A 10-year-old boy who had previously undergone surgical correction for tetralogy of Fallot was referred for cardiac catheterization because of recurrent symptomatic postoperative heart failure owing to major aortopulm...A 10-year-old boy who had previously undergone surgical correction for tetralogy of Fallot was referred for cardiac catheterization because of recurrent symptomatic postoperative heart failure owing to major aortopulmonary collateral arteries （MAPCAs）. A successful occlusion of these MAPCAs was achieved percutaneously using the Amplatzer vascular plug and a detachable coil. Transcatheter occlusion of MAPCAs after surgical correction is an effective method for treatment of post-operative heart failure.展开更多
Background： Patent ductus arteriosus （PDA） is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented...Background： Patent ductus arteriosus （PDA） is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices. Methods： One thousand five hundred and twenty-six patients （537 boys, 989 girls） with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications. Results： Median age and median weight were 4.0 years （range： 0.3 5-2.0 years old） and 15.3 kg （range： 4.5-91.0 kg）, respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 ram, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I （ADO I, 1280, 85.8%）, Cook detachable coils （116, 7.8%）, ADO II （ADO II, 68, 4.6%）, muscular VSD occluder （12, 0.8%）, and Amplatzer vascular plug （16, 1.0%）. Conclusions： Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently.展开更多
Objective:The aims of this retrospective study were to investigate and evaluate the safety and efficacy of three approaches for closure of secundum atrial septal defect(ASD).Methods:In this study,we reviewed clinical ...Objective:The aims of this retrospective study were to investigate and evaluate the safety and efficacy of three approaches for closure of secundum atrial septal defect(ASD).Methods:In this study,we reviewed clinical data for transcatheter occlusion(TCO,n=63),transthoracic occlusion(TTO,n=55),and right anterolateral minithoracotomy(RALT,n=60)techniques used for ASD closure.We compared the safety and efficacy of the three approaches.Results:ASD size in the TTO group was similar to that in the RALT group(P=0.645)and significantly larger than that in the TCO group(P<O.OO1).The RALT group had more non-central types of ASD than the TTO and TCO groups(P=O.019 and P<O.OO1).The operative time in the TTO group was shorter than that in the TCO and RALT groups(P<O.OO1 and P<0.001).The ventilation time and intensive care unit duration were shorter in the TTO group than in the RALT group(P<O.OO1 and P<O.OO1).Hospital duration in the TCO group was shorter than that in the TTO and RALT groups(P<O.OO1 and P<O.OO1).There were no residual shunt and mortality in any group in hospital or during follow-up.There was no significant difference in the incidence of total complications among the three groups(P=0.738).Conclusion:TCO,TTO,and RALT can be performed with favorable cosmetic and clinical results for closing ASD.Appropriate patient selection is an important factor for successful closure.These techniques are promising alternatives to standard median sternotomy and merit additional study.展开更多
Background Transcatheter closure of coronary artery fistula （CAF） has emerged as a successful alternative to surgery. We described our experiences in 10 children patients who were accepted for transcatheter closure ...Background Transcatheter closure of coronary artery fistula （CAF） has emerged as a successful alternative to surgery. We described our experiences in 10 children patients who were accepted for transcatheter closure of CAF. Methods Ten children were 3-10 years old （seven males） with CAF who underwent percutaneous transcatheter closure between October 1995 and April 2008. Sites of origin of these fistulas were： right coronary artery in seven, left anterior descending coronary artery in two, and left circumflex coronary artery in one patient. Drainage sites of these fistulas were： right atrium in seven, right ventricle in two and left ventricle in one patient. All of these fistulas were congenital and had only one orificium fistula.Results A Cook coil was used in four patients and an Amplatzer patent ductus arteriosus （PDA） occluder was used in six patients. Checking the angiogram after the procedure revealed complete occlusion in nine patients （90%） and minimal residual flow in one （10%） patient. Technical success was achieved in all patients. Follow-up studies at short term showed complete abolition of shunt in all patients with no evidence of recanalization leading to recurrence of shunt. Conclusions Transcatheter therapy using either Cook coil or Amplatzer PDA occluder is suggested to be a safe and effective method of occlusion. The midterm outcome of the intervention for CAF is satisfactory.展开更多
Transcatheter occlusion of patent ductus arterious （PDA） using various occluders and coils has been a well-established method since Porstmann and colleagues reported the first case in 1967. However, when patients as...Transcatheter occlusion of patent ductus arterious （PDA） using various occluders and coils has been a well-established method since Porstmann and colleagues reported the first case in 1967. However, when patients associated with anomalous inferior vein cava drainage or/and huge high pulmonary artery pressure ductus （HPAP-PDA）, the method is not suitable. First, it is unfeasible to carry out the procedure via femoral vein. Second,展开更多
文摘A 10-year-old boy who had previously undergone surgical correction for tetralogy of Fallot was referred for cardiac catheterization because of recurrent symptomatic postoperative heart failure owing to major aortopulmonary collateral arteries （MAPCAs）. A successful occlusion of these MAPCAs was achieved percutaneously using the Amplatzer vascular plug and a detachable coil. Transcatheter occlusion of MAPCAs after surgical correction is an effective method for treatment of post-operative heart failure.
文摘Background： Patent ductus arteriosus （PDA） is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices. Methods： One thousand five hundred and twenty-six patients （537 boys, 989 girls） with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications. Results： Median age and median weight were 4.0 years （range： 0.3 5-2.0 years old） and 15.3 kg （range： 4.5-91.0 kg）, respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 ram, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I （ADO I, 1280, 85.8%）, Cook detachable coils （116, 7.8%）, ADO II （ADO II, 68, 4.6%）, muscular VSD occluder （12, 0.8%）, and Amplatzer vascular plug （16, 1.0%）. Conclusions： Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently.
基金supported by grants from the National Natural Science Foundation of China(No.81873502 and No.31330029).
文摘Objective:The aims of this retrospective study were to investigate and evaluate the safety and efficacy of three approaches for closure of secundum atrial septal defect(ASD).Methods:In this study,we reviewed clinical data for transcatheter occlusion(TCO,n=63),transthoracic occlusion(TTO,n=55),and right anterolateral minithoracotomy(RALT,n=60)techniques used for ASD closure.We compared the safety and efficacy of the three approaches.Results:ASD size in the TTO group was similar to that in the RALT group(P=0.645)and significantly larger than that in the TCO group(P<O.OO1).The RALT group had more non-central types of ASD than the TTO and TCO groups(P=O.019 and P<O.OO1).The operative time in the TTO group was shorter than that in the TCO and RALT groups(P<O.OO1 and P<0.001).The ventilation time and intensive care unit duration were shorter in the TTO group than in the RALT group(P<O.OO1 and P<O.OO1).Hospital duration in the TCO group was shorter than that in the TTO and RALT groups(P<O.OO1 and P<O.OO1).There were no residual shunt and mortality in any group in hospital or during follow-up.There was no significant difference in the incidence of total complications among the three groups(P=0.738).Conclusion:TCO,TTO,and RALT can be performed with favorable cosmetic and clinical results for closing ASD.Appropriate patient selection is an important factor for successful closure.These techniques are promising alternatives to standard median sternotomy and merit additional study.
文摘Background Transcatheter closure of coronary artery fistula （CAF） has emerged as a successful alternative to surgery. We described our experiences in 10 children patients who were accepted for transcatheter closure of CAF. Methods Ten children were 3-10 years old （seven males） with CAF who underwent percutaneous transcatheter closure between October 1995 and April 2008. Sites of origin of these fistulas were： right coronary artery in seven, left anterior descending coronary artery in two, and left circumflex coronary artery in one patient. Drainage sites of these fistulas were： right atrium in seven, right ventricle in two and left ventricle in one patient. All of these fistulas were congenital and had only one orificium fistula.Results A Cook coil was used in four patients and an Amplatzer patent ductus arteriosus （PDA） occluder was used in six patients. Checking the angiogram after the procedure revealed complete occlusion in nine patients （90%） and minimal residual flow in one （10%） patient. Technical success was achieved in all patients. Follow-up studies at short term showed complete abolition of shunt in all patients with no evidence of recanalization leading to recurrence of shunt. Conclusions Transcatheter therapy using either Cook coil or Amplatzer PDA occluder is suggested to be a safe and effective method of occlusion. The midterm outcome of the intervention for CAF is satisfactory.
文摘Transcatheter occlusion of patent ductus arterious （PDA） using various occluders and coils has been a well-established method since Porstmann and colleagues reported the first case in 1967. However, when patients associated with anomalous inferior vein cava drainage or/and huge high pulmonary artery pressure ductus （HPAP-PDA）, the method is not suitable. First, it is unfeasible to carry out the procedure via femoral vein. Second,
