| Bioptome-assisted coil occlusion of moderate-large patent ductus arteriosus in infants and small children. | |
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MedLine Citation:
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PMID: 15170724 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Coil occlusion of patent ductus arteriosus (PDA), although inexpensive, is technically challenging for the moderate-large ducts in small children. Bioptome assistance allows better control and precision. We describe case selection strategies, technique, immediate and short-term results of bioptome-assisted closure of moderate-large (>/= 3 mm) PDA in 86 infants and children </= 10 kg (age, 18 days to 3 years; median, 8 months; weight, 6.6 +/- 1.9 kg; duct size, 3.6 +/- 0.8 mm; pulmonary artery mean pressures, 33 +/- 12 mm Hg). Patients with PDA > 6 mm (> 4 mm for children under 5 kg) and/or shallow ampullae (by echocardiography) underwent operation (n = 41). Specific technical modifications included use of long sheaths (5.5-8 Fr) for duct delineation and coil delivery, cutting of coils turns (51 patients) to accommodate the coils in the ampulla, and simultaneous delivery of multiple coils (n = 43). As far as possible, coils were deployed entirely in the ampulla. Median fluoroscopy time was 7.3 min (1.2-42 min). Successful deployment was feasible in all (final pulmonary artery mean pressures, 20 +/- 4.6 mm Hg). Coils embolized in 14 (16%) patients (all retrieved). Complete occlusion occurred immediately in 63 patients (73%) and in 77 patients (89%) at 24 hr. Three patients had new gradients in the left pulmonary artery. Follow-up (62 patients; median duration, 13 months) revealed small residual Doppler flows in 11 patients (18%) at the most recent visit. Bioptome-assisted coil occlusion of moderate-large PDA in selected infants and small children is feasible with encouraging results. |
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Authors:
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Raman Krishna Kumar; Sivadasan Radha Anil; Bhava R J Kannan; Ancil Philip; Kothandam Sivakumar |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 62 ISSN: 1522-1946 ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2004 Jun |
Date Detail:
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Created Date: 2004-06-01 Completed Date: 2004-11-08 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 266-71 Citation Subset: IM |
Copyright Information:
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Copyright 2004 Wiley-Liss, Inc. |
Affiliation:
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Amrita Institute of Medical Sciences, Kochi, Kerala, India. rkrishnakumar@aimshospital.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Flow Velocity
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physiology Child Welfare Child, Preschool Coronary Angiography Coronary Circulation / physiology Device Removal Ductus Arteriosus, Patent / diagnosis, physiopathology, therapy* Echocardiography, Doppler, Color Embolization, Therapeutic / instrumentation* Equipment Design Follow-Up Studies Heart Catheterization Humans India Infant Infant Welfare Infant, Newborn Postoperative Complications / diagnosis, etiology, physiopathology Pulmonary Wedge Pressure / physiology Severity of Illness Index Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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