736 results match your criteria atrial septostomy


Hemodynamic adaptation of heart failure to percutaneous venoarterial extracorporeal circulatory supports.

Authors:
P Hála O Kittnar

Physiol Res 2020 11 9;69(5):739-757. Epub 2020 Sep 9.

Department of Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.

Extracorporeal life support (ECLS) is a treatment modality that provides prolonged blood circulation, gas exchange and can partially support or fully substitute functions of heart and lungs in patients with severe but potentially reversible cardiopulmonary failure refractory to conventional therapy. Due to high-volume bypass, the extracorporeal flow is interacting with native cardiac output. The pathophysiology of circulation and ECLS support reveals significant effects on arterial pressure waveforms, cardiac hemodynamics, and myocardial perfusion. Read More

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November 2020

Beyond transplant: Roles of atrial septostomy and Potts shunt in pediatric pulmonary hypertension.

Pediatr Pulmonol 2021 03 11;56(3):656-660. Epub 2020 Sep 11.

Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA.

Despite significant successes in treating children with pulmonary hypertension, many still die from their disease. Death most often results from right ventricular failure. Bilateral lung transplantation has historically been the ultimate palliation for children who develop heart failure despite maximal medical therapy. Read More

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Aortic Root Thrombosis on ECMO-A Novel Management Strategy.

World J Pediatr Congenit Heart Surg 2020 09;11(5):643-645

Division of Pediatric Cardiology, Department of Pediatrics, 14444Rady Children's Hospital, University of California, San Diego, CA, USA.

A 15-year-old presented in cardiogenic shock secondary to viral myocarditis requiring venoarterial extracorporeal membrane oxygenation (ECMO) support. He developed large thrombi of the left ventricle and aortic root. Anticoagulation was increased, and medications were initiated to decrease the likelihood of aortic valve opening. Read More

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September 2020

Performing an urgent neonatal cardiac intervention safely during the COVID-19 pandemic.

Prog Pediatr Cardiol 2021 Mar 25;60:101265. Epub 2020 Jun 25.

Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Irving Medical Center, Morgan Stanley Children's Hospital, New York, NY, USA.

The current pandemic has driven the medical community to adapt quickly to unprecedented challenges. Among these challenges is the need to minimize staff exposure to COVID-19 during neonatal cardiac procedures. In this report, we describe measures we have taken to protect health care workers while ensuring successful outcomes. Read More

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The evolving role of interventional cardiology in the treatment of pulmonary hypertension.

Catheter Cardiovasc Interv 2021 03 1;97(4):E446-E453. Epub 2020 Aug 1.

Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota.

Pulmonary hypertension (PH) is a heterogeneous group of diseases defined by a mean pulmonary arterial pressure greater than 20 mmHg. Clinically, PH is classified into five groups and the group of PH generally defines the cause of PH and the therapeutic options. Currently, medical therapies that target the prostacyclin, endothelin, and nitric oxide pathways are used in pulmonary arterial hypertension and chronic thromboembolic PH (CTEPH) patients. Read More

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Urgent neonatal balloon atrial septostomy in simple transposition of the great arteries: predictive value of fetal cardiac parameters.

Ultrasound Obstet Gynecol 2021 05;57(5):756-768

Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.

Objectives: To investigate the impact of abnormal perinatal loading conditions on cardiac geometry and function in term fetuses and neonates with transposition of the great arteries with intact interventricular septum (simple TGA), and to explore the predictive value of fetal cardiac parameters for an urgent balloon atrial septostomy (BAS) after birth.

Methods: This was a prospective longitudinal follow-up study of women delivering at term, including both uncomplicated pregnancies with normal outcome and pregnancies affected by fetal simple TGA. Conventional, spectral-tissue Doppler and speckle-tracking echocardiographic parameters were obtained within 1 week before delivery and within the first few hours after delivery. Read More

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Veno-venous Extracorporeal Membrane Oxygenation for Right Ventricular Failure with Atrial Septostomy After Corrective Repair of Tetralogy of Fallot.

Int Heart J 2020 ;61(4):848-850

Division of Cardiovascular Surgery, Department of Surgery, Mackay Memorial Hospital.

Right ventricular (RV) dysfunction may occur after cardiac surgery and it is not rare after corrective repair of tetralogy of Fallot (TOF). If traditional treatments with volume management, infusion of inotropic agents, and use of pulmonary vasodilators cannot stabilize the patient, extracorporeal membrane oxygenation (ECMO) or a ventricular assist device (VAD) will be considered as the last resort. Here, we report a young infant patient with RV failure after corrective repair of TOF and without closure of an atrial septal defect (ASD), who was rescued by veno-venous (VV) -ECMO. Read More

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Supraventricular tachycardia in one of the twins: The ethical dilemmas involved in treatment.

Ann Pediatr Cardiol 2020 Apr-Jun;13(2):150-152. Epub 2020 Apr 13.

Department of Obstetrics and Gynaecology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.

The pediatric cardiologist now has an important role to play in fetal medicine. They are often called upon to manage fetal cardiac problems such as arrhythmias or perform fetal cardiac interventions such as balloon valvuloplasty or atrial septostomy. In these scenarios, it becomes very important for the pediatric cardiologist to understand the concepts of "fetus as a patient," "viability," etc. Read More

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Transcatheter balloon atrial septostomy in thoraco-omphalopagus conjoined twins.

Postepy Kardiol Interwencyjnej 2020 Jun 23;16(2):209-212. Epub 2020 Jun 23.

Department of Pediatrics, Division of Pediatric Cardiology, University of Minnesota, Masonic Children's Hospital, Minneapolis, MN, USA.

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Prenatal Diagnosis of Transposition of the Great Arteries Reduces Postnatal Mortality: A Population-Based Study.

Can J Cardiol 2020 10 20;36(10):1592-1597. Epub 2020 Jan 20.

The Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address:

Background: Transposition of the great arteries (TGA) may present as a life-threatening neonatal malformation. Although prenatal detection facilitates the perinatal management, the impact on outcome is controversial.

Methods: This study reviewed the differences in prenatal diagnosis of TGA from 2009 to 2014 among the 5 geographic areas in Ontario and compared the management, morbidity, and mortality among neonates with a prenatal (prenatal cohort; n = 70) vs a postnatal (postnatal cohort; n = 76) anomaly diagnosis. Read More

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October 2020

Balloon atrial septostomy and transition of subcutaneous to intravenous prostacyclin infusion for rescuing advanced right heart failure in idiopathic pulmonary arterial hypertension: a case report.

Eur Heart J Case Rep 2020 Jun 3;4(3):1-5. Epub 2020 May 3.

Cardiovascular Center, Taichung Veterans General Hospital, No. 1650. Sec. 4, Taiwan Boulevard, Taichung 40705, Taiwan.

Background: Intravenous (IV) prostacyclin analogues infusion and balloon atrial septostomy (BAS) are two important treatment options for managing advanced right heart failure in patients with idiopathic pulmonary arterial hypertension (IPAH). References and protocols are rare for dose titrations and transitions between subcutaneous and IV prostacyclin in functional Class IV IPAH patients. Balloon atrial septostomy is rarely done in very few expert centres. Read More

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Transposition of the Great Arteries-Are We Doing Better? Correlating Outcome to Change in Renal Function Over 2 Decades of Arterial Switch Operation.

Pediatr Crit Care Med 2020 09;21(9):e782-e788

Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.

Objectives: It is believed that management of neonates with dextro-transposition of the great arteries is constantly improving. Renal function may play a role in the prognosis of patients after congenital heart surgery. The aim of this study was to describe the outcome of neonates who underwent arterial switch operation during the past 2 decades using renal function as a surrogate marker for morbidity and mortality. Read More

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September 2020

Improving transport time for babies with antenatally diagnosed transposition of the great arteries reduces the need for ECMO.

J Perinatol 2020 10 11;40(10):1570-1575. Epub 2020 May 11.

Murdoch Children's Research Institute, Melbourne, VIC, Australia.

Objective: To assess the effect of reducing retrieval team response time on the outcomes of babies born outside a cardiac centre (outborn) with antenatally diagnosed transposition of the great arteries.

Study Design: Retrospective cohort study of all outborn babies with antenatally diagnosed TGA anticipated to require transfer for urgent balloon atrial septostomy over a 6-year period (15 babies pre intervention and 27 post intervention). The intervention involved a collaborative multicomponent practice change aiming to reduce retrieval team response time. Read More

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October 2020

A Case of Delayed Presentation of Transposition of the Great Arteries.

Pediatr Emerg Care 2020 Feb 22. Epub 2020 Feb 22.

From the Western Michigan University School of Medicine, Kalamazoo, MI.

Intro: Transposition of the great arteries (TGA) is a rare cyanotic congenital heart defect (CHD) typically presenting the first month of life. Late presentations may occur in patients with associated cardiac anomalies allowing for mixing of oxygenated and deoxygenated blood, such as ventral septal defects or large atrial septal defects (ASD). We present a case of a late-presenting TGA with no ventral septal defect, and only small ASD and patent ductus arteriosus (PDA). Read More

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February 2020

Identification of Risk Factors for Early Fontan Failure.

Semin Thorac Cardiovasc Surg 2020 Autumn;32(3):522-528. Epub 2020 Feb 20.

Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, New York. Electronic address:

Despite improvements in operative and perioperative care, the risk of significant morbidity and mortality for children undergoing Fontan procedures persists. Previous investigations have identified peri-Fontan characteristics that may predict early adverse events. The purpose of this study was to identify characteristics from throughout a patient's lifespan, including all perioperative stages, that might predict early Fontan failure-defined as death, Fontan takedown, or listing for cardiac transplantation before hospital discharge or within 30 postoperative days. Read More

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October 2020

The results of interventional catheterization in infants weighing under 2,000 g.

Turk Gogus Kalp Damar Cerrahisi Derg 2019 Jul 21;27(3):304-313. Epub 2019 Jun 21.

Department of Cardiovascular Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.

Background: The aim of this study was to evaluate the early and mid-term results of interventional cardiac catheterization and procedure-related complications in infants weighing <2,000 g.

Methods: Between May 1998 and April 2017, 22 patients (14 males, 8 females; mean age 14±8.4 days; range, 1 to 30 days) weighing <2,000 g who underwent a total of 23 interventional cardiac catheterization were retrospectively analyzed. Read More

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Prenatal risk factors for urgent atrial septostomy at birth in fetuses with transposition of the great arteries: a systematic review and meta-analysis.

J Matern Fetal Neonatal Med 2020 Feb 10:1-9. Epub 2020 Feb 10.

Department of Obstetrics and Gynaecology, Ospedali Riuniti, University of Foggia, Foggia, Italy.

To explore the role of fetal echocardiography in predicting the risk of urgent balloon atrial septostomy (BAS) at birth in fetuses diagnosed with transposition of the great arteries (TGA). Medline, Embase, and Cochrane databases were searched. The primary aim was to explore the differences in prenatal echocardiographic parameters among fetuses diagnosed with TGA that required urgent BAS within 24 h of birth due to life-threatening cyanosis compared to those who did not require such procedure. Read More

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February 2020

The hemodynamic effect of different left ventricular unloading techniques during veno-arterial extracorporeal life support: a systematic review and meta-analysis.

Perfusion 2020 10 17;35(7):664-671. Epub 2020 Jan 17.

Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.

Background: Pulmonary edema and left ventricular thrombosis may arise during veno-arterial extracorporeal life support due to an increase in cardiac load. This mechanical stress can be reduced through different left ventricular unloading techniques. We set out to quantitatively summarize the hemodynamic effects of available methods in patients treated with veno-arterial extracorporeal life support. Read More

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October 2020

A novel unidirectional-valved shunt approach for end-stage pulmonary arterial hypertension: Early experience in adolescents and adults.

J Thorac Cardiovasc Surg 2021 Apr 14;161(4):1438-1446.e2. Epub 2019 Nov 14.

Departments of Thoracic & Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn; Department of Biomedical Engineering, Columbia University, New York, NY. Electronic address:

Objectives: Despite advances in treatment of idiopathic pulmonary arterial hypertension (IPAH), there remains no medical cure, and patients can experience disease progression leading to right heart failure, progressive exercise intolerance, and death. The reversed Potts shunt (left pulmonary artery to descending aorta) was reintroduced for treatment of end-stage IPAH to permit decompression of the suprasystemic right ventricle by right to left shunting, with preservation of upper body oxygenation. The shunt has the potential to delay the need for lung transplantation and offer a treatment for those who are transplant ineligible. Read More

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Successful multimodality management of severe pulmonary arterial hypertension during pregnancy with VA-ECMO and atrial septostomy using stent.

BMJ Case Rep 2019 Dec 2;12(12). Epub 2019 Dec 2.

Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

A 30-year-old Thai woman (gravida 1, para 0) at 33 weeks gestation was referred to our hospital due to acute right ventricular failure. Pulmonary vasodilators were gradually administered before delivery. On the verge of sudden postpartum cardiac circulation collapse, she was resuscitated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Read More

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December 2019

A unique indication for the senning procedure: Atrioventricular discordance with ventriculoarterial concordance.

J Card Surg 2020 Feb 3;35(2):444-446. Epub 2019 Dec 3.

Division of Cardiothoracic Surgery, American Family Children's Hospital, University of Wisconsin, Madison, Wisconsin.

Objective: We describe experience treating a patient with atrioventricular (AV) discordance with ventriculoarterial (VA) concordance, ventricular septal defect (VSD), and situs inversus. This is a rare congenital lesion in which closing the VSD would septate D-transposition physiology and performing an arterial switch and VSD closure would produce congenitally corrected transposition of the great arteries physiology. As such, it is the only lesion for which an isolated atrial switch (and VSD closure) remains the preferred correction. Read More

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February 2020

Graded balloon atrial septostomy for palliation of congenital pulmonary hypertension in a dog: A case report.

J Vet Intern Med 2020 Jan 26;34(1):283-288. Epub 2019 Nov 26.

VCA West Los Angeles, Los Angeles, California.

Case Description: A 6-month-old intact female Maltese dog was presented for acute onset of syncope.

Clinical Findings: The dog was presented for collapse upon excitement and exercise. It collapsed at discharge and suffered cardiopulmonary arrest. Read More

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January 2020

Outcomes of hypoplastic left heart syndrome: analysis of National Inpatient Sample Database 1998-2004 versus 2005-2014.

Eur J Pediatr 2020 Feb 18;179(2):309-316. Epub 2019 Nov 18.

Department of Pediatric Critical Care, Cleveland Clinic Children's, 9500 Euclid Ave. M14, Cleveland, OH, 44195, USA.

Neonates with hypoplastic left heart syndrome (HLHS) were identified from the National Inpatient Sample dataset for the years 1998-2014. These patients were stratified into two chronological groups, past group (1998-2005) and recent group (2006-2014). A total of 20,649 neonates with HLHS were identified. Read More

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February 2020

Central Extracorporeal Membrane Oxygenation and Early Rehabilitation for Persistent Severe Pulmonary Hypertension Following Pulmonary Endarterectomy.

Acute Crit Care 2019 May 7;34(2):158-164. Epub 2018 Nov 7.

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Chronic thromboembolic pulmonary hypertension is potentially curable with a pulmonary endarterectomy. However, approximately 20% of patients have persistent pulmonary hypertension after pulmonary endarterectomy, which is a major risk factor for postoperative death. Here, we report a 34-year-old woman who suffered persistent severe pulmonary hypertension following a successful pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Read More

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Modified Septostomy in d-Transposition of Great Arteries With Aneurysmal and Intact Atrial Septum.

World J Pediatr Congenit Heart Surg 2019 11;10(6):789-790

Department of Pediatric Cardiology and Adult Congenital Heart Disease, Mitera Children's Hospital, Athens, Greece.

A male term patient was delivered electively due to prenatal diagnosis of d-transposition of great arteries. Postpartum arterial saturation measured 65%. Transthoracic echo revealed an extremely aneurysmal atrial septum with no obvious atrial septal defect. Read More

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November 2019

Prevalence and Outcomes of Balloon Atrial Septostomy in Neonates With Transposition of Great Arteries.

Pediatr Crit Care Med 2020 04;21(4):324-331

Department of Neonatology, Cleveland Clinic Children's, Cleveland, OH.

Objectives: Transposition of the great arteries is the most common cyanotic congenital heart defect. Surgical correction usually occurs in the first week of life; presence of restrictive interatrial communication and severe hypoxemia warrants urgent intervention with balloon atrial septostomy and medical stabilization prior to surgery. The main objective of this study is to compare the characteristics, outcomes, and mortality risks in patients with transposition of the great arteries who underwent balloon atrial septostomy during their hospitalization versus transposition of the great arteries patients who have not undergone this procedure. Read More

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Preoperative Venovenous Extracorporal Membrane Oxygenation for Transposition of Great Arteries With Severe Pulmonary Hypertension in a Newborn.

Ann Thorac Surg 2020 05 3;109(5):e329-e330. Epub 2019 Oct 3.

Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong.

Severe persistent pulmonary hypertension in a newborn combined with transposition of great arteries increases the risk of early death before the arterial switch operation. We report the case of a newborn with transposition of great arteries and ventricular septal defect associated with severe pulmonary hypertension. Profound hypoxemia, despite successful balloon atrial septostomy and conventional supportive measures with mechanical ventilation, inhaled nitric oxide, and inotropes, led to the use of venovenous extracorporeal membrane oxygenation to rapidly stabilize the child preoperatively. Read More

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Strategies for Left Ventricular Decompression During Venoarterial Extracorporeal Membrane Oxygenation - A Narrative Review.

J Cardiothorac Vasc Anesth 2020 Jan 26;34(1):208-218. Epub 2019 Aug 26.

Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore; Department of Anaesthesiology, Singapore General Hospital, Singapore. Electronic address:

Extracorporeal cardiopulmonary resuscitation involves the application of venoarterial extracorporeal membrane oxygenation for patients in cardiac arrest who have received good quality conventional cardiopulmonary resuscitation, and who are deemed to have a reversible cause and no contraindications. Systemic perfusion is maintained by the extracorporeal life support, allowing time for the underlying cause to be treated and the heart to recover. Specific considerations to promote cardiac recovery are discussed, including the maintenance of sinus rhythm, promotion of cardiac ejection, management of pulmonary hypertension, management of intravascular volume, and prevention of ventricular distention. Read More

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January 2020

Can fetal echocardiograms reliably predict the need for urgent balloon atrial septostomy in transposition of the great arteries?

Arch Dis Child 2019 11 17;104(11):1114-1116. Epub 2019 Aug 17.

Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.

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November 2019

Transvenous implantation of the Occlutech Atrial Flow Regulator: Preliminary results from swine models.

Congenit Heart Dis 2019 Sep 22;14(5):819-831. Epub 2019 Jul 22.

Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Aurora, Colorado.

Aims: To evaluate in domestic pigs the histopathological processes after implanting the Occlutech Atrial Flow Regulator (AFR).

Methods And Results: Eleven pigs were chosen and had successful implantation of the AFR. Five pigs were sacrificed at 28 days, and 5 pigs at 90 days. Read More

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September 2019