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Transcatheter closure of high pulmonary artery pressure persistent ductus arteriosus with the Amplatzer muscular ventricular septal defect occluder

Thanopoulos, B D ; Tsaousis, G S ; Djukic, M ; Al Hakim, F ; Eleftherakis, N G ; Simeunovic, S D

British heart journal, 2002-03, Vol.87 (3), p.260-263 [Periódico revisado por pares]

London: BMJ Publishing Group Ltd and British Cardiovascular Society

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Título:
Transcatheter closure of high pulmonary artery pressure persistent ductus arteriosus with the Amplatzer muscular ventricular septal defect occluder
Autor: Thanopoulos, B D ; Tsaousis, G S ; Djukic, M ; Al Hakim, F ; Eleftherakis, N G ; Simeunovic, S D
Assuntos: Amplatzer muscular ventricular septal defect occluder ; Amplatzer VSD occluder ; AMVSDO ; Balloon Occlusion - instrumentation ; Balloon Occlusion - methods ; Biological and medical sciences ; Blood Pressure - physiology ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation - methods ; Cardiac Catheterization - instrumentation ; Cardiac Catheterization - methods ; Cardiology. Vascular system ; Catheters ; Child ; Child, Preschool ; Confidence intervals ; Congenital Heart Disease ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Coronary vessels ; Defects ; Ductus Arteriosus, Patent - physiopathology ; Ductus Arteriosus, Patent - therapy ; Embolization, Therapeutic - instrumentation ; Embolization, Therapeutic - methods ; Follow-Up Studies ; Heart ; high pulmonary artery pressure ducts ; HPAP-PDA ; Humans ; Hypertension ; Medical sciences ; Patients ; PDA ; persistent ductus arteriosus ; Prosthesis Design ; Pulmonary arteries ; Pulmonary Artery - physiology ; pulmonary hypertension ; Retention ; Systole - physiology ; Veins & arteries
É parte de: British heart journal, 2002-03, Vol.87 (3), p.260-263
Notas: istex:59C854AD44B359F4E9BFFD3337675750B56B51DD
Correspondence to:  Dr Vasilios D Thanopoulos, Department of Cardiology, Aghia Sophia Children's Hospital, Thivon and Levadias 1, Athens 11527, Greece;  vasiliosthanopoulos@usa.net
local:0870260
PMID:11847167
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Correspondence to: Dr Vasilios D Thanopoulos, Department of Cardiology, Aghia Sophia Children's Hospital, Thivon and Levadias 1, Athens 11527, Greece; vasiliosthanopoulos@usa.net
This study was presented at the World Congress of Pediatric Cardiology and Cardiac Surgery, Toronto, May 27–31, 2001.
Descrição: Background: The design of devices currently used for closure of persistent ductus arteriosus (PDA) with high pulmonary artery pressure is not ideal and there is a risk of embolisation into the aorta. Objective: To investigate the use of the Amplatzer muscular ventricular septal defect occluder (AMVSDO) for treatment of PDA with high pulmonary artery pressure. Patients and design: Seven patients, aged 5–12 years, with large PDAs and systemic or near systemic pulmonary artery pressure underwent attempted transcatheter closure using the AMVSDO. The device consists of two low profile disks made of a nitinol wire mesh with a 7 mm connecting waist. Balloon occlusion of the duct was performed before closure from the venous side, and prosthesis size was chosen according to the measured diameter of the occluding balloon. A 7 French sheath was used to deliver the device. All patients underwent a complete haemodynamic and angiographic study one year after occlusion. Results: The mean (SD) angiographic PDA diameter was 9.8 (1.7) mm (range 7–13 mm) and the mean AMVSDO diameter was 11.4 (1.8) mm (range 9–16 mm). Qp/Qs ranged from 1.9–2.2 (mean 2.0 (0.1)). Successful device delivery and complete closure occurred in all patients (100% occlusion rate, 95% confidence interval 59.04% to 100.00%). Mean systolic pulmonary artery pressures were as follows: before balloon occlusion, 106 (13) mm Hg; during occlusion, 61 (6) mm Hg; immediately after the procedure, 57 (5) mm Hg; and at the one year follow up catheterisation, 37 (10) mm Hg. Fluoroscopy time was 10.4 (4.3) min (range 7–18 min). No complications occurred. Conclusions: AMVSDO is an important adjunct for closure of large PDAs associated with high pulmonary artery pressure. Further studies are required to document its efficacy, safety, and long term results in a larger number of patients.
Editor: London: BMJ Publishing Group Ltd and British Cardiovascular Society
Idioma: Inglês

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Transcatheter closure of high pulmonary artery pressure persistent ductus arteriosus with the Amplatzer muscular ventricular septal defect occluder

Thanopoulos, B D ; Tsaousis, G S ; Djukic, M ; Al Hakim, F ; Eleftherakis, N G ; Simeunovic, S D

London: BMJ Publishing Group Ltd and British Cardiovascular Society

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