous closure of a lateral tunnel leak is described.
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percutaneous management of cyanosis in fontan patients using amplatzer Occluders
Catheterization and Cardiovascular Interventions, 2008Co-Authors: Jozef Masura, Lucia Borodacova, Peter Tittel, Pavel Berden, Tomaž PodnarAbstract:Objectives: To determine causes of cyanosis and to evaluate percutaneous management of cyanosis in a group of consecutive Fontan patients. Background: A variety of communications allow a right-to-left shunt in Fontan circulation causing cyanosis and these communications are amenable to percutaneous closure. Methods: Between November 1997 and November 2007, 45 consecutive patients ranging in age from 2.5 to 26 years (median 8 years) with Fontan circulation and cyanosis underwent cardiac catheterization and percutaneous closure of superfluous communications using different types of Amplatzer Occluders. Results: Altogether, 51 communications were detected and 50 of them were closed. In 5 patients (11.1%), multiple communications were present and were closed. Fenestration was detected in 37 of 41 patients (90.2%) after total cavopulmonary connection and all were closed by Amplatzer septal Occluders. Five venous collaterals were revealed in 3 of 41 patients (7.3%) with total cavopulmonary anastomosis and were closed by Amplatzer vascular plugs. In 3 patients, lateral tunnel leaks were detected and were closed by Amplatzer PFO Occluders. In 4 patients after Kawashima operation, 3 major pulmonary arterio-venous malformations and single venous collateral contributed to the cyanosis and all were closed using Amplatzer vascular plugs. Conclusions: Different communications cause cyanosis in Fontan patients. Progressive decline of percutaneous oxygen saturation is suggestive of development of venous collaterals or pulmonary arteriovenous malformations. Superfluous communications are amenable to percutaneous closure using various types of Amplatzer Occluders. A novel use of an Amplatzer PFO occluder for the percutaneous closure of a lateral tunnel leak is described. © 2008 Wiley-Liss, Inc.
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long term outcome of transcatheter patent ductus arteriosus closure using amplatzer duct Occluders
American Heart Journal, 2006Co-Authors: Jozef Masura, Peter Tittel, Pavol Gavora, Tomaž PodnarAbstract:Background Immediate-, short-, and intermediate-term results of percutaneous patent ductus arteriosus (PDA) closure using Amplatzer duct Occluders are excellent. However, long-term results have not yet been reported to date. Methods Between September 1996 and April 2002, 64 consecutive patients having isolated PDA with minimal diameter of ≥2 mm underwent percutaneous closure using Amplatzer duct Occluders. All patients were included in this study and have been followed up until September 2005. Results Patients have been followed up from 40 to 108 months (median 58 months). The mean PDA diameter was 3.5 ± 1.6 mm. There were no deaths or significant complications during the study period. At a 1-month follow-up, all PDA were completely closed and remained closed thereafter. Conclusions Since the initial clinical experience in September 1996, the Amplatzer duct occluder has been proven as a safe and effective device for transcatheter PDA closure. Based on our experience, we believe that in patients having completely closed PDA with laminar blood flow pattern in the descending thoracic aorta and left pulmonary artery at a 1-year follow-up, there is no need for further evaluations. In contrast, few remaining patients need a careful follow-up until a complete normalization of all findings.
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long term outcome of transcatheter secundum type atrial septal defect closure using amplatzer septal Occluders
Journal of the American College of Cardiology, 2005Co-Authors: Jozef Masura, Pavol Gavora, Tomaž PodnarAbstract:Objectives The aim of this study was to assess long-term results of percutaneous closure of secundum-type atrial septal defect (ASD II) using Amplatzer septal Occluders (ASO). Background Only immediate-, short-, and intermediate-term results of ASO implantation are known so far. Methods Between September 1995 and January 2000, 151 patients underwent a successful percutaneous closure of ASD II in our institution. All were included in the present study and were followed up until September 2004. Results This group of patients was followed up from 56 to 108 months (median 78 months). The mean stretched defect diameter was 15.9 ± 4.8 mm. There were no deaths or significant complications during the study. At three years of follow-up, all defects were completely closed and remained closed thereafter. Conclusions Since the first human implantations in September 1995, the Amplatzer septal occluder proved as a safe and effective device for percutaneous closure of ASD II.
Jacek Bialkowski - One of the best experts on this subject based on the ideXlab platform.
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preliminary experience in the use of cera Occluders for closure of different intracardiac and extracardiac shunts
Journal of Invasive Cardiology, 2014Co-Authors: Roland Fiszer, Malgorzata Szkutnik, Beata Chodor, Jacek BialkowskiAbstract:BACKGROUND Transcatheter closure has become the method of choice for treatment of many heart defects. Recently, Lifetech Scientific introduced the Cera occluder (CO), a self-expandable nitinol wire-mesh device covered with ceramic coating. We present our preliminary experience in transcatheter closure of atrial septal defect (ASD), patent foramen ovale (PFO), patent ductus arteriosus (PDA), and post-infarction ventricular septal defect (PIVSD) with the CO. METHODS The study population consisted of 25 patients (17 female) ages 1.1-82 years (median age, 34.0 years) with either ASD (n = 7), PFO (n = 11), PDA (n = 6), or PIVSD (n = 1). All patients were treated percutaneously with appropriate CO devices, without any preliminary patient selection. The implantation technique applied in these procedures was the same as previously described for Amplatzer Occluders. RESULTS All procedures were performed successfully. Complete shunt closure was achieved in all but 1 patient with PIVSD. No complications were observed during procedures or during follow-up of 0.5-4 months. CONCLUSIONS Our preliminary experience in the clinical application of COs for transcatheter closure of ASD, PFO, PDA, and PIVSD has confirmed their utility, feasibility, and safety, at least in the short-term follow-up.
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transcatheter closure of ventricular septal defects with nitinol wire Occluders of type patent ductus arteriosus
Advances in Interventional Cardiology, 2014Co-Authors: Arkadiusz Wierzyk, Malgorzata Szkutnik, Roland Fiszer, Pawel Banaszak, Szymon Pawlak, Jacek BialkowskiAbstract:Ventricular septal defects closure (VSD) depending on the anatomy and clinical setting can be performed surgically or by a hybrid and transcatheter approach. Two cases of children with VSD will be presented. Patients' defects were closed with various types of Occluders made of nitinol wire mesh occluder, patent ductus arteriosus (PDA) type. The first case was a 2.5-year-old boy after cardiosurgical correction of tetralogy of Fallot (TOF). After the procedure, a significant haemodynamic residual VSD was observed, which was not successfully closed during the subsequent reoperation. Despite pharmacological treatment, symptoms of heart failure were observed in this patient. In echocardiographic images the residual VSD was presented as a tunnel-like dissection of the ventricular septum (length 6 mm and diameter 3.4 mm). The defect was closed via arterial access with an Amplatzer Duct Occluder II (ADO II). The procedure was successfully performed without any medical complications. In this child, a significant shunt reduction and a noticeable improvement in the patient's clinical status and diminished symptoms of heart failure were noticed. The second patient was a 4-year-old girl suffering from a multi-perforated perimembranous VSD accompanied by a ventricular septal defect with aneurysm. The defect was closed by a venous approach with a PDA Cardio-O-Fix occluder (very similar to ADO I). No short-term or long-term complications were visible during or after the procedure. Only a mild residual shunt through the VSD was observed 6 months afterwards. Transcatheter VSD closure with a proper morphology, with Occluders of type Amplatzer Duct Occluder ADO I or ADO II, constitutes a safe and effective therapeutic alternative.
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application of cardio o fix Occluders for transcatheter closure of patent ductus arteriosus and interatrial communications preliminary experience
Cardiology Journal, 2010Co-Authors: Jacek Bialkowski, Malgorzata Szkutnik, Roland Fiszer, Pawel Banaszak, Jan Glowacki, Marian ZembalaAbstract:Background: Transcatheter treatment has become the method of choice for treating many heart defects. Recently, Cardio-O-Fix occluder (COF) - a new, self-expandable nitinol wire-mesh device very similar to the Amplatzer device - has been introduced into clinical practice. To the best of our knowledge, this is the first publication related to its application. Methods: Five patients aged from six months to 69 years were included in the study: two with atrial septal defect (ASD), one with patent foramen ovale (PFO) after cryptogenic stroke, and two with patent ductus arteriosus (PDA). These latter two comprised one six month old infant with co-existent hypertrophied cardiomyopathy, and a 53 year-old woman with recanalized PDA after previous ligation. All were treated percutaneously with COF. There was no preliminary patient selection. The only limitation was the size of the devices in our possession (16 and 22 mm ASD COF, 25 PFO COF, 4/6 and 6/8 PDA COF). The implantation technique was the same as previously described for Amplatzer Occluders. Results: All procedures were finished successfully with complete closure of the shunt. No complications were observed during a six month follow-up. In the child with PDA, we observed decrease of gradient from 80 to 60 mm Hg in hypertrophied left ventricular outflow tract, although a small protrusion of PDA-COF device was noted in the descending aorta (8 mm Hg gradient in ECHO). In the patient with recanalized PDA, the procedure was performed after arterio-venous loop creation. Mean fluoroscopy time was 4.4 (range from 1.6 to 11) minutes. Conclusions: Our preliminary experience indicates that the application of Cardio-O-Fix devices is safe and effective. (Cardiol J 2010; 17, 6: 607-611)
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postinfarction ventricular septal defect closure with amplatzer Occluders
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Malgorzata Szkutnik, Pawel Banaszak, Jacek Bialkowski, Jacek Kusa, Jacek Baranowski, Mariusz Gąsior, Piotr Chodor, M ZembalaAbstract:Objective: Postinfarction ventricular septal defect (PIVSD) is a rare and life-threatening complication with high risk of both surgical and medical treatment. Another option available now is transcatheter closure. The purpose of this paper is to report the results of such treatment with Amplatzer Occluders. Method: Seven patients aged from 51 to 71 years were included. The procedure was performed between 2 and 10 weeks after myocardial infarction. One patient had double residual VSD (2 months after previous surgery) and another, coexisting critical stenosis of right coronary artery (RCA). All patients were in III/IV NYHA class, on intropes, one patient on aortic balloon counterpulsation. Venous jugular approach was used to close the VSD in six patients, venous transfemoral in one patient. Implantation of six Ampaltzer atrial septal Occluders (ASO) and one muscular Amplatzer VSD occluder (VSO) were performed. Results: All procedures but two were finished successfully. In one patient, the defect could not be entered neither from the venous nor the arterial side due to unusual oblique course (which was confirmed during subsequent operation). In the second patient (2 weeks after MI), the reason was unstable position of 24 mm ASO (probably due to necrotic borders of VSD). Immediate significant clinical improvement was achieved in all patients, in whom PIVSD was closed with Amplatzer Occluders. In one postsurgical patient, two ASO were used; in another patient, prior to VSD closure, PTCA and stent implantation to RCA was performed. The stretched diameter of PIVSD ranged from 8 to 22 mm, the size of implanted Amplatzer Occluders from 12 to 24 mm. Fluoroscopy time was 60 min (18-120). During the procedure, ventricular fibrillation requiring defibrillation was observed in three patients. One patient died 1 week after the procedure because of multiorgan failure and increasing mitral incompetence (MI). Conclusions: Despite some technical problems, implantation of Amplatzer Occluders, is an attractive option of treatment of patients with subacute PIVSD.
Malgorzata Szkutnik - One of the best experts on this subject based on the ideXlab platform.
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preliminary experience in the use of cera Occluders for closure of different intracardiac and extracardiac shunts
Journal of Invasive Cardiology, 2014Co-Authors: Roland Fiszer, Malgorzata Szkutnik, Beata Chodor, Jacek BialkowskiAbstract:BACKGROUND Transcatheter closure has become the method of choice for treatment of many heart defects. Recently, Lifetech Scientific introduced the Cera occluder (CO), a self-expandable nitinol wire-mesh device covered with ceramic coating. We present our preliminary experience in transcatheter closure of atrial septal defect (ASD), patent foramen ovale (PFO), patent ductus arteriosus (PDA), and post-infarction ventricular septal defect (PIVSD) with the CO. METHODS The study population consisted of 25 patients (17 female) ages 1.1-82 years (median age, 34.0 years) with either ASD (n = 7), PFO (n = 11), PDA (n = 6), or PIVSD (n = 1). All patients were treated percutaneously with appropriate CO devices, without any preliminary patient selection. The implantation technique applied in these procedures was the same as previously described for Amplatzer Occluders. RESULTS All procedures were performed successfully. Complete shunt closure was achieved in all but 1 patient with PIVSD. No complications were observed during procedures or during follow-up of 0.5-4 months. CONCLUSIONS Our preliminary experience in the clinical application of COs for transcatheter closure of ASD, PFO, PDA, and PIVSD has confirmed their utility, feasibility, and safety, at least in the short-term follow-up.
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transcatheter closure of ventricular septal defects with nitinol wire Occluders of type patent ductus arteriosus
Advances in Interventional Cardiology, 2014Co-Authors: Arkadiusz Wierzyk, Malgorzata Szkutnik, Roland Fiszer, Pawel Banaszak, Szymon Pawlak, Jacek BialkowskiAbstract:Ventricular septal defects closure (VSD) depending on the anatomy and clinical setting can be performed surgically or by a hybrid and transcatheter approach. Two cases of children with VSD will be presented. Patients' defects were closed with various types of Occluders made of nitinol wire mesh occluder, patent ductus arteriosus (PDA) type. The first case was a 2.5-year-old boy after cardiosurgical correction of tetralogy of Fallot (TOF). After the procedure, a significant haemodynamic residual VSD was observed, which was not successfully closed during the subsequent reoperation. Despite pharmacological treatment, symptoms of heart failure were observed in this patient. In echocardiographic images the residual VSD was presented as a tunnel-like dissection of the ventricular septum (length 6 mm and diameter 3.4 mm). The defect was closed via arterial access with an Amplatzer Duct Occluder II (ADO II). The procedure was successfully performed without any medical complications. In this child, a significant shunt reduction and a noticeable improvement in the patient's clinical status and diminished symptoms of heart failure were noticed. The second patient was a 4-year-old girl suffering from a multi-perforated perimembranous VSD accompanied by a ventricular septal defect with aneurysm. The defect was closed by a venous approach with a PDA Cardio-O-Fix occluder (very similar to ADO I). No short-term or long-term complications were visible during or after the procedure. Only a mild residual shunt through the VSD was observed 6 months afterwards. Transcatheter VSD closure with a proper morphology, with Occluders of type Amplatzer Duct Occluder ADO I or ADO II, constitutes a safe and effective therapeutic alternative.
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application of cardio o fix Occluders for transcatheter closure of patent ductus arteriosus and interatrial communications preliminary experience
Cardiology Journal, 2010Co-Authors: Jacek Bialkowski, Malgorzata Szkutnik, Roland Fiszer, Pawel Banaszak, Jan Glowacki, Marian ZembalaAbstract:Background: Transcatheter treatment has become the method of choice for treating many heart defects. Recently, Cardio-O-Fix occluder (COF) - a new, self-expandable nitinol wire-mesh device very similar to the Amplatzer device - has been introduced into clinical practice. To the best of our knowledge, this is the first publication related to its application. Methods: Five patients aged from six months to 69 years were included in the study: two with atrial septal defect (ASD), one with patent foramen ovale (PFO) after cryptogenic stroke, and two with patent ductus arteriosus (PDA). These latter two comprised one six month old infant with co-existent hypertrophied cardiomyopathy, and a 53 year-old woman with recanalized PDA after previous ligation. All were treated percutaneously with COF. There was no preliminary patient selection. The only limitation was the size of the devices in our possession (16 and 22 mm ASD COF, 25 PFO COF, 4/6 and 6/8 PDA COF). The implantation technique was the same as previously described for Amplatzer Occluders. Results: All procedures were finished successfully with complete closure of the shunt. No complications were observed during a six month follow-up. In the child with PDA, we observed decrease of gradient from 80 to 60 mm Hg in hypertrophied left ventricular outflow tract, although a small protrusion of PDA-COF device was noted in the descending aorta (8 mm Hg gradient in ECHO). In the patient with recanalized PDA, the procedure was performed after arterio-venous loop creation. Mean fluoroscopy time was 4.4 (range from 1.6 to 11) minutes. Conclusions: Our preliminary experience indicates that the application of Cardio-O-Fix devices is safe and effective. (Cardiol J 2010; 17, 6: 607-611)
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postinfarction ventricular septal defect closure with amplatzer Occluders
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Malgorzata Szkutnik, Pawel Banaszak, Jacek Bialkowski, Jacek Kusa, Jacek Baranowski, Mariusz Gąsior, Piotr Chodor, M ZembalaAbstract:Objective: Postinfarction ventricular septal defect (PIVSD) is a rare and life-threatening complication with high risk of both surgical and medical treatment. Another option available now is transcatheter closure. The purpose of this paper is to report the results of such treatment with Amplatzer Occluders. Method: Seven patients aged from 51 to 71 years were included. The procedure was performed between 2 and 10 weeks after myocardial infarction. One patient had double residual VSD (2 months after previous surgery) and another, coexisting critical stenosis of right coronary artery (RCA). All patients were in III/IV NYHA class, on intropes, one patient on aortic balloon counterpulsation. Venous jugular approach was used to close the VSD in six patients, venous transfemoral in one patient. Implantation of six Ampaltzer atrial septal Occluders (ASO) and one muscular Amplatzer VSD occluder (VSO) were performed. Results: All procedures but two were finished successfully. In one patient, the defect could not be entered neither from the venous nor the arterial side due to unusual oblique course (which was confirmed during subsequent operation). In the second patient (2 weeks after MI), the reason was unstable position of 24 mm ASO (probably due to necrotic borders of VSD). Immediate significant clinical improvement was achieved in all patients, in whom PIVSD was closed with Amplatzer Occluders. In one postsurgical patient, two ASO were used; in another patient, prior to VSD closure, PTCA and stent implantation to RCA was performed. The stretched diameter of PIVSD ranged from 8 to 22 mm, the size of implanted Amplatzer Occluders from 12 to 24 mm. Fluoroscopy time was 60 min (18-120). During the procedure, ventricular fibrillation requiring defibrillation was observed in three patients. One patient died 1 week after the procedure because of multiorgan failure and increasing mitral incompetence (MI). Conclusions: Despite some technical problems, implantation of Amplatzer Occluders, is an attractive option of treatment of patients with subacute PIVSD.
Shenghua Zhou - One of the best experts on this subject based on the ideXlab platform.
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non surgical repair of ventricular septal rupture after acute myocardial infarction
International Journal of Cardiology, 2015Co-Authors: Liang Tang, Zhenfei Fang, Jiangjun Tang, Xiangqian Shen, Yanshu Zhao, Shenghua ZhouAbstract:Abstract Background Ventricular septal rupture (VSR) following myocardial infarction is a rare complication with high mortality. Although transcatheter closure has emerged as a less invasive method of VSR closure, the optimal timing and technique remain unclear. Methods This is a single-center, retrospective, cohort study. Eleven patients that underwent transcatheter closure of post-AMI VSR from 2006 to 2013 at the Second Xiangya Hospital were included in this study. The clinical, procedural, and outcome data were analyzed. Results VSR occurred in 4 patients at anterior, 4 at posterior, and 3 at apical ventricular septum. Atrial Septal Defect occluder was used in 2 patients, muscular Ventricular Septal Defect occluder was used in 6 patients, and Patent Ductus Arteriosus occluder was used in 3 patients. The median time between VSR diagnosis and transcatheter closure was 18days (range, 13–30days). The median size of the VSR was 12mm (range, 8–17mm). The occlusion device was deployed successfully in 10 of 11 patients. Three patients died between zero and seven days after the procedure (30-day mortality, 27.3%). Eight patients survived during a follow-up of 150–1960days. A follow-up TTE showed no residual shunt in three patients and a trivial or small residual shunt in five patients. Conclusion Transcatheter closure of post-AMI VSR using Atrial Septal Defect, Ventricular Septal Defect, and Patent Ductus Arteriosus Occluders is feasible and effective. If the clinical conditions permit, intervention can be delayed to the late phase (>2–3weeks) after VSR diagnosis.
