Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Sep 2001
Platypnea-orthodeoxia: management by transcatheter buttoned device implantation.
Dyspnea and arterial desaturation on upright position in elderly subjects is described as platypnea-orthodeoxia syndrome (POS) and in some patients it is due to right-to-left shunt across the atrial septal defect (ASD)/patent foramen ovale (PFO). Surgical closure of ASD/PFO has been the only available treatment option. Buttoned device has been used for occlusion of ostium secundum ASD, PFO associated with presumed paradoxical embolism and cerebrovascular accidents and ASD/PFO in association with other congenital heart defects causing right-to-left shunt. ⋯ Follow-up of 1-36 months (median 12 months) revealed persistent improvement of symptoms. Buttoned device occlusion of ASD/PFO to relieve hypoxemia of POS is feasible, safe, and effective and is an excellent alternative to surgery. Cathet Cardiovasc Intervent 2001;54:77-82.
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Catheter Cardiovasc Interv · Sep 2001
Case ReportsSimultaneous transcatheter occlusion of two atrial baffle leaks and stent implantation for SVC obstruction in a patient after Mustard repair.
A 19.5-year-old patient after Mustard operation was found to have baffle leaks and obstruction. This patient underwent successful device closure of the leaks using the Amplatzer device and stent implantation with complete resolution of the symptoms. Cathet Cardiovasc Intervent 2001;54:72-76.
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Catheter Cardiovasc Interv · Jun 2001
Comparative StudyMinor myocardial injury after elective uncomplicated successful PTCA with or without stenting: detection by cardiac troponins.
Cardiac troponins are sensitive and specific markers for the detection of minor myocardial injury. However, they have been rarely used to monitor myocardial injury after coronary stenting. The purpose of the study was to measure cardiac troponin I (cTnI) and cardiac troponin T (cTnT) levels after elective uncomplicated successful percutaneous transluminal coronary angioplasty (PTCA) with or without coronary stenting and to compare their results with serum creatinine kinase MB isoenzyme (CKMB). ⋯ Cardiac troponins, especially cTnI, are more sensitive than CKMB for the detection of this minor myocardial injury. Total time of inflation and inflation maximal pressure are predictors of postprocedural elevation of cardiac troponins. Side-branch occlusion may account for some, but not all, periprocedural minor myocardial injury.
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Catheter Cardiovasc Interv · Apr 2001
Case ReportsRight heart catheterization in the presence of an inferior vena cava filter.
Inferior vena cava filters are being inserted with increasing frequency. When such patients later require right heart catheterization, brachial or jugular vein access is usually attempted. ⋯ There were no complications, and in no case did the filter migrate or become dislodged. This technique may prove useful when right heart catheterization is indicated in a patient who has a Greenfield inferior vena cava filter.
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Catheter Cardiovasc Interv · Mar 2001
Case ReportsStent implantation for superior vena cava occlusion after the Mustard operation.
A 25-year-old man who had undergone a Mustard repair for complete transposition of the great arteries 21 years previously developed complete occlusion of the superior vena cava and obstruction of the inferior vena cava. Transcatheter recanalization was performed using needle puncture of the superior obstruction followed by stent implantation into both systemic venous pathways with relief of obstructive symptoms.