1/307. Simultaneous surgical treatment of atrial septal defect and atrial flutter using a simple modification of the atrial incision.The reentrant circuit of common atrial flutter is known to be located in the right atrium between two anatomical barriers. Recent electrophysiologic studies have defined the tricuspid annulus as the anterior barrier, and the terminal crest and its continuation as the eustachian ridge as the posterior barrier. Construction of a bidirectional block to conduction between these two barriers by means of lesions created with radiofrequency current have been shown to be effective in ablating the flutter. We now find that surgical creation of such a block to conduction between the barriers by a simple modification of the atrial incision line is equally effective. In a 6-year-old boy, who was admitted to our hospital for closure of an atrial septal defect and treatment of sustained atrial flutter, the atriotomy was performed perpendicular to the terminal groove and extended towards the tricuspid annulus, placing some cryothermal lesions between the end of the incision and the annulus. The septal defect was closed using a Dacron patch. The child was free of arrhythmia both during the postoperative stay and over the initial three months of follow-up. We conclude that this simple modification of the atrial incision line provides cure of atrial flutter in children who require atriotomy for repair of congenital cardiac anomalies. It may also be beneficial in preventing 'incisional' reentrant tachycardia.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
2/307. Infective endocarditis on an occluder closing an atrial septal defect.Closure of atrial septal defects be means of intravenous catheterisation has been undertaken using a variety of devices as an alternative to surgical closure. We describe the first case, to the best of our knowledge, of infective endocarditis complicating a successful transcatheter closure. This highlights the potential risk of this procedure, and emphasises the need for appropriate antibiotic prophylaxis until complete endothelialization of the device has occurred.- - - - - - - - - - ranking = 2keywords = closure (Clic here for more details about this article) |
3/307. Fatal pulmonary embolism after atrial septal defect closure in a paediatric patient.A four-year-old girl died of massive acute bilateral pulmonary embolism 11 days after direct closure of a secundum atrial septal defect (ASD II), despite postoperative anticoagulation until the patient was ambulatory. An autopsy showed thrombotic deposits on the suture line of the ASD closure, bilateral 90% occlusion of the pulmonary arteries, and haemorrhagic ulcerative ischaemic colitis of the descending colon and the sigmoid.- - - - - - - - - - ranking = 6keywords = closure (Clic here for more details about this article) |
4/307. Transcatheter closure of a patent foramen ovale following mitral valve replacement.We report the successful closure of a postoperative patent foramen ovale in a patient who underwent coronary artery bypass grafting and mitral valve replacement for severe mitral insufficiency. The postoperative course was complicated by severe hypoxemia due to a large patent foramen ovale. The patient underwent transcatheter closure with the Das Angel Wings transcatheter occluder (Microvena Corporation, White Bear Lake, MN) with immediate improvement.- - - - - - - - - - ranking = 6keywords = closure (Clic here for more details about this article) |
5/307. Intermittent hypoxaemia without orthodeoxia due to right-to-left shunting related to an elongated aorta.An elderly woman presented with unexplained, intermittent hypoxaemia unrelated to posture. Subsequent investigations revealed intermittent and variable right-to-left interatrial shunting through a patent foramen ovale in the presence of normal pulmonary arterial and intracardiac pressures, caused by right atrial compression from a horizontal, elongated ascending aorta. Surgical closure of the foramen resulted in marked clinical improvement.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
6/307. Transcatheter closure of a large residual shunt after deployment of the Das-Angel Wings device using the Amplatzer septal occluder.A 35-year-old female patient with a large residual shunt following transcatheter closure of a large secundum atrial septal defect using the Das-Angel Wings device underwent successful complete closure of the residual shunt using a 15-mm Amplatzer Septal Occluder. Transesophageal (two- and three-dimensional) echocardiography was of great help during the closure procedure. Cathet. Cardiovasc. Intervent. 48:184-187, 1999.- - - - - - - - - - ranking = 7keywords = closure (Clic here for more details about this article) |
7/307. Redo cardiac surgery for atrial septal defect in a patient with idiopathic thrombocytopenic purpura. Preoperative management with high-dose intravenous gamma-globulin.A 58-year-old woman with idiopathic thrombocytopenic purpura required redo cardiac surgery of atrial septal defect closure, mitral annuloplasty, and tricuspid annuloplasty. Preoperative high-dose intravenous gamma-globulin and platelet transfusion after termination of cardiopulmonary bypass allowed successful redo cardiac surgery. Management of a patient with idiopathic thrombocytopenic purpura undergoing open heart surgery are discussed.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
8/307. Repair of cor triatriatum associated with partially unroofed coronary sinus.A young patient with cor triatriatum, secundum atrial septal defect, persistent left superior vena cava, partially unroofed coronary sinus, and moderate tricuspid regurgitation was documented to have both a left-to-right shunt from the common pulmonary venous chamber to the right atrium and a right-to-left shunt from the partially unroofed coronary sinus to the left atrium. Resection of the membrane dividing the left atrium, closure of the atrial septal defect and the partially unroofed coronary sinus with pericardial patches, and a tricuspid annuloplasty resulted in an excellent hemodynamic result.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
9/307. Transseptal approach in children after patch occlusion of atrial septal defect: first experience with the cutting balloon.Two children required a transseptal approach to the left heart for endovascular stent redilation late after pericardial patch closure of atrial septal defects performed at the time of their initial surgical intervention. Following perforation of thickened interatrial patches in both patients, cutting balloons were used to create adequate interatrial communications. Cathet. Cardiovasc. Intervent. 48:378-381, 1999.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
10/307. Transcatheter closure of patent foramen ovale for hypoxemia during left ventricular assist device support.A patent foramen ovale with right-to-left shunting was responsible, in part, for profound hypoxemia in a patient who required mechanical support with a left ventricular assist device for cardiogenic shock. The patent foramen ovale was detected with contrast transesophageal echocardiography, and the defect was closed successfully with a transcatheter septal defect closure device.- - - - - - - - - - ranking = 5keywords = closure (Clic here for more details about this article) |
| | Next -> |