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  • Open Access

    ARTICLE

    Perforation of the atretic pulmonary valve using chronic total occlusion (CTO) wire and coronary microcatheter

    Bruno Lefort1,2, Christophe Saint‐Etienne1, Nathalie Soulé1, Iris Ma1, Fanny Dion1, Alain Chantepie1,2

    Congenital Heart Disease, Vol.14, No.5, pp. 814-818, 2019, DOI:10.1111/chd.12812

    Abstract Background and objective: Chronic total occlusion (CTO) guidewire have been recently reported as an alternative to radiofrequency for perforating atretic pulmonary valve. Since procedure failures or perforation of the right ventricle still occurred with CTO, we tried to enhance the stability, steering, and pushability of the wire using a microcatheter in order to improve the safety and efficacy of the procedure.
    Methods: We performed pulmonary valve perforation with CTO guidewire and microcatheter in five consecutive newborns with pulmonary atresia with intact ventricular septum (PA‐IVS) under fluoroscopic and echocardiographic control.
    Results: The valve was easily perforated at the first… More >

  • Open Access

    ARTICLE

    Echocardiographic parameters associated with biventricular circulation and right ventricular growth following right ventricular decompression in patients with pulmonary atresia and intact ventricular septum: Results from a multicenter study

    Shiraz A. Maskatia1, Christopher J. Petit2,3, Curtis D. Travers2, David J. Goldberg4, Lindsay S. Rogers4, Andrew C. Glatz4, Athar M. Qureshi6, Bryan H. Goldstein5, Jingning Ao2,3, Ritu Sachdeva2,3

    Congenital Heart Disease, Vol.13, No.6, pp. 892-902, 2018, DOI:10.1111/chd.12671

    Abstract Background: In patients with pulmonary atresia, intact ventricular septum (PA/IVS) following right ventricular (RV) decompression, RV size and morphology drive clinical outcome. Our objectives were to (1) identify baseline and postdecompression echo‐ cardiographic parameters associated with 2V circulation, (2) identify echocardio‐ graphic parameters associated with RV growth and (3) describe changes in measures of RV size and changes in RV loading conditions.
    Methods: We performed a retrospective analysis of patients who underwent RV de‐ compression for PA/IVS at four centers. We analyzed echocardiograms at baseline, postdecompression, and at follow up (closest to 1‐year or prior to Glenn… More >

  • Open Access

    ARTICLE

    Achieving biventricular circulation in patients with moderate hypoplastic right ventricle in pulmonary atresia intact ventricular septum after transcatheter pulmonary valve perforation

    Robin H.S. Chen1, Adolphus K.T. Chau1, Pak Cheong Chow1, Tak Cheung Yung1, Yiu Fai Cheung1,2, Kin Shing Lun1

    Congenital Heart Disease, Vol.13, No.6, pp. 884-891, 2018, DOI:10.1111/chd.12658

    Abstract Objective: Transcatheter valve perforation for pulmonary atresia intact ventricular septum is the standard of care for patients with mild right ventricular hypoplasia. However, its role in moderate right ventricular hypoplasia has been less well defined. We sought to report the long‐term outcome of patients with moderate hypoplastic right ventricle who had undergone the procedure.
    Design, Settings, and Patients: We performed a retrospective analysis on patients who had undergone transcatheter pulmonary valve perforation from January 1996 to January 2015 at our institution. The procedures would be carried out irrespective of the right ventricular size, as long as there… More >

  • Open Access

    ARTICLE

    Perforation and right ventricular outflow tract stenting: Alternative palliation for infants with pulmonary atresia/ventricular septal defect

    David Aurigemma, John W. Moore, Gabrielle Vaughn, Nasser Moiduddin, Howaida G. El-Said

    Congenital Heart Disease, Vol.13, No.2, pp. 226-231, 2018, DOI:10.1111/chd.12552

    Abstract Background: Right ventricular outflow tract (RVOT) stents have been used as palliation in patients with severe tetralogy of Fallot (TOF). Radiofrequency perforation of the RVOT has also been described in patients with pulmonary atresia (PA)/ventricular septal defect (VSD). However, RVOT stenting in conjunction with radiofrequency perforation as a means for establishing reliable pulmonary blood flow in patients with PA/VSD has not previously been reported.
    Objectives: Our aim is to report our experience with using perforation of plate-like pulmonary valve atresia combined with stenting of RVOT as an alternative and equally efficacious intervention for infants with PA/VSD, as… More >

  • Open Access

    ARTICLE

    Aortic perfusion score for pulmonary atresia with intact ventricular septum: An antegrade coronary perfusion scoring system that is predictive of need for transplant and mortality

    Rohit S. Loomba1,2, Andrew N. Pelech1,2

    Congenital Heart Disease, Vol.13, No.1, pp. 92-97, 2018, DOI:10.1111/chd.12510

    Abstract Background: Pulmonary atresia with intact ventricular septum is a unique congenital malformation of the heart in which patients may undergo single-, two- or 1½- ventricle repair. Size of the tricuspid valve annulus, morphology of the right ventricle and presence of ventriculocoronary connections can all impact the selection of appropriate palliative strategy. We developed the aortic perfusion score, a novel scoring system based on anterograde coronary perfusion with the aim of being able to identify patients at risk for death or transplant.
    Methods: A retrospective study was conducted. Patients were included if an initial catheterization was done prior… More >

  • Open Access

    ARTICLE

    Stenting the vertical ductus arteriosus via axillary artery access using “wire-target” technique

    Tugcin Bora Polat

    Congenital Heart Disease, Vol.12, No.6, pp. 800-807, 2017, DOI:10.1111/chd.12512

    Abstract Objectives: To retrospectively review the outcome of stent placement in neonates with a vertical ductus, present a technique of ductal stenting via the axillary artery and compare it to ductal stening via the femoral venous access.
    Design: Nineteen patients with duct-dependent pulmonary circulations through a vertical ductus arteriosus were treated with stent implantation. Those patients were retrospectively included in the study. In the first nine of these cases, stent delivery was done transvenously. In the latter ten cases, we favored the axillary artery access to the transvenous approach for stenting the vertical ductus arteriosus. Wire-target technique was… More >

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