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Kobayashi Junjiro - - 2011
Although porcine aortic valves or pericardial tissue mounted on a stent have made implantation techniques easier, these valves sacrifice orifice area and increase stress at the attachment of the stent, which causes primary tissue failure. Optimizing hemodynamics to prevent patient-prosthetic mismatch and improve durability, stentless bioprostheses use was revived in ...
Gutiérrez-González Raquel - - 2010
Ventriculovascular shunts via the femoral vein have been described as a feasible alternative for cerebrospinal fluid diversion in those complex cases of hydrocephalus in which other accesses are discarded. However, experience is short. To our knowledge, only 4 cases have been reported in the literature to date. We report 2 ...
Arambepola Priyangee K - - 2010
Therapeutic parent artery occlusion has been routinely utilized for management of some intracranial aneurysms. One possible long-term complication of this procedure is "de novo" formation of aneurysms. The purpose of this paper is to estimate the incidence of de novo aneurysm formation, the time period between occlusion and formation, and ...
Karur Satish - - 2011
An infant with cyanotic cardiac disease that was palliated with a bidirectional cavopulmonary shunt developed progressive and worsening cyanosis 5 years after the surgical procedure. A large venous collateral was found to be decompressing the bidirectional Glenn shunt from the superior caval vein to the inferior caval vein and was ...
Nakamura Ken - - 2010
Coronary arteriovenous fistulas (CAF) and coronary artery aneurysms (CAA) are uncommon, but their detection has recently increased. In this case we succeeded in identifying the residual shunt flow by using an intraoperative fluorescence imaging technique with indocyanine green after surgical treatment. The photodynamic eye imaging system is based on fluorescence ...
Nabo Manal Mohamed Helmy - - 2010
The purpose of this study was to assess the feasibility of multidetector-row computed tomography (MDCT) for the evaluation of modified Blalock-Taussig (B-T) shunt in children with congenital heart disease associated with reduced pulmonary blood flow. A total of 25 consecutive patients (mean age, 2.6 ± 3.6 years; range, 2 months-16 ...
Vohra H A - - 2010
This is the first report of the construction of a modified Blalock-Taussig shunt using a Contegra conduit reinforced with Goretex in a 4-year-old boy. The patient had a complex cardiac history with a primary diagnosis of pulmonary atresia, hypoplastic right ventricle (RV) and RV-coronary artery fistula.
Cleuziou J - - 2010
Pulmonary atresia with intact ventricular septum (PA-IVS) is a complex congenital heart defect with a large variety of right heart-sided morphologies. We undertook a retrospective review of 86 patients with PA-IVS with a special emphasis on the angiographic findings. The aim of the study was to determine predictors for biventricular ...
Ballweg Jean A - - 2010
OBJECTIVE: We previously reported no difference in morbidity or mortality in a cohort of infants undergoing stage 1 and 2 reconstructions for hypoplastic left heart syndrome with either a modified Blalock-Taussig shunt or a right ventricular to pulmonary artery conduit. This article compares the hemodynamics and perioperative course at the ...
Rondelet Benoit - - 2010
Experimental left-to-right shunt-induced pulmonary arterial hypertension (PAH) can be partially prevented by the endothelin-A receptor blocker sitaxsentan or by the phosphodiesterase-5 inhibitor sildenafil. We hypothesized that the combined administration of these drugs would completely prevent shunt-induced PAH, arguing in favor of a major role of endothelial dysfunction in the initiation ...
Sanchez-Recalde Angel - - 2010
This case is the first report of slow-growing pseudoaneurysm after vessel dissection secondary to two stents implantation into classic Blalock Taussig shunt in a patient with pulmonary atresia and ventricular septal defect. Pseudoaneurysm was successfully excluded by a percutaneous approach with self-expandable stent graft deployment from the aorta to the ...
Kandakure Pramod Reddy - - 2010
Central aorta-pulmonary artery shunts have fallen into disfavor because of shunt thrombosis and congestive heart failure, and a modified Blalock-Taussig shunt via thoracotomy can lead to pulmonary artery hypoplasia and distortion. We reviewed the outcomes of a modified Blalock-Taussig shunt by a sternotomy approach in 20 infants from July 2007 ...
Biermann Jürgen - - 2010
A 69-year-old woman with an acute pulmonary embolism developed an intracardiac right-to-left shunt, which was diagnosed early on and quantified via biphasic transcardiopulmonary thermodilution curves. With transesophageal echocardiography, a patent foramen ovale and an impressive atrial right-to-left shunt were visualized.
Momin Eric N - - 2010
Ventriculoatrial (VA) shunting is commonly used to treat hydrocephalus when ventriculoperitoneal shunting has failed. Placement of a VA shunt in patients with narrowing or occlusion of the central veins presents considerable difficulty because few imaging modalities exist to safely and reliably insert a guidewire or atrial catheter past the occlusion. ...
Beck Carsten - - 2010
Since March 2008, the new Amplatzer duct occluder II (ADO II) has been used clinically for PDA closure in Europe. We report an interesting case of a 2(1/2)-year-old girl with a 3-mm conical shape PDA (type A PDA) who underwent uneventful implantation of 3/4 ADO II with complete closure by ...
Raja Shahzad G - - 2010
Over the last quarter of a century, improvements in antenatal diagnosis, preoperative care, neonatal surgical techniques, arch reconstruction, cardiopulmonary bypass strategies, catheter-based interventions and postoperative care have all resulted in dramatic improvements in the outcomes of the Norwood procedure for palliation of hypoplastic left heart syndrome. One such modification of ...
Verbelen Tom O - - 2010
PURPOSE: To describe our experience with balloon dilatation and stenting of modified systemic-to-pulmonary artery (PA) shunts in relation to an assessment and interpretation of the mechanical properties of thin-walled expandable polytetrafluoroethylene (ePTFE) stretch vascular grafts. METHODS: Our pediatric cardiology/cardiac surgery database was reviewed to identify all infants and children with ...
Dhawan Naresh - - 2010
The authors investigated the effects of intravenous etomidate on hemodynamics in children with congenital cardiac shunts. Prospective observational study. Catheterization laboratory in tertiary referral cardiac center. Thirty children with congenital cardiac shunt lesions. Fifteen children having congenital right to left shunts (group A) and 15 children with left to right ...
Ayaz Hossain Mohammad - - 2010
Introduction: Cerebrospinal fluid (CSF) diversion into the right atrium or peritoneal cavity is the mainstay of treatment for normotensive hydrocephalus. Unfortunately multiple shunt failures can lead to patients returning for repeat interventions, leaving drainage options limited. We present a case series of five patients requiring venous access for shunt placement. ...
Starr Joanne P - - 2010
Tetralogy of Fallot (TOF) is a cyanotic congenital cardiac defect that was first described by Stenson in 1672 and later named for Fallot, who in 1888 described it as a single pathological process responsible for (1) pulmonary outflow tract obstruction, (2) ventricular septal defect (VSD), (3) overriding aortic root, and ...
Gerrah Rabin - - 2011
Pulmonary artery (PA)-left atrial (LA) shunt models in piglets have been described, but technical details critical to limit morbidity/mortality and promote study of chronic cyanosis are lacking. Accordingly, we describe our experience with an optimized technique. In 25 6- to 8-wk-old Yorkshire piglets, a beveled, 8 mm, polytetrafluoroethylene tube graft ...
Ban Yukiko - - 2010
We report a Kawashima procedure (total cavopulmonary shunt) successfully carried out for asplenia syndrome, pulmonary atresia, and major aortopulmonary collateral arteries. At the age of 8, the patient underwent staged bilateral unifocalizations using confluent central pulmonary arteries concomitant with bilateral modified Blalock-Taussig shunts. As the result of an interrupted inferior ...
Krings Timo T Division of Neuroradiology, Department of Medical Imaging, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, - - 2010
Spinal vascular malformations are rare diseases with a wide variety of neurologic presentations. Their classification depends on the differentiation of shunting versus nonshunting lesions, the latter being the spinal cord cavernomas. In the shunting lesions, the next step in the proposed classification scheme is related to the feeding artery which ...
Moszura Tomasz - - 2010
Modified Blalock-Taussig (B-T) shunt occlusion results in a sudden reduction of pulmonary vascular perfusion, causing dramatic saturation drop and cyanosis which pose a direct hazard to a child's life. The results of percutaneous local r-tpa infusion, balloon angioplasty and additionally stent implantation in obstructed modified B-T shunts were studied to ...
Chan W S W - - 2010
This paper assesses the feasibility of transcatheter embolisation of arteriovenous shunts in patients with hepatocellular carcinoma, and reviews available embolic agents, based on our experience and a literature review. From 2001 to 2007, 11 patients with unresectable hepatocellular carcinoma and significant arteriovenous shunts underwent transcatheter embolisation of liver arteriovenous shunts. ...
Suzuki Yasuyuki - - 2010
There are some controversies regarding the usefulness of leaving additional pulmonary blood flow when establishing a bidirectional cavopulmonary shunt. From April 2002 to September 2008, 13 patients (mean age, 24 +/- 16 months) underwent a bidirectional cavopulmonary shunt procedure with fine adjustment of additional pulmonary blood flow, as an intermediate ...
Diller Gerhard-Paul - - 2010
Atrial septostomy is performed in patients with severe pulmonary arterial hypertension, and has been shown to improve symptoms, quality of life and survival. Despite recognized clinical benefits, the underlying pathophysiologic mechanisms are poorly understood. We aimed to assess the effects of right-to-left shunting on arterial delivery of oxygen, mixed venous ...
Monnin-Bares Val?rie - - 2010
The authors describe an endovascular technique to reduce shunt diameter in the management of transjugular intrahepatic portosystemic shunt (TIPS)-induced refractory hepatic encephalopathy. Five patients were treated with a constrained stent-graft by using a commercially available balloon-expandable stent-graft narrowed by using a lasso catheter. This offers the possibility of an adjustable ...
Newman Beverley - - 2010
BACKGROUND: Heterotaxy with polysplenia is associated with many cardiovascular anomalies including the occasional occurrence of congenital extrahepatic portosystemic shunts (CEPS). Missing this anomaly can lead to inappropriate and ineffective therapy. OBJECTIVE: To emphasize the importance and associated anatomy of CEPS in conjunction with heterotaxy with polysplenia. MATERIALS AND METHODS: Review ...
Sze Daniel Y - - 2010
Paradoxical embolization can occur when a right-to-left shunt allows a venous thromboembolus to escape filtration by the lungs. Venous collateral pathways draining into the left heart incited by superior vena cava obstruction are a rare acquired right-to-left shunt. Herein, the authors report on a case of transient ischemic attack in ...
Li Wei - - 2009
BACKGROUND: Abnormal apoptosis of pulmonary artery smooth muscle cells (PASMCs) is an important pathophysiological process in the pulmonary artery structural remodeling and pulmonary hypertension. We investigated possible effect of endogenous hydrogen sulfide (H2S) on apoptosis of PASMCs during the development of pulmonary hypertension induced by high pulmonary blood flow. METHODS: ...
Ruggiero Claudio - - 2010
Migration of the distal catheter into the heart is an extremely rare complication of ventriculoperitoneal shunt, with only 11 cases reported in literature; in only four of them, there was also the migration into the pulmonary artery. The authors report the case of a young patient with this rare complication ...
Ghosh J - - 2009
Management of symptomatic multifocal supra-aortic atherosclerotic disease presents a complex surgical challenge. We describe a novel approach where a temporary extra-corporeal femoro-carotid shunt was used to maintain cerebral perfusion during hybrid surgical and endovascular treatment for tandem supra-aortic lesions.
Santoro Giuseppe - - 2009
OBJECTIVES: The aim of this study was to compare the pulmonary artery (PA) growth after arterial duct (AD) stenting versus modified Blalock-Taussig shunt (MBTS) in neonates with congenital heart disease with duct-dependent pulmonary circulation (CHD-DPC). BACKGROUND: Arterial duct stenting is increasingly deemed a reliable alternative to surgical shunt in CHD-DPC. ...
Jung Sung Mee - - 2010
OBJECTIVE: To compare the effect of thoracic epidural local anesthetic, epidural opioid, and intravenous opioid on pulmonary shunt fraction, arterial oxygenation, and hemodynamic changes during one-lung ventilation (OLV) in patients undergoing thoracic surgery. DESIGN: A prospective, randomized, double-blind study. SETTING: A university hospital. PARTICIPANTS: Thirty-nine patients undergoing OLV for pulmonary ...
Lochner Piergiorgio - - 2010
The transesophageal echocardiography (TEE) and contrast-enhanced transcranial Doppler/Duplex ultrasonography (ceTCD) are complementary methods for diagnosing a right to left shunt across a patent foramen ovale. We report on a case of paradoxical embolism across a subclavian arterial-venous fistula. This case underlines the necessity of performing the ceTCD, as in this ...
Boixadera Helena - - 2010
A 48-year-old man with alcoholic liver cirrhosis and hepatic encephalopathy was found to have a large, spontaneous mesocaval shunt. The shunt was successfully occluded with the use of an Amplatzer Vascular Plug. To our knowledge, this is the first report of the use of this device to embolize a mesocaval ...
Hayabuchi Yasunobu - - 2011
Multidetector-row computed tomography visualized peripheral pulmonary artery patency in a 19-year-old female with a single ventricle and an occluded Blalock-Taussig shunt whereas conventional invasive angiography did not.
Bell Aaron - - 2009
OBJECTIVES: To determine whether noninvasive assessment of pulmonary artery flow (Qp) by cardiac magnetic resonance (CMR) would predict pulmonary vascular resistance (PVR) in patients with congenital heart disease characterized by an unrestricted left-to-right shunt. BACKGROUND: Patients with an unrestricted left-to-right shunt who are at risk of obstructive pulmonary vascular disease ...
Desai Tarak - - 2009
The Norwood stage 1 procedure was modified by Sano with right ventricle-pulmonary artery (RV-PA) conduit replacing BT shunt. In our institution, this has been further modified by placing the conduit from the RV outflow tract to the right side of the neo-aorta. Between April 2002 and October 2008, 227 modified ...
O'Kelly Cian J - - 2009
OBJECT: Chronic shunt-dependent hydrocephalus is a recognized complication of aneurysmal subarachnoid hemorrhage. While its incidence and risk factors have been well described, the long-term performance of shunts in this setting has not been not widely reported. METHODS: Using administrative databases, the authors derived a retrospective cohort of patients undergoing treatment ...
Sanikommu Vijaya - - 2009
Right to left shunting through a patent foramen ovale (PFO) or atrial septal defect (ASD) can cause platypnea-orthodeoxia even in a setting of normal pulmonary artery pressures. However, the late onset of symptoms despite the congenital origin of the anatomical defects is not well understood. We report a case series ...
Troisi Nicola - - 2010
The use of a carotid shunt is a well-accepted method for the prevention of cerebral ischemia during carotid surgery. Although carotid surgeons are familiar with the risks associated with shunt use, few reports have been published detailing the nature, incidence, or severity of shunt-related complications. We report on a patient ...
Fujii Yoko - - 2009
Three dogs presented for the evaluation of cardiac murmurs were diagnosed with aberrant arteriovenous shunts. All cases demonstrated the following findings: 1) relatively soft continuous murmur loudest at the left heart base resembling patent ductus arteriosus (PDA); 2) shunt flow signals in the pulmonary artery on echocardiography; and 3) no ...
Ruf Bettina - - 2010
We report a symptomatic newborn with Osler-Rendu-Weber syndrome, multiple and diffuse pulmonary arteriovenous malformations, and right-to-left shunting in the left lung. Right-to-left shunting was significantly decreased by selectively banding the left pulmonary branch artery and clipping one large feeding vessel so that total resection of the left lung could be ...
Iida Taku - - 2010
In this report, we describe a living donor liver transplantation (LDLT) in a patient (7-year-old boy) with Abernethy type 2 congenital extrahepatic portocaval shunts (CEPS). This patient underwent a surgical shunt ligation as the first treatment for pulmonary hypertension; pulmonary hypertension was improved and controlled successfully 4 years after the ...
Chan V L - - 2009
SETTING: Tertiary referral centres. OBJECTIVE: To provide comprehensive updates on the aetiologies, angiographic findings and outcomes of bronchial artery embolisation (BAE) for life-threatening haemoptysis in Hong Kong. DESIGN: Retrospective review of clinical records of consecutive patients presenting with life-threatening haemoptysis from 2000 to 2006. RESULTS: There were 3006 admissions due ...
Thaiyananthan Nandhitha N - - 2009
Anatomic right-to-left shunt causes hypoxemia that can pose a diagnostic challenge to clinicians. Among the many possible causes of right-to-left shunt, persistent left-sided superior vena cava (PLSVC) with an "unroofed" coronary sinus represents an uncommon congenital anomaly in which detection by saline-contrast echocardiogram (bubble echo) or contrast-enhanced CT scan requires ...
Divekar Abhay - - 2009
A 57-year-old man presented with symptomatic right-to-left shunts decades after surgical closure of an atrial septal defect and partial anomalous pulmonary veins. Two sources of shunting were identified: a baffle leak from the right superior vena cava (RSVC) to the left atrium secondary to complete occlusion of the RSVC-to-right atrium ...
Komotar Ricardo J - - 2009
OBJECT: Chronic hydrocephalus requiring shunt placement is a common complication following aneurysmal subarachnoid hemorrhage (SAH). Controversy exists over whether microsurgical fenestration of the lamina terminalis during aneurysm surgery affords a reduction in the development of shunt-dependent hydrocephalus. To resolve this debate, the authors performed a systematic review and quantitative analysis ...
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