Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Feb 2009
Case ReportsTranscatheter membranous ventricular septal defect closure through a mechanical aortic prosthesis using the Amplatzer membranous ventricular septal defect occluder.
An iatrogenic ventricular septal defect (VSD) after aortic valve replacement is rare, but represents a significant complication. Repeat surgery to repair such a defect carries a high surgical risk. ⋯ We describe the successful transcatheter closure of an iatrogenic VSD with an Amplatzer membranous VSD occluder in a patient with previous combined mitral and aortic mechanical valve replacements. The device was implanted through a CarboMedics mechanical valve in the aortic position.
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Catheter Cardiovasc Interv · Feb 2009
Stenting of stenotic or occluded iliofemoral veins, superior and inferior vena cavae in children with congenital heart disease: acute results and intermediate follow up.
To determine the short and intermediate term outcome following systemic venous stent placement in children with congenital heart disease. ⋯ Systemic venous stents are safe and effective in recanalizing stenosed or occluded vessels. At follow-up, reocclusion can occur, however, previously placed stents can be safely recanalized if necessary. Future studies will determine if stenting is indicated in a broader population.
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Catheter Cardiovasc Interv · Jan 2009
Multicenter StudyMulticenter international registry of unprotected left main coronary artery percutaneous coronary intervention with drug-eluting stents in patients with myocardial infarction.
Patients who present with myocardial infarction (MI) and unprotected left main coronary artery (ULMCA) disease represent an extremely high-risk subset of patients. ULMCA percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in MI patients has not been extensively studied. ⋯ Patients with MI and ULMCA disease represent a very high-risk subgroup of patients who are critically ill. PCI with DES appears to be technically feasible, associated with acceptable long-term outcomes, and a reasonable alternative to surgical revascularization for MI patients with ULMCA disease. Randomized trials are needed to determine the ideal revascularization strategy for these patients.
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Catheter Cardiovasc Interv · Jan 2009
Comparative StudyPCI versus CABG for multivessel coronary disease in diabetics.
To explore the clinical performance of a strategy of revascularization by percutaneous coronary intervention (PCI) with drug-eluting stent (DES) in diabetic patients with multivessel disease (MVD) compared with coronary artery bypass graft (CABG), when it is based on clinical judgment. ⋯ For patients with DM and MVD, a clinical judgment-based revascularization by DES-PCI is not associated with worse 2-year outcome compared with CABG.
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Catheter Cardiovasc Interv · Jan 2009
Clinical TrialAerosolized iloprost for pulmonary vasoreactivity testing in children with long-standing pulmonary hypertension related to congenital heart disease.
In congenital heart disease with increased pulmonary blood flow and pressure, progressive changes in the vascular structure can lead to irreversible pulmonary hypertension (PH). Pulmonary hemodynamic parameters are used to determine whether surgical correction is no longer indicated. In this study, aerosolized iloprost was used to assess pulmonary vasoreactivity in children with long-standing PH related to congenital heart disease. ⋯ Iloprost-induced pulmonary vasodilator responses vary among children with PH related to congenital heart disease. The use of inhaled iloprost in the cardiac catheterization laboratory results in pulmonary vasoreactivity for some of these children particularly a reduction in PVR and the pulmonary-to-systemic vascular resistance ratio.