Document Detail


Atrial septal stent implant: atrial septal defect creation in the management of complex congenital heart defects in infants.
MedLine Citation:
PMID:  18377559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Certain congenital heart defects require the creation of an unrestrictive atrial septal defect (ASD) to relieve atrial hypertension, to maintain systemic cardiac output, or to achieve adequate atrial mixing to improve systemic oxygen saturation. We describe a series of patients, ranging in age from 5 weeks to 17 months, in whom we implanted a stent across the atrial septum to create a lasting, unrestrictive interatrial communication. METHODS: Five patients with left heart obstructive defects presented with severe left atrial hypertension. The patients weighed 3.5-10.1 kg. Patients 1 and 2 presented at 5 and 9 weeks of age, respectively. Patient 1 had a restrictive patent foramen ovale, and patient 2 had an intact atrial septum. Patients 3, 4, and 5 had previous cardiac surgery including atrial septectomy. At presentation, all patients were poor surgical candidates. RESULTS: Using standard percutaneous technique, a premounted Palmaz-Genesis stent (Cordis Corporation) was implanted across the atrial septum in all 5 patients, using balloons ranging from 7 to 10 mm diameter. Each patient had a dramatic decrease in left atrial pressure and increased ASD diameter. All stented ASDs remained widely patent, confirmed by Doppler echocardiography, until elective surgical stent explant. CONCLUSION: Patients presenting beyond the neonatal period with left heart obstructive defects and intact atrial septum or restrictive ASD present a challenging problem. We report a safe and effective technique for relief of left atrial hypertension in infants using premounted intravascular stents. All patients had immediate marked hemodynamic improvement.
Authors:
Glenn T Leonard; Henri Justino; Karina M Carlson; Joseph W Rossano; Steven R Neish; Charles E Mullins; Ronald G Grifka
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  1     ISSN:  1747-0803     ISO Abbreviation:  -     Publication Date:  2006 May 
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-04-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  129-35     Citation Subset:  IM    
Affiliation:
Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
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MeSH Terms
Descriptor/Qualifier:
Atrial Function, Left
Atrial Septum / surgery*
Cyanosis / surgery
Heart Defects, Congenital / surgery*
Humans
Hypertension / surgery
Infant
Infant, Newborn
Prosthesis Implantation / instrumentation*
Stents*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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