Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Nov 2006
Case ReportsLate migration of a Sideris buttoned device for occlusion of atrial septal defect.
We describe a 17-year-old patient with an atrial septal defect who underwent device closure with a second generation Sideris buttoned device at 4 years of age. She presented 13 years after the procedure with the acute onset of chest discomfort, at which time a chest radiograph showed migration of the wire of the right atrial counter-occluder to the lateral aspect of the right atrial wall, with an associated right atrial perforation. The patient underwent uneventful surgical device retrieval and atrial septal defect closure. Late migration of a portion of the Sideris buttoned device can occur, suggesting the need for continued follow up, and a high index of suspicion for device failure should a patient become symptomatic.
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Catheter Cardiovasc Interv · Nov 2006
Case ReportsFailure of cutting balloon angioplasty to prevent restenosis in childhood pulmonary venous stenosis.
We describe bilateral pulmonary vein stenosis in a 5-year-old boy. He initially presented with haemoptysis secondary to left upper lobe pulmonary vein atresia and left lower lobe stenosis and subsequently he underwent left-sided pneumonectomy. ⋯ Despite satisfactory initial results the pulmonary venous stenosis reoccurred as early as 2 months following balloon angioplasty. Although cutting balloon angioplasty has demonstrated effective immediate alleviation of pulmonary venous stenosis its utility in providing sustained improvement in pulmonary vein stenosis is limited.
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Catheter Cardiovasc Interv · Sep 2006
Comparative StudySubcutaneous administration of nitroglycerin to facilitate radial artery cannulation.
To study the effect of sublingual versus subcutaneous nitroglycerin on radial artery spasm caused by failed access attempts. ⋯ Subcutaneous administration of nitroglycerin is superior in facilitating radial artery cannulation after initial failed attempt.
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Catheter Cardiovasc Interv · Sep 2006
Case ReportsPercutaneous ex-vivo femoral arterial bypass: a novel approach for treatment of acute limb ischemia as a complication of femoral arterial catheterization.
This report describes the use of a percutaneous ex-vivo femoral arterial bypass in three patients with acute lower extremity ischemia that occurred as a complication of femoral artery catheterization. Utilizing standard equipment and techniques, a percutaneous ex-vivo femoral artery bypass can restore antegrade flow to the ischemic limb in patients with impaired aorto-iliac inflow circulation, which may arise from iatrogenic dissection or the need for large in-dwelling sheaths required for hemodynamic support. This technique is considered a temporizing measure when conventional therapies are not possible. Contrast angiography is recommended to localize and define the cause of limb ischemia, and to permit safe placement of vascular sheaths in the "donor and recipient" arteries.