American heart journal
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American heart journal · Oct 1996
Multicenter Study Comparative StudyTranscatheter closure with single or multiple Gianturco coils of patent ductus arteriosus in infants weighing < or = 8 kg: retrograde versus antegrade approach.
Experience with transcatheter closure (TCC) of patent ductus arteriosus (PDA) in small infants is limited. Our goals were to evaluate the immediate and short-term results of TCC of PDA in small infants (< or = 8 kg) as attempted with single or multiple Gianturco coils and to compare results for PDA < or = 2.5 mm versus PDA > 2.5 mm. Twenty-four infants underwent an attempt at TCC of PDA at a median age of 0.7 years (range 2 weeks to 1.5 years) and median weight of 6.5 kg (range 2.3 to 8 kg). ⋯ The median fluoroscopy time was 19 minutes. Complications included transient loss of femoral pulse in 2 infants, mild left pulmonary artery obstruction in 2, and nonretrievable coil migration to the right lung in one. We conclude that TCC is effective therapy for small infants with a PDA of diameter < or = 5.2 mm by the single-or multiple-coil technique on an outpatient basis and that TCC can be performed in neonates as small as 2.3 kg.
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American heart journal · Oct 1996
Intermittent inotropic therapy in an outpatient setting: a cost-effective therapeutic modality in patients with refractory heart failure.
Patients with intractable heart failure (New York Heart Association [NYHA] class III and IV) who were receiving maximal conventional treatment were enrolled in an outpatient program that included inotropic infusions, intensive patient education, and close follow-up. The effects of this approach to therapy were evaluated on (1) the number of hospital admissions, (2) length of stay, and (3) number of emergency room visits during the ensuing year. These data were compared with similar data from the year before entry in the program for each patient. ⋯ After enrollment, patients had 10 emergency room visits, 34 admissions, and 150 days spent in the hospital. In conclusion, this therapeutic regimen reduced the number of hospital admissions, days spent in the hospital, and emergency room visits. Our study supports the concept that the use of intermittent inotropic therapy in the outpatient setting plays an important role in managing this severely ill group of patients.