Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Jul 2011
Comparative StudyComparison of closure strategies after balloon aortic valvuloplasty: suture mediated versus collagen based versus manual.
To compare complication rates of a collagen-mediated closure device, suture-mediated closure technique and manual compression for access site management following balloon aortic valvuloplasty (BAV). ⋯ In our case series, collagen-based closure devices and suture-mediated closure devices had fewer vascular complications than manual compression for hemostasis following BAV. Patient selection for collagen-based versus suture-mediated closure requires further study.
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Catheter Cardiovasc Interv · Jul 2011
Comparative StudyUse of a dose-dependent follow-up protocol and mechanisms to reduce patients and staff radiation exposure in congenital and structural interventions.
Increasingly complex structural/congenital cardiac interventions require efforts at reducing patient/staff radiation exposure. Standard follow-up protocols are often inadequate in detecting all patients that may have sustained radiation burns. ⋯ Dose-based follow-up protocols are superior in detecting radiation burns when compared to fluoroscopy time-based protocols. Frame rate reduction of fluoroscopy and cine acquisition and use of modified imaging equipment can achieve a significant reduction to patient/staff exposure.
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Catheter Cardiovasc Interv · Jul 2011
Transaortic flow velocity from dual-source MDCT for the diagnosis of aortic stenosis severity.
To describe a method for the estimation of transaortic flow from multidetector computer tomography (MDCT). ⋯ We show for the first time that transaortic flow velocity can be estimated by dual-source MDCT and has a better sensitivity for the detection of severe aortic stenosis than AVA planimetry when compared to the gold standard of TTE peak flow velocity.
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Catheter Cardiovasc Interv · Jul 2011
Case ReportsTwo-step approach of percutaneous closure of a paravalvular leak and atrial septal defect after mitral valve reoperation.
Severe paravalvular leakage following mitral valve replacement, a rare but potentially serious complication, may result in heart failure and significant hemolysis. Reoperation is considered standard of care. However, in selected patients, re-do sternotomy carries excessively high surgical risk. ⋯ We present a case of a highly symptomatic 42-year-old male who underwent successful percutaneous closure of two paravalvular leaks and a post-operative atrial septal defect after re-do mitral valve replacement surgery. As access to the left atrium was expected to be difficult following percutaneous atrial septal defect closure, a two-step approach of paravalvular leak closure followed by atrial septal defect closure was chosen. Difficulties of atrial septal defect closure following closure of a paravalvular leak next to the inter-atrial septum will be discussed.
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Catheter Cardiovasc Interv · Jul 2011
Hybrid aortic reconstruction for treatment of recurrent aortic obstruction after stage 1 single ventricle palliation: medium term outcomes and results of redilation.
We describe a hybrid approach to the treatment of aortic obstruction after stage 1 palliation (S1P) of hypoplastic left heart syndrome. ⋯ HAR allows for placement of stents that can ultimately reach adult size in small infants who have recurrent aortic obstruction after balloon angioplasty following S1P. Advantages include freedom from delivery sheath constraints when determining stent type/size, facilitation of precise stent position, and avoidance of vascular damage or hemodynamic compromise during the procedure. Longer follow-up and larger experience are required to determine if this therapy will provide a long-term solution to this difficult problem.