WorldWideScience

Sample records for amplatzer septal occluder

  1. Assessment of the geometric profile of the Amplatzer and Cardioseal septal occluders by three dimensional echocardiography

    OpenAIRE

    Acar, P; Saliba, Z; Bonhoeffer, P; Sidi, D; Kachaner, J

    2001-01-01

    OBJECTIVE—To apply three dimensional echocardiography to describe the geometric profile of the Amplatzer and Cardioseal occluders after deployment for closure of atrial septal defect.
METHODS—20 patients (mean (SD) age, 14 (5) years) were enrolled for transcatheter closure of a secundum atrial septal defect with the Amplatzer occluder (10) or with the Cardioseal occluder (10). The two populations were matched for the stretched diameter of the defect (mean 18 (6) mm). The profile of the two oc...

  2. Transcatheter closure of secundum atrial septal defect using an Amplatzer septal occluder

    Institute of Scientific and Technical Information of China (English)

    孔祥清; 曹克将; 杨荣; 许迪; 盛燕辉; 黄峻; 马文珠

    2002-01-01

    Objective To evaluate the safety and efficacy of the Amplatzer septal occluder for transcatheter closure in patients with secundum atrial septal defect (ASD Ⅱ). Methods Patients with clinically confirmed ASD Ⅱ were recommended for transcatheter closure of ASD Ⅱ. Results 30 ASD Ⅱ patients (20 females) underwent transcatheter closure at a median age of 18.4 years (5-55 years). Both the stretched diameters of ASDs and the sizes of the devices were from 18 to 34?mm (25±7?mm). The successful placement rate was 100%. The rest shunt documented by color Doppler, was immediately after implantation in 40% of patients, in 9.9% after 24 hours, and in 3.3% trace at 3 months. No serious complications were observed. There was improvement in symptoms and in cardiac size. Septal motion abnormalities normalized in all patients after 3 months follow-up. Conclusion The Amplatzer septal occluder is a safe and effective device for transcatheter closure of ASD Ⅱ. Long-term follow-up is still required before widespread clinical use can be recommended.

  3. The clinical application of Amplatzer duct occluder Ⅱ in treating perimembranous ventricular septal defects

    International Nuclear Information System (INIS)

    Objective: To discuss the feasibility of using Amplatzer duct occluder Ⅱ to treat perimembranous ventricular septal defects. Methods: Transcatheter closure by using Amplatzer duct occluder Ⅱ was carried out in two female infants with small perimembranous ventricular septal defect. One female infant was 3 years old. The echocardiogram showed that the diameter of VSD was 5.5 mm in left ventricle side and 2.3 mm in right ventricle side. The distance of the upper border of VSD to aortic valve was 4 mm. The other female infant was 2 years and 10 months old, the diameter of VSD was 7.8 mm in left ventricle side and 2.0 mm in right ventricle side. The distance between the upper border of VSD to aortic valve was 5.8 mm. Results: For one infant the 4 by 4 mm Amplatzer duct occluder Ⅱ and 5 F TorqVue low profile delivery catheter was employed, while for the other infant 3 by 4 mm Amplatzer duct occluder Ⅱ and 4 F delivery catheter was used. In accordance with the standard procedure the arteriovenous pathway was set up first, than the left shed and right shed were released in turn. After the operation, echocardiogram showed that there was no residual shunt and aortic regurgitation in occluded site, but mild atrioventricular regurgitation was seen in one infant. The electrocardiogram performed two days after procedure was normal. Conclusion: Transcatheter closure by using Amplatzer duct occluder Ⅱ is very effective for the treatment of small perimembranous ventricular septal defects in infants. This technique has some advantages such as the use of small delivery catheter, minimally-invasive to the vessels, etc. In a short-term after the operation no complications such as residual shunt, valve regurgitation, arrhythmia, etc. occur. (authors)

  4. Endocarditis and Incomplete Endothelialization 12 Years after Amplatzer Septal Occluder Deployment.

    Science.gov (United States)

    Nguyen, Allan K; Palafox, Brian A; Starr, Joanne P; Gates, Richard N; Berdjis, Farbouch

    2016-06-01

    A 4-year-old boy had a 15-mm atrial septal defect repaired percutaneously with use of an Amplatzer Septal Occluder. At age 16 years, he presented with a week's history of fever, chills, dyspnea, fatigue, and malaise. Cultures grew methicillin-sensitive Staphylococcus aureus. A transesophageal echocardiogram showed a 1.25 × 1.5-cm pedunculated mass on the left aspect of the atrial septum just superior to the mitral valve, and a smaller vegetation on the right inferior medial aspect of the septum. At surgery, visual examination of both sides of the septum revealed granulation tissue, the pedunculated mass, the small vegetation, and exposed metal wires that suggested incomplete endothelialization of the occluder. We removed the occluder and patched the septal defect. The patient returned to full activity after 4 months and was asymptomatic 3 years postoperatively. Our report reinforces the need for further investigation into prosthetic device endothelialization, endocarditis prophylaxis, and recommended levels of physical activity in patients whose devices might be incompletely endothelialized. In addition to reporting our patient's case, we review the medical literature on this topic. PMID:27303238

  5. Home-made fenestrated amplatzer occluder for atrial septal defect and pulmonary arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    Fabio Dell'Avvocata; Gianluca Rigatelli; Paolo Cardaioli; Massimo Giordan

    2011-01-01

    We report the management of a patient with secundum atrial septal defect (ASD)and severe pulmonary hypertension.A 65-year-old male with recently diagnosed atrial serital defect was referred to our centre for decompensated right heart failure with rest and exercise induced dispnea and severe pulmonary hypertension.Right heart catheterization confirmed a mean pulmonary pressure of about 55 mmHg and a Qp/Qs of 2.7.An occlusion test with a compliant large balloon demonstrated partial fall of pulmonary arterial pressure.The implantation of a home-made fenestrated Amplatzer ASD Occluder (ASO) was planned in order to decrease lefttoright shunt and promote further decrease of pulmonary arterial pressure in the long-term.Thus,by means of mechanical intracardiac echocardiography study with a 9F 9 MHz Ultralce catheter(Boston Scientific Corp.),we selected a 34 mm ASO for implantation.Four millimeter fenestration was made inflating a 4 ntm non-compliant coronary balloon throughout the waist of the ASO,which was successfully implanted under intracardiac echocardiography.After six months,a decrease of pulmonary arterial pressure to 24 mmHg and full compensated right heart failure was observed on transthoracic echocardiography and clinical examination.This case suggests that transcatheter closure with home-made fenestrated ASD in elderly patients with severe pulmonary hypertension is feasible.

  6. Reliability of transthoracic echocardiography in estimating the size of Amplatzer septal occluder and guiding percutaneous closure of atrial septal defects

    Institute of Scientific and Technical Information of China (English)

    LI Gui-shuang; KONG Guang-ming; JI Qiu-shang; LI Ji-fu; CHEN Yu-guo; YOU Bei-an; ZHANG Yun

    2008-01-01

    Background In China,transthoracic echocardiography(TTE)is popularly used for pre-intervention examination for atrial septal defect(ASD)and for guiding ASD closure.However,the ability to determine ASD size and the safety and efficacy of TTE for guiding ASD closure still has not been widely accepted This study aimed to evaluate the efficacy and safety of TTE used before,during and after transcatheter ASD closure with Amplatzer septal occluders(ASO).Methods Sixty-eight subjects(15 men and 53 women;mean age(33.7±17.3)years)were enrolled.TTE was used to measure the diameters and guide transcatheter closure of ASD.The ASD was examined by long-axis view,basal short-axis view,apical four-chamber view and the subcostal view to observe position.diameter and reIation with neighbouring structures.The largest diameter was selected as the reference diameter.Patients were divided into 3 groups according to the ASD reference diameter:22 subjects with ASD diameter 4-14 mm(group A):21 subjects with ASD diameter 15-20 mm(group B);and 25 subjects with ASD diameter 21-33 mm(group C).Results ASD was occluded successfully in groups A and B.In group C.occlusion failed in 2 cases;1 case remained with a 3-mm residual shunt sustained untiI 6-month follow-up.However,at 6-month follow-up,no case of thromboembolism,ASO dislocation or death occurred in the three groups.The diameter of ASD measured bv TTE could accurately predict the ASO size that could successfully occlude the ASD.especially in patients with ASD<20 mm.The ASD diameter measured by TTE correlated well with ASO size(r=0.925,P<0.001:r=0.976,P<0.001;r=0.929,P<0.001 respectively).Conclusions ASD diameter measured by TTE can accurately estimate the size of the ASO needed for successful closure of ASD.The larger the ASD,the much larger the ASo needed.TTE is a satisfactory guiding imaging tool for ASD closure.

  7. Transcatheter Closure of Atrial Septal Defect with Amplatzer Septal Occluder in Adults: Immediate, Short, and Intermediate-Term Results

    Directory of Open Access Journals (Sweden)

    Majid Dehghani

    2011-05-01

    Full Text Available Background: The transcatheter closure of the atrial septal defect (ASD has become an alternative technique to surgical procedures. The aim of this study was to assess the immediate, short, and intermediate-term results of the transcatheter closure of the secundum ASD with the Amplatzer Septal Occluder (ASO in adult Iranian patients.Methods: Between December 2004 and July 2008, the transcatheter closure of the ASD using the ASO was attempted in 58consecutive, adult patients. The mean age of the patients was 37.1 ± 12.7 years (range = 19 - 75 years.All the procedures were performed under local anesthesia with transthoracic or transesophageal echocardiography and fluoroscopic guidance. The stretched diameter of the ASD was determined with a balloon sizing catheter, and device selection was based on and matched to the stretched diameter of the septal defect.Transthoracic echocardiography was performed immediately after the release of the device and before discharge.Further follow-up at one month, six months, and yearly thereafter included physical examination, electrocardiography, andtransthoracic echocardiography.Results: The mean ASD diameter, as measured by esophageal echocardiography, was 24.8 ± 5.4 mm (range = 13 - 34 mm.The mean stretched diameter, as measured by the balloon catheter, was 27.1 ± 6.4 mm (range = 12.5 - 39 mm. Deploymentof the ASO was successful in 52 (89.6% patients and failed in 6 (10.4%. Four patients experienced severe complications,1 had tamponade requiring drainage, 2 had device embolization to the left atrium and right ventricular outflow tract, and 1 had late wire fracture (surgical removal and repair of the ASD. The position of two large devices (34 mm and 36 mm was considered unsuitable and unstable after implantation and resulted in the removal of these devices.Minor complications included transient complete atrioventricular block in 1 patient, paroxysmal supra tachycardia in 3 patients, atrial flutter in 1 patient

  8. Usefulness of Transesophageal Echocardiography for Transcatheter Closure of Ostium Secundum Atrial Septum Defect with the Amplatzer Septal Occluder

    Directory of Open Access Journals (Sweden)

    Chun-Yu Chen

    2005-12-01

    Full Text Available Background: Transcatheter closure of ostium secundum atrial septum defect (ASDIIusing the new self-centering occluder, Amplatzer Septal Occluder (ASO,has been well developed in recent years. We describe the importance and roleof transesophageal echocardiography (TEE in the selection and closure ofsuch defects.Methods: Thirty patients referred for transcatheter closure of ASDII by ASO wereenrolled in this study. During catheterization, two-dimensional TEE was performedon all patients during and after transcatheter closure. ASD size andmorphology were assessed by TEE before catheterization. The ASDstretched diameter was also measured by TEE and fluoroscopy.Results: With the aid of TEE, transcatheter closure of an ASD was successfully, safelyand effectively performed on 29 patients. The mean ASD diameter determinedby TEE was 17.4 4.8 mm. The mean stretched diameters measuredby TEE and fluoroscopy were 18.7 5.6 mm and 17.9 5.5 mm, respectively.The mean device diameter was 19 5.6 mm. Immediate completeclosure was documented by color Doppler TEE in 29 patients. Complicationswere encountered in one patient, with the device becoming dislodged into themain pulmonary artery. The device was retrieved by surgery and the defectwas repaired in the operating room.Conclusions: Transcatheter closure of ASDs using an Amplatzer device is feasible, safeand effective. Two-dimensional TEE can provide useful information before,during and after transcatheter closure of ASDs.

  9. Balloon Occlusive Diameter of Non-Circular Atrial Septal Defects in Transcatheter Closure with Amplatzer Septal Occluder

    OpenAIRE

    Kim, Kwang Hoon; Song, Jinyoung; Kang, I-Seok; Chang, Sung-A; Huh, June; Park, Seung Woo

    2013-01-01

    Background and Objectives The aim of this study was to investigate the balloon occlusive diameter (BOD) of non-circular defects in the transcatheter closure of atrial septal defect (ASD). Subjects and Methods A total of 67 patients who had undergone transcatheter closure of an ASD were reviewed retrospectively. A non-circular defect was defined as the ratio of the short diameter to the long diameter of the defect on the en-face image less than 0.75. The BOD was compared with the long diameter...

  10. The role of MRI for the evaluation of atrial septal defects before and after percutaneous occlusion with the Amplatzer Septal Occluder trademark

    International Nuclear Information System (INIS)

    Purpose: Evaluation of morphologic and functional MRI of atrial septal defects (ASD) before and after percutaneous occlusion with the Amplatzer Septal Occluder (AOC). Comparison of MRI with transesophageal echocardiography (TEE), balloon measurement (IVBM) and cardiac catheterization with shunt quantification (CCSQ). Materials and Methods: Twenty patients with ASD were examined before and three months after AOC implantation. ECG-triggered, breath-hold T1-weighted Turbo Spin Echo Segmented FLASH 2D and dynamic turbo-FLASH-GRE sequences after application of 0,2 mmol gadolinium DTPA per kg body weight were obtained in a 1.5 T MRI system. Defect size, and distance to coronal sinus (CS) and right upper pulmonary vein (RUPV) were determined for pre-interventional planning, and the AOC size was measured quantitatively for post-interventional follow-up. The shunts were evaluated qualitatively (occurrence of jets), semiquantitatively (jet length, turbulence square product) and quantitatively (flow measurement in the thoracic aorta and in the left and right pulmonary arteries). Results: The average size of the ASD measured by MRI was 17.6 mm (11-24.8 mm) in the axial view, 15.9 mm (10.8-28.9 mm) in the sagittal view and 16.4 mm (12.1-24.8 mm) in the short axis view. In comparison, the average defect size was 15 mm (8-24 mm) by TEE and 20 mm (13-27 mm) by IVBM. The average distance to the RUPV was 17 mm (9.6-21.9 mm) and to the CS 11.2 mm (5-17 mm). The AOC was visualized with only minimal artifacts. Qualitative analysis of the MRI findings revealed an occurence of jets in 17/20 patients. Semiquantitative analysis documented a high correlation for jet length and square product of the turbulence to defect size r=0.81 resp. r=0.82. Mean QP/QS-ratio measured by MR-volumetry was 1.6±0.29 and by MR-flow 1.6±0.26. The corresponding measurements were 1.7±0.3 for TEE and 1.5±0.5 for CCSQ. In comparison to TEE, the correlation coefficient was r=0.96 for MR-volumetry and r=0.85 for

  11. Atrial septal defects type II: noninvasive evaluation of patients before implantation of an amplatzer septal occluder and on follow-up by magnetic resonance imaging compared with TEE and invasive measurement

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate morphological and functional MRI of atrial septal defects (ASD) before and after interventional occlusion by the Amplatzer Septal Occluder (AOC) in comparison to trans-oesophageal echocardiography (TEE), invasive balloon measurement (IVBM) and cardiac catheterisation (QCC). Sixty patients with an ASD type II were enrolled. They underwent TEE, IVBM, QCC and MRI at 1.5T. Cine gradient echo, steady-state free precession sequences and a gradient echo phase contrast sequence were used. In MRI, pulmonary-to-systemic flow ratio (Qp/Qs) was calculated and compared with the QCC Qp/Qs ratio. Qp/Qs ratio in baseline MRI examination was 1.56 ± 0.29 (range: 1.05-2.2) and in QCC 1.71 ± 0.30 (range: 1.2-2.4) with a significant correlation (R = 0.65, P < 0.01). Defect size on MRI was 15.3 ± 7.4 mm (range: 3-30 mm), in TEE 14.3 ± 4.9 mm (range: 4-24 mm), and the balloon stretched diameter in IVBM was 23.4 ± 4.2 mm (range: 14-32 mm). Correlation between defect size in MRI vs. TEE was R = 0.67 (P < 0.01) and MRI vs. IVBM was R = 0.77 (P < 0.01). Right ventricular volumes decreased after intervention. MRI is an accurate noninvasive test for diagnosis, planning and follow-up after interventional ASD occlusion using an AOC. (orig.)

  12. Atrial septal defects type II: noninvasive evaluation of patients before implantation of an amplatzer septal occluder and on follow-up by magnetic resonance imaging compared with TEE and invasive measurement

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Christoph; Adam, Gerhard [University Medical Center Hamburg-Eppendorf, Diagnostic Center, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Weber, Michael; Ekinci, Okan; Neumann, Thomas; Deetjen, Anja; Rolf, Andreas; Hamm, Christian W.; Dill, Thorsten [Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim (Germany)

    2008-11-15

    The purpose of this study was to evaluate morphological and functional MRI of atrial septal defects (ASD) before and after interventional occlusion by the Amplatzer Septal Occluder (AOC) in comparison to trans-oesophageal echocardiography (TEE), invasive balloon measurement (IVBM) and cardiac catheterisation (QCC). Sixty patients with an ASD type II were enrolled. They underwent TEE, IVBM, QCC and MRI at 1.5T. Cine gradient echo, steady-state free precession sequences and a gradient echo phase contrast sequence were used. In MRI, pulmonary-to-systemic flow ratio (Qp/Qs) was calculated and compared with the QCC Qp/Qs ratio. Qp/Qs ratio in baseline MRI examination was 1.56 {+-} 0.29 (range: 1.05-2.2) and in QCC 1.71 {+-} 0.30 (range: 1.2-2.4) with a significant correlation (R = 0.65, P < 0.01). Defect size on MRI was 15.3 {+-} 7.4 mm (range: 3-30 mm), in TEE 14.3 {+-} 4.9 mm (range: 4-24 mm), and the balloon stretched diameter in IVBM was 23.4 {+-} 4.2 mm (range: 14-32 mm). Correlation between defect size in MRI vs. TEE was R = 0.67 (P < 0.01) and MRI vs. IVBM was R = 0.77 (P < 0.01). Right ventricular volumes decreased after intervention. MRI is an accurate noninvasive test for diagnosis, planning and follow-up after interventional ASD occlusion using an AOC. (orig.)

  13. Percutaneous ventricular septal defect closure with Amplatzer devices resulting in severe tricuspid regurgitation.

    Science.gov (United States)

    Matyal, Robina; Wang, Angela; Mahmood, Feroze

    2013-11-15

    While percutaneous intervention is an alternative for patients who are not surgical candidates, the rate of morbidity and mortality is comparable to open repair. Appending the reported complications associated with percutaneous intervention (device mal-positioning, dislodgement, and entrapment in the sub-valvular apparatus), we report mechanical damage to the tricuspid valve (TV). Percutaneous closure with an Amplatzer septal occluder device was attempted on three patients who developed a ventricular septal defects (VSD) after myocardial infarction. In all three cases, damage to the tricuspid leaflet was noted post-procedure. The accompanying severe tricuspid regurgitation led to right ventricular failure, even in the patients where the VSD was considered successfully occluded. Despite successful deployment of the Amplatzer device, complications with catheter manipulation may still arise. Damage to the TV can occur during percutaneous VSD closure with Amplatzer device. Periprocedure TEE monitoring can detect damage to the tricuspid leaflets. PMID:23553968

  14. Amplatzer封堵器治疗儿童伴有假性室隔瘤的膜周部室间隔缺损%Transcatheter closure of aneurysm of perimembrane ventricular septal defect with Amplatzer duct occluder in children

    Institute of Scientific and Technical Information of China (English)

    唐礼江; 高伟; 方崇峰; 林仙方; 江建军; 刘志国

    2004-01-01

    我们应用Amplatzer不对称的膜周部室间隔缺损封堵器介入治疗伴有假性室隔瘤的膜周部室间隔缺损(Aneurysm of perimembrane ventricular septal defect)28例,现报告如下。

  15. Treatment of patent ductus arteriosus by the use of an Amplatz canine ductal occluder device.

    Science.gov (United States)

    White, Pam

    2009-04-01

    A 7-month-old female, spayed border collie was referred to the Ontario Veterinary College due to a continuous murmur noted by the referring veterinarian prior to ovariohysterectomy. Auscultation confirmed a grade VI/VI continuous murmur. An echocardiogram confirmed patent ductus arteriosus (PDA). An Amplatz canine ductal occluder device was successfully placed for occlusion of blood flow though the ductus. PMID:19436449

  16. Simultaneous stent implantation for coarctation of the aorta and closure of patent ductus arteriosus using the Amplatzer duct occluder.

    Science.gov (United States)

    Hakim, F; Hawelleh, A A; Goussous, Y; Hijazi, Z M

    1999-05-01

    We report on a 13-year-old girl with coarctation of the aorta and patent ductus arteriosus who underwent successful simultaneous stent implantation for the coarctation and catheter closure of the ductus using an Amplatzer duct occluder. PMID:10385155

  17. Real-time-MR guidance for placement of a self-made fully MR-compatible atrial septal occluder: in vitro test

    International Nuclear Information System (INIS)

    Purpose: This in vitro study investigated the feasibility to visualize the placement of three different atrial septal occluder systems using real-time MR control. Methods: The experiments were performed on an interventional 1.5 T high field whole body system. Real-time MR imaging was achieved by radial or spiral k-space filling in conjunction with the sliding window reconstruction technique yielding an imaging speed of 15 frames per second. The CardioSeal, Ampaltzer Septal Occluder and a specially designed MR-compatible closure device were tested in a water bath. A punctured plastic wall served as model for the atrial septal defect. Results: The delivery systems of the CardioSeal and Amplatzer Occluder were ferromagnetic and caused substantial artifacts, making the device placement impossible, even if the magnetic forces would have been acceptable. The self-made prototype caused only minor susceptibility artifacts allowing its visualization on the MR images. The MR imaging techniques applied enabled real-time control of the occluder including steering through the artificial septal foramen and visualization of the occluder deployment. Conclusion: Real-time MR imaging allows for guidance and placement of an MR-compatible septal occluder in vitro suggesting the feasibility to perform atrial septal occlusion under MR-guidance in vivo as well. (orig.)

  18. Completely endoscopic removal of a dislocated Amplatzer atrial septal defect closure device.

    Science.gov (United States)

    Bonatti, Johannes; Bonaros, Nikolaos; Müller, Silvana; Bartel, Thomas

    2008-02-01

    Surgical treatment of residual shunts after transcatheter occlusion of atrial septal defect or patent foramen ovale is reported in approximately one to two percent of these percutaneous interventions. Minimally invasive surgery on the atrial septum is getting more and more common but little data is available on Amplatzer device explantation through limited access. No completely endoscopic device removal has been described previously. We report a case of a 57-year-old woman in whom an Amplatzer device was removed in a robotic totally endoscopic fashion through ports only using the daVinci telemanipulation system. PMID:17951273

  19. Ventricular Septal Perforation after Biventricular Takotsubo Cardiomyopathy Successfully Repaired with an Amplatzer Device: First Report in the Literature

    Science.gov (United States)

    Rodríguez, Alfredo E.; Fernandez-Pereira, Carlos; Mieres, Juan; Ascarrunz, Diego; Gabe, Eduardo; Rodríguez-Granillo, Alfredo Matías; Frattini, Romina; Stuzbach, Pablo

    2016-01-01

    A 79-year-old female was admitted with sudden onset dyspnea, mild oppressive chest pain, and severe anxiety disorder. Patient had history of hypertension, dyslipidemia, smoking, and chronic obstructive pulmonary disease. On admission blood pressure was 160/90 and heart rate was 130 bpm. Transthoracic echocardiography (TE) and contrast tomography showed a thin septum with an abnormal left and right ventricular contraction with an “apical ballooning” pattern and mild increase of cardiac enzymes. At the 4th day of admission, the patient presented symptoms and signs of congestive heart failure and developed cardiogenic shock. EKG showed an inversion of T waves in all precordial leads. In a new TE, a ventricular septal perforation (VSP) in the apical portion of the septum was seen. Coronary angiogram showed angiographically “normal” coronary arteries. With a diagnosis of VSP in takotsubo cardiomyopathy, a percutaneous procedure to repair the VSP was performed 11 days after admission. The VSP was closed with an Amplatzer device. TE performed 24 hours after showed significant improvement of ventricular function and good apposition of the Amplatzer device. Three days later she was discharged from the hospital. To our knowledge, this is the first reported case of a VSP in a TCM repaired percutaneously with an occluder device.

  20. Initial experience in Brazil with the Helex septal occluder for percutaneous occlusion of atrial septal defects

    Directory of Open Access Journals (Sweden)

    Pedra Carlos A.C.

    2003-01-01

    Full Text Available OBJECTIVE: To evaluate the initial clinical experience with the Helex septal occluder for percutaneous closure of atrial septal defects. METHODS: Ten patients underwent the procedure, 7 patients with ostium secundum atrial septal defects (ASD with hemodynamic repercussions and 3 patients with pervious foramen ovale (PFO and a history of stroke. Mean age was 33.8 years and mean weight was 55.4 kg. Mean diameter by transesophageal echocardiography and mean stretched ASD diameter were 11.33 ± 3.3mm, and 15.2 ± 3.8mm, respectively. The Qp/Qs ratio was 1.9 ± 0.3 in patients with ASD. RESULTS: Eleven occluders were placed because a patient with 2 holes needed 2 devices. It was necessary to retrieve and replace 4 devices in 3 patients. We observed immediate residual shunt (< 2mm in 4 patients with ASD, and in those with patent foramen ovale total occlusion of the defect occurred. No complications were noted, and all patients were discharged on the following day. After 1 month, 2 patients with ASD experienced trivial residual shunts (1mm. In 1 patient, we observed mild prolapse in the proximal disk in the right atrium, without consequences. CONCLUSION: The Helex septal occluder was safe and effective for occluding small to moderate atrial septal defects. Because the implantation technique is demanding, it requires specific training of the operator. Even so, small technical failures may occur in the beginning of the learning curve, but they do not involve patient safety.

  1. The exploration of the closure of patent ductus arteriosus with Amplatzer occluder through single venous approach under ultrasound monitoring

    International Nuclear Information System (INIS)

    Objective: To explore the feasibility and effectiveness of transcatheter closure of patent ductus arteriosus (PDA) with Amplatzer occluder by using single venous approach method under ultrasound monitoring. Methods: During the period from May 2003 to April 2010, transcatheter closure of PDA were performed in 123 cases. Of the 123 patients, the procedure was accomplished by using arteriovenous dual approach method in 46 and by using single venous approach method in 77. All the procedures were monitored by ultrasound. The shape, size of PDA and immediate therapeutic results were checked with angiography in arteriovenous dual approach method or with ultrasonography in single venous approach method. The size of Amplatzer occluder was individually selected according to the smallest diameter of PDA. Echocardiography was performed at 3 days, one, 6 and 12 months after the procedure to evaluate the results. Results: Successful device placement with the initially selected occluder was obtained in 118 cases. In 4 cases the procedure was eventually completed after a bigger occluder was employed to replace the initial one, while in one case a smaller occluder had to use to replace the first one. The technical success rate was 100%. Conclusion: The transcatheter closure of PDA with Amplatzer occluder under ultrasound monitoring by single venous approach method is clinically effective and feasible. Being technically simple and time-saving, this single venous approach method is of great value in clinical practice. (authors)

  2. Closure of a short patent ductus arteriosus using an atrial septal occluder

    Institute of Scientific and Technical Information of China (English)

    Keyhan Sayadpour Zanjani

    2010-01-01

    @@ Patent ductus arteriosus (PDA) device closure was first attempted by Porstmann et al1 in 1967. Due to the rapid development in this field, it is the therapy of choice in current era. As most of PDAs have conical shape, Amplatzer PDA occluders were designed to fit into these ducts.

  3. The first clinical experience with the new GORE® septal occluder (GSO)

    DEFF Research Database (Denmark)

    Søndergaard, Lars; Loh, Poay Huan; Franzen, Olaf;

    2013-01-01

    Aims: A new GORE® septal occluder (GSO) was granted CE mark in Europe in June 2011 for the treatment of patent foramen ovale and atrial septal defect. Major changes have been made to the device and delivery system compared to the HELEX® device. The new delivery system has simplified the implantat......Aims: A new GORE® septal occluder (GSO) was granted CE mark in Europe in June 2011 for the treatment of patent foramen ovale and atrial septal defect. Major changes have been made to the device and delivery system compared to the HELEX® device. The new delivery system has simplified the...... of these patients had patent foramen ovale and one had secundum atrial septal defect. In all the cases, the GSO devices were successfully deployed in the first attempt without any complication. Only one patient had a minor residual shunt detected immediately after the device deployment. All the...

  4. Percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder

    Directory of Open Access Journals (Sweden)

    Er-Ping Xi

    2012-11-01

    Full Text Available OBJECTIVE: Ventricular septal defects resulting from post-traumatic cardiac injury are very rare. Percutaneous closure has emerged as a method for treating this disorder. We wish to report our experience in three patients who underwent percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder. METHODS: We treated three patients with post-traumatic ventricular septal defects caused by stab wounds with knives. After the heart wound was repaired, patient examinations revealed ventricular septal defects with pulmonary/systemic flow ratios (Qp/Qs of over 1.7. The post-traumatic ventricular septal defects were closed percutaneously with a patent ductus arteriosus occluder (Lifetech Scientific (Shenzhen Co., LTD, Guangdong, China utilizing standard techniques. RESULTS: Post-operative transthoracic echocardiography revealed no residual left-to-right shunt and indicated normal ventricular function. In addition, 320-slice computerized tomography showed that the occluder was well placed and exhibited normal morphology. CONCLUSION: Our experiences indicate that closure of a post-traumatic ventricular septal defect using a patent ductus arteriosus occluder is feasible, safe, and effective.

  5. Initial experience of occluding special type patent ductus arterioses using the Amplatzer vascular plug

    Institute of Scientific and Technical Information of China (English)

    ZHANG Po; ZHU Xian-yang; WANG Qi-guang; ZHANG Duan-zhen; HAN Xiu-min

    2013-01-01

    Background Occluders licensed for clinical use are not fit for some special Krichenko E patent ductus arterioses.The Amplatzer vascular plug I (AVP1) has not been licensed for use for closure of patent ductus arteriose.We report our initial experience to occluding special type patent ductus arterioses with the AVP1-a single lobe device of single layer Nitinol mesh for short vessel landing zones.Methods Patients referred with small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter underwent occlusion using AVP1.All cases underwent pre-,intra-and post-procedural echocardiography and chest X-ray at the completion of the procedure,the next day and at a 30-day,3-month and 6-month follow-up visits.Device sizing for device waist diameter and length was based on aortography.Results From April 2008 to June 2012,26 patients with a mean age of (7.6±8.0) years (range 6 months-32 years)and a mean weight of (23.8±14.8) kg (range 7-67 kg) underwent successful patent ductus arteriose closure.The mean ductus diameter was (2.1±0.7) mm (range 1-3 mm).Transpulmonary (22/26) and transaortic approaches (4/26) were used.No persistent patency was observed after 24 hours and after one month.No device displacement,residual flow and iatrogenic coarctation of the aorta were observed after three months and six months.Conclusions The AVP1 makes it easy to close some Krichenko E patent ductus arterioses.Smaller delivery catheter profile and symmetric cylindrical device shape allow for use for small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter and small patients through transaortic approaches.Broader experience is required to further delineate device and patient selection as well as to document its long-term efficacy and safety.

  6. Transcatheter Closure of a Chronic Iatrogenic Arteriovenous Fistula Between the Carotid Artery and the Brachiocephalic Vein with an Amplatzer Duct Occluder in Combination with a Carotid Stent

    International Nuclear Information System (INIS)

    We report an original method of transcatheter closure of an arteriovenous fistula using the combination of an Amplatzer PDA occluder and a carotid stent. The fistula was between the left carotid artery and the brachiocephalic vein. The patient had significant left-to-right shunt and was highly symptomatic. Due to the large orifice and pseudoaneurysmatic enlargement of the fistula, we had to use a large Amplatzer PDA occluder and the protruding part of the PDA device disk had to be covered with a carotid stent. The fistula was completely closed. The patient stopped having symptoms and, 2 years after the procedure, the effect persists.

  7. Experiência inicial no fechamento percutâneo da comunicação interatrial com a prótese de Amplatzer Initial experience in percutaneous occlusion of atrial septal defects with the Amplatzer device

    Directory of Open Access Journals (Sweden)

    Valmir F. Fontes

    1998-03-01

    Full Text Available OBJETIVO: Analisar a experiência inicial no fechamento percutâneo da comunicação interatrial ostium secundum (CIA OS com a prótese de Amplatzer. MÉTODOS: Sete pacientes foram submetidos ao procedimento através da via venosa anterógrada, orientados pela ecocardiografia transesofágica (ETE e sob anestesia geral. Uma criança era portadora de 2 CIA e de canal arterial (CA. As CIA medidas pelo ETE variaram de 8,7 a 20mm. Um ecocardiograma transtorácico foi realizado na manhã seguinte do procedimento. RESULTADOS: Oito próteses foram implantadas nos 7 pacientes com sucesso. Em um paciente, o CA foi ocluído na mesma sessão com mola de Gianturco, tendo surgido taquicardia supraventricular durante a oclusão de uma das CIA, controlada com adenosina. Todos receberam alta hospitalar na manhã seguinte, com oclusão total dos defeitos. CONCLUSÃO: O procedimento mostrou-se seguro, eficaz e versátil, podendo ser considerado como uma alternativa terapêutica inicial em pacientes selecionados com CIA OS.PURPOSE: To evaluate our initial experience with percutaneous closure of secundum type atrial septal defects (ASD with the Amplatzer septal occluder. METHODS: Seven patients underwent occlusion by anterograde approach, under general anesthesia and transesophageal echocardiography (TEE guidance. One child had 2 ASD and a patent ductus arteriosus (PDA. The ASD size ranged from 8,7 to 20mm as measured by TEE. A transthoracic echocardiogram was performed in the morning after the procedure. RESULTS: Eight devices were successfully implanted in 7 patients and the PDA was occluded with a Gianturco coil at the same session. In this patient, there was an episode of supraventricular tachycardia during the occlusion of one ASD which was reverted with adenosin. All patients were discharged the day after, with complete occlusion of all defects. CONCLUSION: The procedure is safe, effective and versatile. It can be applied as an initial alternative to the

  8. Interventional Closure of Patent Foramen Ovale (PFO with Amplatzer PFO Occluder in Patients with Paradoxical Cerebral Embolism

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Haji Zeinali

    2006-08-01

    Full Text Available Background: Percutaneous transcatheter closure has been proposed as an alternative to surgical closure or long-term anticoagulation in patients with presumed paradoxical embolism and patent foramen ovale (PFO. Methods: There were two symptomatic patients (29 and 47 years old who underwent percutaneous transcatheter closure of PFO after at least two events of cerebral ischemia; one embolic event had occurred under anti-platelet therapy. For both patients, Amplatzer PFO occluder measuring 25 mm in diameter were used. In both cases, complete occlusion by color Doppler and transesophageal contrast echocardiography investigation was achieved after the procedure and lasted at least up to 3 months after implantation as determined by our follow up. Mean fluoroscopy time was 16.7 minutes. Results: Percutaneous transcatheter closure was technically successful in both patients (100%. No residual shunt was seen at the end of the procedure or in follow-ups. In-hospital follow-up was uneventful. At a mean follow-up of 3 months, no recurrent embolic neurological events were observed. Conclusion: Transcatheter closure of PFO with Amplatzer PFO occluder devices is a safe and effective therapy for patients with previous paradoxical embolism PFO. Percutaneous closure is associated with a high success rate, low incidence of hospital complications, and freedom of cerebral ischemic events.

  9. Live/Real Time Three-Dimensional Trans Esophageal Echocardiographic Findings in Amplatzer ASD Closure Devices in Adults

    Directory of Open Access Journals (Sweden)

    Fatemeh Nabavizadeh

    2012-09-01

    Full Text Available Six female patients aged from 19 to 73 years, with ostium secundum atrial septal defect underwent closure procedure with Amplatzer septal occluder device. Three-dimensional Echocardiography (3D-TEE was done during the procedure or one day after the procedure. 3D-TEE provides incremental value over Two- dimensional trans-esophageal echocardiography in measuring Amplatzer septal occluder disc sizes and correlates well with manufacture device size. 3D-TEE will surely prove to increase the technical efficiency and it will become an important tool for the interventionists for periprocedural evaluation of device closures.

  10. Short- and Mid-term Results of Atrial Septal Defect and Patent Foramen Ovale Occlusion with Starway Septal Occluder Device

    Directory of Open Access Journals (Sweden)

    J Kojuri

    2011-09-01

    Full Text Available Background: With a prevalence of almost 7% of all congenital heart diseases, atrial septal defect (ASD is a common condition. Patent foramen ovale (PFO is also a congenital heart disease which is frequently sustained into adulthood. Objectives: To study the feasibility of closure of ASD and PFU by Starway septal occluder device and the incidence of its inherent complications and procedural failure in 62 patients referred to our center. Methods: Starway septal occluder device was used for closure of ASD and PFO in 62 patients. After left and right heart catheterization, transesophageal echocardiography-guided closure was done for the patients with immediate recording of the results. Patients were followed for 6 months by transesophageal echocardiography for observing short- and mid-term complications. Results: The 62 studied patients were categorized into 2 groups. Group 1 included 31 patients (64% females with ASD (mean±SD age: 26.7±7.6 years. Group 2 consisted of 31 patients (35.6% females with PFO (mean±SD age: 53.5±12.4 years. Size of the right ventricle (RV annulus was significantly (P=0.005 decreased after the intervention in the ASD group. Overall 5 (8% patients developed post-intervention complications (transient ischemic attack, leg edema, and residual shunt and procedural failure—4 (13% in ASD group and 1 (3% in PFO group. None of the patients developed device-related thrombosis, significant arrhythmia, aortic regurgitation and pericardial effusion after intervention. Conclusion: Starway occluder device is effective and safe with very low short- and mid-term complication rates.

  11. Patent ductus arteriosus equipment and technique. Amplatzer duct occluder: intermediate-term follow-up and technical considerations.

    Science.gov (United States)

    Thanopoulos, B D; Hakim, F A; Hiari, A; Tsaousis, G S; Paphitis, C; Hijazi, Z M

    2001-04-01

    Between May 1997 and June 2000, 69 patients, ages 0.1 to 34 years, underwent attempted anterograde transcatheter closure of a patent ductus arteriosus (PDA) using the Amplatzer Duct Occluder (ADO). The ADO is a cone-shaped, self-centering, and repositionable occluder made of nitinol wire mesh. A 5Fr to 7Fr sheath was used for the delivery of the device. The mean PDA diameter (at the pulmonary end) was 4.6 +/- 1.9 mm (range 1 mm-8.5 mm). Sixty-seven of the 69 patients had successful device placement. The mean ADO smallest diameter was 6.9 +/- 1.8 mm (range 4 mm-12 mm). Complete angiographic closure occurred in 62 (92.5%) of 67 patients (95% confidence interval, 88.22%-98.77%). In five patients, there was a trivial residual shunt immediately after the procedure. At 24 hours, color Doppler flow imaging revealed complete closure in all 67 (100%) patients. The unsuccessful attempts occurred in two patients with a small, 1-mm diameter native PDA and residual PDA after surgical occlusion. Fluoroscopy time was 7.6 +/- 1.8 minutes (4 min-18 min). No complications were observed. At a median follow-up of 1.5 years (range 0.25 to 3.2 years), all patients had complete closure without complications. We conclude that transcatheter closure using the ADO is a highly effective and safe treatment for most patients with PDA. PMID:12053313

  12. Long-Term Follow-up of Patent Ductus Arteriosus Closure with the Amplatzer Duct Occluder in Children

    Directory of Open Access Journals (Sweden)

    Mostafa Behjati-Ardakani

    2015-10-01

    Full Text Available Background: Transcatheter closure of patent ductus arteriosus (PDA has become an alternative treatment to surgery. We evaluated the long-term results of the transcatheter closure of PDA with the Amplatzer Duct Occluder (ADO in children.Methods: Between May 2004 and October 2012, 138 children with PDA (43 males and 95 females underwent transcatheter PDA closure. Clinical, electrocardiographic, echocardiographic, and hemodynamic data were assessed pre and postprocedurally and at follow-up.Results: The mean age of the patients at procedure was 3.53 ± 2.43 years (range = 1.1 to 9.5 years, mean weight was11.9±4.6 kg (range = 6 to 29 kg, median pulmonary end diameter of the PDA was 5 mm (range = 4 to 15 mm, and median diameter of the ADO was 8 mm (range = 6 to 16 mm. The mean follow-up time was 43.4 ± 23.5 months (range = 13.5 to98 months.The devices were successfully deployed in 136 (98.5% patients. Device embolization occurred in 2 patients, immediately in one patient and during the first postprocedural night in the other patient. The first patient had percutaneous device retrieval, followed by implantation of a larger device. The second patient had surgical device removal and PDA ligation. Immediately after device implantation, trivial to mild residual shunts were detected in 112 (80% patients; all the shunts, however, disappeared 24 hours after the procedure. One patient had left pulmonary artery stenosis with a gradient of 25 mm Hg at 24 hours', 40 mmHg at one month's, and 64 mmHg at 6 months' follow-up. There were no cases of late embolization, aortic obstruction, late hemolysis, infective endocarditis, or death.Conclusion: Transcatheter PDA closure with the ADO was safe and effective, with a high success rate at long-term follow-up.

  13. Transcatheter coil occluder for closure of ventricular septal defect (a report of 4 cases)

    International Nuclear Information System (INIS)

    Objective: To explore the indication, methodology and complication of transcatheter coil closure of ventricular septal defect (VSD) in children. Methods: Transcatheter closure of perimembranous VSD with coils was performed in 4 cases from 2003 to 2005. The Duct-Occlude (pfm) and detachable coil (Cook) were chosen for embolization depending on the results of the left ventricular angiogram. The coil size was generally about 1-4 mm larger than the diameter of VSD. Follow up was carried out with echocardiography, ultrasound and clinical examination. Results: The defect diameters of the four cases were 2.0 mm, 2.7 mm, 2.5 mm and 1.5 mm respectively. The Duct-Occlude were successfully implanted in 3 cases of perimembranous VSD with the same type coil (OD[mm]7-3-6, windings 5-3-4) for each. One detachable coil (Cook) (5 x 5) was implanted in the remaining case. All cases had trivial residual shunt immediately after implantation which disappeared 24 hours later. Follow-up for 2 months to one year showed no coil displacement and secondary bacterial arteritis. No tricuspid and aortic regurgitation, no emboli, no endocarditis, and no arrhythmia were found. Conclusions: Coil closure of some small VSD with membranate part pseudo-ventricular aneurysm has good efficacy with the advantages of simple operation, less metal content and mini-invasion also applicable for infants. (authors)

  14. Application of Amplatzer vascular occluder in hepatic artery closure as a method of treatment of high-flow arterioportal fistula before liver transplantation

    International Nuclear Information System (INIS)

    Arterioportal fistula (APF) is an abnormal, direct connection between hepatic artery or its branch and the portal vein. Fistula can be acquired or, rarely, congenital. One of the acquired causes of fistula is a liver biopsy. Patients with liver cirrhosis are particularly vulnerable to its development due to the large number of performed biopsies. APF increases mortality and morbidity of liver transplantation procedure and may be a contraindication to it. The authors present a patient with liver cirrhosis, in whom percutaneous APF closure facilitated liver transplantation. We describe a case of a 50-year-old patient with liver cirrhosis and APF, probably formed as a result of liver biopsy. Due to the presence of a high-flow fistula, which elevated portal hypertension, patient did not qualify for the liver transplantation. Patient was transferred to the interventional radiology department, where the fistula’s vascular supply was endovascularly closed using the Amplatzer occluder. This subsequently enabled the execution of transplantation. Percutaneous closure of APF should be considered a relatively simple and fast-acting tool to facilitate or even enable liver transplant surgery. Currently, there are more and more products available such as e.g. Amplatzer occluder to simplify the procedure and shorten the duration of exposure to ionizing radiation

  15. Aortic iatrogenic perforation during transseptal puncture and successful occlusion with Amplatzer ductal occluder in a case of mitral paravalvular leak closure.

    Science.gov (United States)

    Mijangos-Vázquez, Roberto; García-Montes, José Antonio; Zabal-Cerdeira, Carlos

    2016-08-01

    Complications of transseptal puncture are significant and potentially life threatening. Aortic perforation is one of these complications and it needs to be repaired immediately. We report the case of a 48-year-old female with a history of rheumatic mitral valve disease. She underwent three previous mitral valve replacements. Her last echocardiogram reported an anterolateral leak in the mitral prosthesis. Catheterization was performed. During the procedure, when attempting to perform transseptal puncture, catheterization was complicated by a forcefully puncture of the aortic root by the Brockenbrough needle followed by an immediately advancement of an 8-Fr Mullins sheath. We decided to leave the 8-Fr sheath in the aortic root recognizing the danger of removing the sheath and finally we advanced a 6/4 mm Amplatzer ductal occluder (ADO I) through the Mullins sheath and under fluoroscopy and TEE guidance we achieved a successful deployment of the device and closure of the perforation. Subsequently, the paravalvular leak was closed with an Amplatzer Vascular Plug (AVP III 10/5 mm). There are only three cases of a similar technique for the same injury in which the authors describe successful closing of aortic perforation with percutaneous closure devices. Our case is the first described during a mitral paravalvular leak closure. It is also the first to describe a different technique of leaving the Mullins sheath in the aortic root and advancing the Amplatzer device through it to achieve successful closure of the aortic perforation. We preferred the percutaneous closure over open-heart repair. © 2015 Wiley Periodicals, Inc. PMID:26489701

  16. Safety and efficacy of nano lamellar TiN coatings on nitinol atrial septal defect occluders in vivo

    International Nuclear Information System (INIS)

    Atrial septal defect (ASD) occlusion devices made of nickel–titanium (NiTi) have a major shortcoming in that they release nickel into the body. We modified NiTi occluders using Arc Ion Plating technology. Nano lamellar titanium–nitrogen (TiN) coatings were formed on the surfaces of the occluders. The safety and efficacy of the modified NiTi occluders were evaluated in animal model. The results showed that 38 out of 39 rams (97%) survived at the end of the experiment. Fibrous capsules formed on the surfaces of the devices. Gradual endothelialization took place through the attachment of endothelial progenitor cells from the blood and the migration of endothelial cells from adjacent endocardium. The neo-endocardium formed more quickly in the coated group than in the uncoated group, as indicated by the evaluation of the six month study group. After TiN coating, there was no significant difference in endothelial cell cycle. TiN coating significantly reduced the release of nickel in both in vivo and in vitro indicating an improved biocompatibility of the nitinol ASD occluders. Superior and modified ASD occluders may provide a good choice for people with nickel allergies after sFDA registration, which is expected in one to two years. - Highlights: ► The nano lamella TiN coating did not change the shape-memory behavior and flexibility of the nitinol occluder. ► Nano lamella TiN coating modifications significantly reduced nickel release from nitinol ASD occluder. ► The new ASD occluder was found to be superior to nitinol ASD occluder with respect to both safety and efficacy

  17. Safety and efficacy of nano lamellar TiN coatings on nitinol atrial septal defect occluders in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Zhi xiong, E-mail: Top5460@163.com [Research Institute of Peking University in Shenzhen, Shenzhen 518057 (China); Fu, Bu fang, E-mail: fubnicpbp@163.com [National Institutes for Food and Drug Control, Beijing (China); Zhang, De yuan, E-mail: Deyuanzhangcn@yahoo.com.cn [Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen (China); Zhang, Zhi wei, E-mail: Zhzhx65@163.com [Guangdong Cardiovascular Institute, Guangzhou (China); Cheng, Yan, E-mail: chengyan@pku.edu.cn [Academy for Advanced Interdisciplinary Studies, Peking University, Beijing (China); Sheng, Li yuan, E-mail: lysheng@yeah.net [Research Institute of Peking University in Shenzhen, Shenzhen 518057 (China); Lai, Chen, E-mail: laichen1110@163.com [Research Institute of Peking University in Shenzhen, Shenzhen 518057 (China); Xi, Ting fei, E-mail: Xitingfie@pku.edu.cn [Research Institute of Peking University in Shenzhen, Shenzhen 518057 (China); Academy for Advanced Interdisciplinary Studies, Peking University, Beijing (China)

    2013-04-01

    Atrial septal defect (ASD) occlusion devices made of nickel–titanium (NiTi) have a major shortcoming in that they release nickel into the body. We modified NiTi occluders using Arc Ion Plating technology. Nano lamellar titanium–nitrogen (TiN) coatings were formed on the surfaces of the occluders. The safety and efficacy of the modified NiTi occluders were evaluated in animal model. The results showed that 38 out of 39 rams (97%) survived at the end of the experiment. Fibrous capsules formed on the surfaces of the devices. Gradual endothelialization took place through the attachment of endothelial progenitor cells from the blood and the migration of endothelial cells from adjacent endocardium. The neo-endocardium formed more quickly in the coated group than in the uncoated group, as indicated by the evaluation of the six month study group. After TiN coating, there was no significant difference in endothelial cell cycle. TiN coating significantly reduced the release of nickel in both in vivo and in vitro indicating an improved biocompatibility of the nitinol ASD occluders. Superior and modified ASD occluders may provide a good choice for people with nickel allergies after sFDA registration, which is expected in one to two years. - Highlights: ► The nano lamella TiN coating did not change the shape-memory behavior and flexibility of the nitinol occluder. ► Nano lamella TiN coating modifications significantly reduced nickel release from nitinol ASD occluder. ► The new ASD occluder was found to be superior to nitinol ASD occluder with respect to both safety and efficacy.

  18. Safety and efficacy of nano lamellar TiN coatings on nitinol atrial septal defect occluders in vivo.

    Science.gov (United States)

    Zhang, Zhi xiong; Fu, Bu fang; Zhang, De yuan; Zhang, Zhi wei; Cheng, Yan; Sheng, Li yuan; Lai, Chen; Xi, Ting fei

    2013-04-01

    Atrial septal defect (ASD) occlusion devices made of nickel-titanium (NiTi) have a major shortcoming in that they release nickel into the body. We modified NiTi occluders using Arc Ion Plating technology. Nano lamellar titanium-nitrogen (TiN) coatings were formed on the surfaces of the occluders. The safety and efficacy of the modified NiTi occluders were evaluated in animal model. The results showed that 38 out of 39 rams (97%) survived at the end of the experiment. Fibrous capsules formed on the surfaces of the devices. Gradual endothelialization took place through the attachment of endothelial progenitor cells from the blood and the migration of endothelial cells from adjacent endocardium. The neo-endocardium formed more quickly in the coated group than in the uncoated group, as indicated by the evaluation of the six month study group. After TiN coating, there was no significant difference in endothelial cell cycle. TiN coating significantly reduced the release of nickel in both in vivo and in vitro indicating an improved biocompatibility of the nitinol ASD occluders. Superior and modified ASD occluders may provide a good choice for people with nickel allergies after sFDA registration, which is expected in one to two years. PMID:23827582

  19. Dexmedetomidine sedation for transesophageal echocardiography during percutaneous atrial septal defect closure in adult

    OpenAIRE

    Jung, Jae Wook; Cheol Go, Gwang; Jeon, Sang Yoon; Bang, Sira; LEE, Ki Hwa; Kim, Yong Han; Kim, Dong-Kie

    2013-01-01

    Atrial septal defect (ASD) is second common congenital heart disease that often leads to adult period. Intracardiac or transesophageal echocardiography (TEE) is essential for percutaneous closure of ASD using Amplatzer septal occluder. Dexmedetomidine (DEX), which is a highly selective α2-agonist, has sedative and analgesic properties without respiratory depression in the clinical dose range. We report percutaneous closure of ASD with TEE under DEX sedation.

  20. Dexmedetomidine sedation for transesophageal echocardiography during percutaneous atrial septal defect closure in adult.

    Science.gov (United States)

    Jung, Jae Wook; Cheol Go, Gwang; Jeon, Sang Yoon; Bang, Sira; Lee, Ki Hwa; Kim, Yong Han; Kim, Dong-Kie

    2013-11-01

    Atrial septal defect (ASD) is second common congenital heart disease that often leads to adult period. Intracardiac or transesophageal echocardiography (TEE) is essential for percutaneous closure of ASD using Amplatzer septal occluder. Dexmedetomidine (DEX), which is a highly selective α2-agonist, has sedative and analgesic properties without respiratory depression in the clinical dose range. We report percutaneous closure of ASD with TEE under DEX sedation. PMID:24550975

  1. Percutaneous closure of congenital aortocaval fistula with a coexisting secundum atrial septal defect

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Jensen, Tim; Søndergaard, Lars

    2012-01-01

    Congenital aortocaval fistula is a very rare anomaly. Clinically, it resembles conditions that cause left-to-right shunt of blood. We report a case of such anomaly in combination with a secundum atrial septal defect in a 13-month-old girl who presented with failure to thrive and exertional...... respiratory symptoms. The aortocaval fistula was occluded percutaneously using an Amplatzer® Duct Occluder....

  2. Study on transcatheter ASD occlusion using modified atrial septal defect occluder with no stainless steel screw in canine model

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety, biocompatibility and efficacy of transcatheter closure of atrial septal defect (ASD) with no stainless-steel-screw occluder in canine model. Methods: The device was constructed from superelastic Nitinol wires tightly woven into two flat disks and sewed with polyester fibers inside, with a pliable loop on the right-atrial-disk of the device, connecting to the delivery cable. ASD was created by transcatheter puncture and balloon dilatation and then closed by occluder under fluoroscopy in the catheterization laboratory. the location and the influence of the implanted device on function of tricuspid valve and mitral valve were evaluated by echocardiography. At 1, 2, 3 and 6 months after the operation, the animals were killed and autopsy was conducted. Results: Eight dogs with puncture-produced ASD underwent ASD closing procedure successfully. the occluder showed no influence on the function of MV and AV demonstrated by echocardiogram. The two disks of the implanted device were covered with a smooth intact neogenesis layer in all dogs. Endocardial cells fully covered the surface of the two disk without inflammating reaction 3 months later. There was no evidence of corrosion on the surface of the nitinol wire removed from the dog after 6 months. Light microscopic examination of the liver, kidney, lung and spleen showed no evidence of embolization and inflammation. Conclusion: Transcatheter ASD occlusion with new-type occluder is safe, feasible, effective and good biocompatibility with a good prospective clinical application. (authors)

  3. Initial Kaiser Permanente Southern California Experience Embracing the New Technology of Transcatheter Closure of Atrial Septal Defects

    OpenAIRE

    Rosengart, Ronald M; Salem, Morris M; Degner, Timothy L; Sapin, Samuel O

    2004-01-01

    As a result of individual physicians’ initiative, transcatheter closure of secundum atrial septal defects—a new procedure—was made available to patients in the Kaiser Permanente (KP) Southern California Region soon after the US Food and Drug Administration (FDA) approved use of the AMPLATZER Septal Occluder. This ingenious device and the procedure for its implantation are described along with results of implantation in our initial 51 pediatric and adult patients. These results are compared wi...

  4. Iatrogenic intra-atrial macro-reenterant tachycardia following transcatheter closure of atrial septal defect treated by radiofrequency ablation

    Directory of Open Access Journals (Sweden)

    Ibrahim Marai

    2011-01-01

    Full Text Available Percutaneous closure of an atrial septal defect (ASD has been established as a safe and effective alternative to surgical management. We describe a case of a 41-year-old patient in whom an Amplatzer septal occluder device was used to close a moderately large ASD and who subsequently developed incessant intra-atrial macro-reenterant tachycardia. The tachycardia was terminated by radiofrequency ablation guided by electroanatomical mapping.

  5. Oclusão percutânea das comunicações interventriculares: experiência inicial Interventricular septal defects percutaneous occlusion: initial experiment

    Directory of Open Access Journals (Sweden)

    Francisco José Araújo Chamié de Queiróz

    2005-09-01

    Full Text Available OBJETIVO: Avaliar a experiência inicial com o fechamento percutâneo das comunicações interventriculares (CIV, em especial, das CIV perimembranosas (CIVPM com a nova prótese de Amplatzer. MÉTODOS: Foram submetidos ao procedimento onze pacientes, seis com CIV perimembranosas (CIVPM e cinco com CIV musculares (CIVM. Dois apresentavam infecções repetidas do trato respiratório e tinham baixo ganho ponderal. Um apresentou história prévia de endocardite infecciosa. Os demais eram assintomáticos e foram selecionados pela ecocardiografia transtorácica (ETT. RESULTADOS: No grupo das CIVM (n=5, um paciente tinha uma CIV apical, dois tinham defeitos médio-septais e dois pacientes apresentavam defeitos múltiplos. Neste grupo, foi utilizada uma prótese de comunicação interatrial (CIA (Amplatzer Septal Occluder® e cinco próteses para CIVM (Amplatzer VSD-MUSC Occluder®, sendo que uma mesma paciente recebeu dois dispositivos. Todos os implantes foram bem sucedidos e transcorreram sem complicações. No grupo das CIVPM (n=6, dois tinham aneurismas de septo membranoso. Em 5, identificamos dois pertuitos com angiografia seletiva. Utilizamos próteses de Amplatzer para canal arterial (PCA (Amplatzer Duct Occluder® em 1 paciente e próteses específicas para CIVPM nos demais (Amplatzer VSD-MEMB Occluder®. Um oclusor perimembranoso migrou imediatamente depois de liberado, sendo retirado da aorta descendente. Outro paciente apresentou bloqueio atrioventricular total (BAVT, que reverteu após corticoterapia. CONCLUSÃO: O procedimento é tecnicamente complexo e deve ser executado apenas em centros especializados. Apesar disso, mostrou-se seguro e eficaz nos casos selecionados, e pode ser oferecido como alternativa ao tratamento cirúrgico tradicional.OBJECTIVE: To assess the initial experiment with percutaneous closure of interventricular septal defects (IVSD, especially perimembranous IVSD (PMIVSD with the new Amplatzer prosthesis. METHODS

  6. Randomized clinical trial comparing percutaneous closure of patent foramen ovale (PFO using the Amplatzer PFO Occluder with medical treatment in patients with cryptogenic embolism (PC-Trial: rationale and design

    Directory of Open Access Journals (Sweden)

    Schuler Gerhard

    2011-02-01

    Full Text Available Abstract Background Several studies have shown an association of cryptogenic stroke and embolism with patent foramen ovale (PFO, but the question how to prevent further events in such patients is unresolved. Options include antithrombotic treatment with warfarin or antiplatelet agents or surgical or endovascular closure of the PFO. The PC-Trial was set up to compare endovascular closure and best medical treatment for prevention of recurrent events. Methods The PC-Trial is a randomized clinical trial comparing the efficacy of percutaneous closure of the PFO using the Amplatzer PFO occluder with best medical treatment in patients with cryptogenic embolism, i.e. mostly cryptogenic stroke. Warfarin for 6 months followed by antiplatelet agents is recommended as medical treatment. Randomization is stratified according to patients age ( Discussion patients were randomized in 29 centers of Europe, Canada, and Australia. Randomization started February 2000. Enrollment of 414 patients was completed in February 2009. All patients will be followed-up longitudinally. Follow-up is maintained until the last enrolled patient is beyond 2.5 years of follow-up (expected in 2011. Trial Registration Trial listed in ClinicalTrials.gov as NCT00166257 and sponsored by AGA Medical, Plymouth, MN, USA

  7. 经胸超声心动图指导下Amplatzer封堵成人房间隔缺损%Transthoracic echocardiographic guidance for closure of secun dum atrial septal defects with the Amplatzer septal occluder device in adults

    Institute of Scientific and Technical Information of China (English)

    张玉顺; 李寰; 张军; 贾国良; 代政学; 王小燕

    2002-01-01

    目的经胸超声心动图(TTE)指导下置人Amplatzer封堵器评价治疗成人继发孔型房间隔缺损(ASD)的可行性和治疗效果. 方法全组74例,年龄14~65 (33.6 ±14.4)岁. 按照术中超声检测的不同,分为TEE组:36例,在TEE和X线透视下监测封堵ASD;TTE组:38例,在T TE和X线透视下监测封堵ASD. 结果两组患者ASD的TTE测量值、BSD值、封堵器直径和透视时间之间等均无显著性差异(P>0.05). TTE组手术时间(64.4±13.6) min明显短于TEE 组的(76.1±16.8) min (P0.05). 随访1~3 mo,封堵器形态,位置良好,未对毗邻结构产生影响. 结论 TTE指导下经导管置入Amplatzer封堵器治疗ASD是一种安全、有效、简便可行的方法.

  8. 房间隔缺损封堵术后头痛与封堵器形态相关分析%Correlation analysis on headache accompanied by atrial septal defect occlusion and morphometric characteristics of occluder

    Institute of Scientific and Technical Information of China (English)

    王星烨; 成革胜; 杜亚娟; 张玉顺

    2013-01-01

    目的:研究房间隔缺损封堵术后头痛与封堵器形态之间的关系,以此探讨术后头痛的原因和机制.方法:继发孔型房间隔缺损患者183(男66,女117)例,年龄6~72(30.1±18.5)岁.经胸心动超声(transthoracic echocardiography,TTE)测量房间隔缺损最大直径为8~35(19.8±7.5) mm,选用的封堵器大小为10~44(25.9 ±8.9)mm.结果:术后3个月新出现头痛症状患者为16例,发生率为8.7%.头痛组房间隔缺损(atrial septal defect,ASD)缺损大小为(27.3 ±6.2)mm,无头痛组为(17.1±7.2) mm,头痛组缺损明显大于无头痛组(P<0.01).头痛组封堵器直径、超声测量封堵器的厚度均较无头痛组大(均P<0,01).封堵器直径与缺损大小的差值和封堵器直径与术后封堵器直径的差值头痛组亦明显大于无头痛组(P<0.05或P<0.01).多因素相关分析显示,头痛与封堵器厚度显著相关(P<0.01),而与年龄、缺损大小、封堵器直径等不相关.结论:封堵器厚度越厚,头痛症状发生率越高.头痛可能与封堵器表面内皮化不全或内皮化进程延长有关.%AIM:This study investigated the causes and mechanism for headache observed after atrial septal defect (ASD) occlusion by studying the correlation between headache and the geometric characteristics of the occluder.METHODS:One hundred eighty three patients (66 male,117 female) with secundum ASD were included with ages of 6-72 (30.1 ± 18.5) years.The maximum size of the defect was in the range of 8-35 mm (19.8-± 7.5) mm,measured by transthoracic echocardiography (TTE).Sizes of the occluders used were 10-44 mm (25.9 ± 8.9).RESULTS:Sixteen patients (8.7% of all patients) reported a postoperative headache after 3 months.The group with reported headache had significantly greater ASD defect sizes (27.3-± 6.2) mm compared with the defect sizes in the group without headache [(17.1 ±7.2) mm,P <0.01].In the group with headaches,both the diameter and thickness (measured by

  9. 生物可吸收室间隔缺损封堵器的体外降解和力学性能%In vitro degradation property and mechanical force test of a bioresorbable ventricular septal defect occluder

    Institute of Scientific and Technical Information of China (English)

    朱玉峰; 陈文瑶; 黄新苗; 白元; 吴弘; 张瑾; 秦永文; 赵仙先

    2013-01-01

    目的 设计和制作生物可吸收室间隔缺损(ventricular septal defect,VSD)封堵器,观察其体外降解特性并对其机械力学性能进行测试,为下一步经导管闭合VSD的动物实验打下基础.方法 采用可降解高分子聚合材料聚对二氧环己酮(polydioxanone,PDO)单丝、聚左旋乳酸(poly-L-lactic acid,PLA)无纺布和聚乙醇酸(polyglycolic acid,PGA)缝线制作生物可吸收VSD封堵器,在封堵器盘片上对称部位缝上金属钽颗粒为X线下显影标记,右侧盘片尾部设计一环形小襻供配套输送系统钳夹输送.体外测试可吸收VSD封堵器的相关力学性能,行体外降解试验,测定封堵器盘片支撑力和质量衰减情况.结果 可吸收VSD封堵器的机械力学性能包括压缩/弹性恢复性能、尾部环形襻极限拉力、左侧盘片支撑力皆满足经导管输送的封堵力学要求.体外降解实验显示,可吸收封堵器8周内结构和形状仍保持不变,12周时PDO丝出现断裂、崩解,盘片结构不完整.左侧盘片支撑力在体外降解2周和3周时支撑力比初始时增强(分别为初始支撑力的121.7%和107.8%),4周和6周时支撑力比初始时下降(分别降至88.6%和85.3%).封堵器质量最初4周下降不到1%,6周以后质量明显下降.结论 用生物可吸收材料制作的VSD封堵器满足经导管植入体内的生物力学要求,可进行下一步的动物实验研究.%Objective To design and prepare a ventricular septal defect (VSD) occluder with bioabsorbable materials and to evaluate its in vitro degradation and mechanical force.Methods A bioresorbable VSD occluder was made of polymeric materials polydioxanone (PDO) monofilament,poly-L-lactic acid (PLA) fabrics and polyglycolic acid(PGA) sutures.Tantalum particles were sewn on the symmetrical parts of the occluder disc as tracers for X-ray,and the end of the right side of the disc was designed with a circular loop for the matched delivery system to clamp and

  10. Ureteric Embolization for Lower Urinary Tract Fistulae: Use of Two Amplatzer Vascular Plugs and N-Butyl Cyanoacrylate Employing the 'Sandwich' Technique

    Energy Technology Data Exchange (ETDEWEB)

    Saad, Wael E. A., E-mail: ws6r@virginia.edu; Kalagher, S.; Turba, U. C.; Sabri, S. S.; Park, A.-W.; Stone, J.; Angle, J. F.; Matsumoto, A. H. [University of Virginia Health System, Department of Radiology and Medical Imaging, Division of Vascular Interventional Radiology (United States)

    2013-08-01

    PurposeThis study describes and evaluated the effectiveness of occluding distal ureters in the clinical setting of urinary vaginal (vesicovaginal or enterovesicovaginal) fistulae utilizing a new technique which combines Amplatzer vascular plugs and N-butyl cyanoacrylate.MaterialsThis is a retrospective study (January 2007-December 2010) of patients with urinary-vaginal fistulae undergoing distal ureter embolization utilizing an Amplatzer- N-butyl cyanoacrylate-Amplatzer sandwich technique. An 8-12-mm type-I or type-II Amplatzer vascular plug was delivered using the sheath and deployed in the ureter distal to the pelvic brim. Instillation of 0.8-1.5 cc of N-butyl cyanoacrylate into ureter proximal to the Amplatzer plug was performed. This was followed by another set of 8-12-mm type-I or type-II Amplatzer vascular plugs in a technique referred to as the 'sandwich technique.'ResultsFive ureters in three patients were occluded utilizing the above-described technique during the 4-year study period. Mean maximum size Amplatzer used per ureter was 10.8 mm (range, 8-12). One ureter required three Amplatzer plugs and the rest required two. Two patients (3 ureters) were clinically successful with complete resolution of symptoms in 36-48 h. The third patient (2 ureters) was partly successful and required a second Amplatzer- N-butyl cyanoacrylate sandwich technique embolization. The mean clinical follow-up was 11.3 months (range, 1.7-29.2).ConclusionsThe Amplatzer- N-butyl cyanoacrylate-Amplatzer sandwich technique for occluding the distal ureter is safe and effective with a quick (probably due to the N-butyl cyanoacrylate) and durable (probably due to the Amplatzer plugs) clinical response.

  11. Ureteric Embolization for Lower Urinary Tract Fistulae: Use of Two Amplatzer Vascular Plugs and N-Butyl Cyanoacrylate Employing the “Sandwich” Technique

    International Nuclear Information System (INIS)

    PurposeThis study describes and evaluated the effectiveness of occluding distal ureters in the clinical setting of urinary vaginal (vesicovaginal or enterovesicovaginal) fistulae utilizing a new technique which combines Amplatzer vascular plugs and N-butyl cyanoacrylate.MaterialsThis is a retrospective study (January 2007–December 2010) of patients with urinary-vaginal fistulae undergoing distal ureter embolization utilizing an Amplatzer- N-butyl cyanoacrylate-Amplatzer sandwich technique. An 8–12–mm type-I or type-II Amplatzer vascular plug was delivered using the sheath and deployed in the ureter distal to the pelvic brim. Instillation of 0.8–1.5 cc of N-butyl cyanoacrylate into ureter proximal to the Amplatzer plug was performed. This was followed by another set of 8–12-mm type-I or type-II Amplatzer vascular plugs in a technique referred to as the “sandwich technique.”ResultsFive ureters in three patients were occluded utilizing the above-described technique during the 4-year study period. Mean maximum size Amplatzer used per ureter was 10.8 mm (range, 8–12). One ureter required three Amplatzer plugs and the rest required two. Two patients (3 ureters) were clinically successful with complete resolution of symptoms in 36–48 h. The third patient (2 ureters) was partly successful and required a second Amplatzer- N-butyl cyanoacrylate sandwich technique embolization. The mean clinical follow-up was 11.3 months (range, 1.7–29.2).ConclusionsThe Amplatzer- N-butyl cyanoacrylate-Amplatzer sandwich technique for occluding the distal ureter is safe and effective with a quick (probably due to the N-butyl cyanoacrylate) and durable (probably due to the Amplatzer plugs) clinical response

  12. Challenges in treatment of postinfarction ventricular septal defect and heart failure

    Directory of Open Access Journals (Sweden)

    Mangovski Ljupčo

    2015-01-01

    Full Text Available Introduction. Acquired ventricular septal defect (VSD is uncommon, but serious mechanical complication of acute myocardial infarction with poor outcome and high mortality rate in surgically or medically treated patients. Case report. We report a 58-year-old male patient admitted to our hospital six days following acute inferior myocardial infarction complicated by ventricular septal rupture with signs of heart failure. Coronary angiography revealed 3-vessel disease, with proximally occluded dominant right coronary artery. Transthoracic echo exam revealed aneurysm of a very thin inferior septum and the basal portion of the inferior left ventricular wall, with septal wall rupture. One of the VSD dimensions was 15 mm and left- to right shunt was calculated 2 : 1. Since the patient was at too high risk for surgical closure, transcatheter closure of VSD was chosen as a better option. Under short intravenous sedation, 24 mm Amplatzer device was implanted percutaneously with transesophageal echo guidance. The post-procedural result revealed a small residual shunt, but it was followed by significant improvement of the patient’s clinical status. A 24h Holter ECG monitoring did not show cardiac rhythm or conduction disturbances. Coronary angiography was repeated ten days following the procedure, after hemodynamic stabilization of the patient, with direct stenting of the circumflex artery and the intermediate artery. Ostial left descending artery lesion was left for further functional significance assessment. Conclusion: Percutaneous closure with a septal occluder device can be definitive primary treatment for anatomically suitable patients or it can serve as a bridge to surgical treatment.

  13. Guidance of secundum atrial septal defects occlusion by using transthoracic echocardiography and X-ray fluoroscopy

    International Nuclear Information System (INIS)

    Objective: To evaluate the treatment efficiency of transcatheter closure of secundum atrial septal defect (ASD) by using Amplatzer occluder device with guidance of transthoracic echocardiography (TTE) and X-ray fluoroscopy. Methods: There were 84 patients. The mean age was 23.6 ± 19.4 years (ranged from 1 to 65 years). The largest diameter of ASD was measured by TTE in all of the patients and the largest diameter was measured by balloon simultaneously in 46 cases. In patients of ASD with solid edge, the largest diameter of ASD was measured directly by TTE, wherever in those with very soft and floppy edge, the solid edge was only measured. The closure procedure was guided by fluoroscopy and TTE. Results: The largest diameter of ASD was 18.7±7.4 mm (ranged from 4 to 36.5 mm) measured by TTE before interventions in 84 cases. There was no difference between the largest diameter measured by TTE (18.6 ± 7.5 mm) and balloon (19.2 ± 7.4 mm) (P>0.05), however, the correspondence was evident (r=0.957, P<0.01). The diameter of selected occluder was 22.1 ± 9.7 mm (ranged from 5 to 40 mm). The successful rate of placement of Amplatzer occluder was 100%. No complications occurred during the procedure, and no one needed for emergency surgery. Trivial to small residual shunts were found in 6 cases (7.1%) immediately after the procedure, and in 3 cases (3.6%) up to 3 days after the procedure. No residual shunts were found in a 6-month follow-up except in 1 case (1.2%) with multiple ASD. TTE examination showed that right heart size was improved in a one-year follow-up in 39 cases. Conclusion: Transcatheter closure of secundum ASD using Amplatzer occluder device with guidance of TTE and X-ray fluoroscopy guidance is an efficient, feasible, and simple method. Large and short-edged ASD, or ASD with thin edge and difficulty in detecting of edge by TTE, should be examined and monitored by TEE before the procedure, and then the procedure can be done by TTE and fluoroscopy guidance

  14. Hybrid management of a large atrial septal defect and a patent ductus arteriosus in an infant with chronic lung disease

    International Nuclear Information System (INIS)

    We report a case wherein a dysmorphic four-month-old infant (weighing 4.5 kgs) with an 8 mm atrial septal defect (ASD), a 1.5 mm patent ductus arteriosus (PDA), a 2 mm mid-muscular ventricular septal defect (VSD) associated with chronic lung disease, and severe pulmonary hypertension, was successfully managed using a hybrid approach, without the use of cardiopulmonary bypass (CPB). Through a median sternotomy, the PDA was ligated and the ASD was closed with a 9 mm Amplatzer septal occluder implanted through peratrial access. The VSD was left untouched. Serial echocardiograms showed complete closure of the ASD and PDA, with progressive normalization of the pulmonary artery (PA) pressures within three months. The child rapidly gained weight and was weaned from sildenafil and oxygen administration. After 12 months, the VSD closed spontaneously and the child remained well, with normal PA pressures. A hybrid approach without the use of CPB should be considered in the management of infants with congenital heart disease, associated with chronic lung disease and pulmonary hypertension

  15. Impella-assisted transcatheter closure of an acute postinfarction ventricular septal defect.

    Science.gov (United States)

    Ibebuogu, Uzoma Nwachukwu; Bolorunduro, Oluwaseyi; Hwang, Inyong

    2016-01-01

    This case report describes a 72-year-old woman who developed an acute postmyocardial infarction ventricular septal defect (VSD) with consequent cardiogenic shock. Intra-aortic balloon pump (IABP) counter-pulsation was urgently initiated in the cardiac catheterisation laboratory, with neither clinical nor haemodynamic improvement, prompting immediate removal of the IABP and the insertion of an Impella 2.5 heart pump (AbioMed Inc; Danvers, Massachusetts, USA), a temporary ventricular assist device. Thereafter, the patient improved clinically and was admitted to the cardiovascular intensive care unit (ICU). While in the cardiovascular ICU, the patient developed worsening mechanical haemolysis of blood cells, stable but persistent cardiogenic shock and a transient ischaemic attack. A consensus decision was made to proceed with percutaneous repair of the VSD as she was deemed at high risk for surgical repair. She underwent successful percutaneous VSD repair on day 4 of hospitalisation, using a single 18 mm Amplatzer muscular VSD occluder (AGA Medical, Plymouth, Minnesota, USA) with trace residual flow across the occluder. Adequate systolic blood pressure and cardiac output was maintained postprocedure with the Impella 2.5 device. The patient, however, succumbed to multiorgan dysfunction occasioned by sepsis. PMID:27030453

  16. Single Centre Experience for Percutaneous Closure of Secundum Atrial Septal Defect

    Directory of Open Access Journals (Sweden)

    Ramazan Aydemir

    2011-12-01

    Full Text Available Introduction: Atrial septal defect (ASD is the most common congenital heart disease in adults and constitutes 5-10% of all congenital heart disease. Primary surgical closure has been the standard approach for many years with high success rate. Transcatheter closure of ASD in selected patients has became the contemprorary practice that has the advantages of short hospital stay and relative ease of prosedure. In this article, we reported the results of percutaneous closure of ASD in our center.
Methods: Between 2009-2011, thirty-two patients (mean age 36±18 years and 24 females who had secundum type ASD which detected by transthoracic echocardiography (TTE and transesophageal echocardiography (TEE were included in this study. Twenty-nine (90,6% patients were closed percutaneously. Tree patients were referred for surgery because of failure of percutaneous closure. Amplatzer Septal Occluder was used in 25 (86,2% patients and Occlutech device was used in other patients. All procedures were performed under local anesthesia. All of the patients were examined with TTE before the procedure and, at the 1st, 3rd, 6th and 12th month follow-up visits.
Results: Pre-operative mean pulmonary artery pressure was 33,3±7,5 mmHg and mean pulmonary to systemic flow (Qp/Qs ratio was 2,9±1,1. Mean ASD diameter measured by TEE was 20,1±6,6 mm and mean streched diameter measured by balloon catheter was 22,1±5,9 mm. Mean device size 24±6 mm (range 12-36 mm. In the follow-up period no major complication was observed, but mild to moderate residual shunt flow was detected in two patients (% 6,8.
Conclusion: Percutaneous ASD closure has been performed with high success and low complication rates in patients with secundum atrial septal defect in our center.

  17. Percutaneous Interventional Treatment of Atrial Septal Defect Secundum in Macedonia

    Directory of Open Access Journals (Sweden)

    Ivan Milev

    2014-03-01

    Conclusion: In conclusion, the implantation of a septal occluder was found to be a safe procedure that resulted in improved hemodynamic parameters that result from right ventricular volume overload with favorable short- and mid-term results.

  18. [Amplatzer® Vascular Plug III, for closing residual mitral paravalvular leak: three-dimensional transesophageal echocardiography image].

    Science.gov (United States)

    Reyes-Gómez, Carlos Alberto; García-Montes, José Antonio; Arias-Godínez, Antonio; Zabal-Cerdeira, Carlos

    2015-01-01

    Paravalvular leak is a significant complication after surgical valve replacement. Traditionally, redo surgery has been considered the treatment of choice, but is associated with high morbidity and mortality as well as increase risk of developing new leaks. Percutaneous treatment of paravalvular leak appears as an attractive alternative. Such treatment has been made possible by the current ability to integrate multiple imaging modalities that have helped to define the anatomy of the defect and planning and guiding the percutaneous closure procedure, thus resulting in better outcomes. The Amplatzer® Vascular Plug III (St. Jude Medical) is the first device specifically designed for percutaneous closure of paravalvular leak with promising results. We present the three-dimensional transesophageal echocardiographic images of a successful outcome of percutaneous closure of a residual mitral paravalvular leak with an Amplatzer® Vascular Plug III device (St. Jude Medical), after an initial procedure of percutaneous closure with an Amplatzer® duct occluder (St. Jude Medical). PMID:25912709

  19. Renal Artery Stump to Inferior Vena Cava Fistula: Unusual Clinical Presentation and Transcatheter Embolization with the Amplatzer Vascular Plug

    International Nuclear Information System (INIS)

    Fistulous communication between the renal artery stump and inferior vena cava following nephrectomy is rare. We describe the case of a 52-year-old man with a fistula detected on investigation for hemolytic anemia in the postoperative period. The patient had had a nephrectomy performed 2 weeks prior to presentation for blunt abdominal trauma. The fistula was successfully occluded percutaneously using an Amplatzer vascular plug. The patient recovered completely and was discharged 2 weeks later.

  20. Transcatheter Closure of Atrial Septal Defects in a Center With Limited Resources: Outcomes and Short Term Follow-Up

    Directory of Open Access Journals (Sweden)

    Sukman T. Putra

    2015-12-01

    Full Text Available Background: Transcatheter closure of atrial septal defects (ASD has been accepted world-wide as an alternative to surgical closure with excellent results. This interventional, non-surgical technique plays an important role in the treatment of ASD mostly in the developing world where resources are limited. Objectives: To report the outcomes and short term follow-up of transcatheter closure of ASD over a 12-year period at our institution with limited resources. Patients and Methods: This retrospective study included all patients with the diagnosis of secundum ASD and significant shunting (Qp/Qs > 1.5:1 as well as dilated right atrium and right ventricle who had transcatheter closure at Integrated Cardiovascular Center (PJT, Dr. Cipto Mangunkusumo Hospital between October 2002 and October 2014. One hundred fifty-two patients enrolled in this study were candidates for device closure. Right and left heart cardiac catheterization was performed before the procedure. All patients underwent physical examination, ECG, chest X-ray and transthoracal echocardiography (TTE prior to device implantation. Results: A total of 152 patients with significant ASD underwent device implantation. Subjects’ age ranged from 0.63 to 69.6 years, with median 9.36 years and mean 16.30 years. They consisted of 33 (21.7% males and 119 (78.3% females, with mean body weight of 29.9 kg (range 8 to 75; SD 18.2. The device was successfully implanted in 150 patients where the majority of cases received the Amplatzer septal occluder (147/150; 98% and the others received the Heart Lifetech ASD occluder (3/150, 2%, whereas two other cases were not suitable for device closure and we decided for surgical closure. The mean ASD size was 19.75 (range 14 - 25 mm. During the procedure, 5 (4.9% patients had bradycardia and 3 (2.9% patients had supraventricular tachycardia (SVT, all of which resolved. Conclusions: In our center with limited facilities and manpower, transcatheter closure of

  1. Feasibility and safety of transthoracic echocardiography-guided transcatheter closure of atrial septal defects with deficient superior-anterior rims.

    Science.gov (United States)

    Li, Gui-Shuang; Li, Hai-De; Yang, Jie; Zhang, Wen-Quan; Hou, Zong-Shen; Li, Qing-Chen; Zhang, Yun

    2012-01-01

    Although previous studies showed that transthoracic echocardiography (TTE) can be used to guide transcatheter closure of atrial septal defect (ASD), whether TTE can be used to guide transcatheter closure of secundum ASD with a deficient superior-anterior rim is unknown and this critical issue was addressed in the present study. A total of 280 patients with secundum ASD who underwent transcatheter ASD closure were recruited and divided into groups A and B depending on ASD superior-anterior rim>4 mm (n = 118) or ≤4 mm (n = 162). TTE was used to guide Amplatzer-type septal occluder (ASO) positioning and assess residual shunt. Procedure success was defined as no, trivial and small residual shunt immediately after the procedure as assessed by color Doppler flow imaging. Group A and group B did not differ in complication rate (8.55% vs.7.55%), procedure success rate (98.3% vs. 95.0%) or complete closure rate immediately after the procedure (89.7% vs. 89.3%) or at 6-month follow-up (98.3% vs. 96.8%). The mean procedure and fluoroscopy time in group B were much longer than those in group A. In conclusion, the absence of a sufficient superior-anterior rim in patients undergoing percutaneous closure of secundum-type ASDs using fluoroscopic and TTE guidance is associated with slightly greater device malposition and migration as well as increased procedural and fluoroscopic times, but the overall complication rate did not differ with TTE guidance when compared to historical controls that used TEE guidance. PMID:23284660

  2. Feasibility and safety of transthoracic echocardiography-guided transcatheter closure of atrial septal defects with deficient superior-anterior rims.

    Directory of Open Access Journals (Sweden)

    Gui-Shuang Li

    Full Text Available Although previous studies showed that transthoracic echocardiography (TTE can be used to guide transcatheter closure of atrial septal defect (ASD, whether TTE can be used to guide transcatheter closure of secundum ASD with a deficient superior-anterior rim is unknown and this critical issue was addressed in the present study. A total of 280 patients with secundum ASD who underwent transcatheter ASD closure were recruited and divided into groups A and B depending on ASD superior-anterior rim>4 mm (n = 118 or ≤4 mm (n = 162. TTE was used to guide Amplatzer-type septal occluder (ASO positioning and assess residual shunt. Procedure success was defined as no, trivial and small residual shunt immediately after the procedure as assessed by color Doppler flow imaging. Group A and group B did not differ in complication rate (8.55% vs.7.55%, procedure success rate (98.3% vs. 95.0% or complete closure rate immediately after the procedure (89.7% vs. 89.3% or at 6-month follow-up (98.3% vs. 96.8%. The mean procedure and fluoroscopy time in group B were much longer than those in group A. In conclusion, the absence of a sufficient superior-anterior rim in patients undergoing percutaneous closure of secundum-type ASDs using fluoroscopic and TTE guidance is associated with slightly greater device malposition and migration as well as increased procedural and fluoroscopic times, but the overall complication rate did not differ with TTE guidance when compared to historical controls that used TEE guidance.

  3. Transient ST-segment-elevation during transcatheter closure of atrial septal defect(ASD) with ASD occluder made in China: A report of two cases%国产封堵器闭合房间隔缺损过程中的短暂ST段抬高2例

    Institute of Scientific and Technical Information of China (English)

    王显; 胡大一; 孙琪; 谭琛

    2008-01-01

    目的 国产房间隔封堵器闭合房间隔缺损的安全性和有效性已得到证实.我们报告在使用国产封堵器闭合房间隔缺损过程中出现的短暂ST段抬高现象2例.方法 适合进行经皮封堵术的房间隔缺损患者35例,使用北京华医圣杰公司生产的房间隔封堵器进行封堵.术前经胸超声充分评估缺损的大小、位置、与周围结构的距离以及房间隔的软硬边缘等,选择封堵器要与缺损的伸展直径相匹配.手术过程在局部麻醉或者基础麻醉下进行,术中使用经胸超声引导.封堵器释放后有效闭合缺损、位置稳定且不影响周边结构视为手术成功.术后3,6,12月进行随访.结果 在35例患者中有2例在封堵器释放过程中,出现短暂性ST段抬高超过2 mV,伴有心绞痛发作.心电图改变和症状发作平均持续时间(4.2±2.2)min,2例心电图改变均发生于Ⅱ,Ⅲ和aVF导联,此过程伴有心率减慢和血压降低.静脉注射硝酸甘油后心电图和症状没有得到即刻改善,但封堵器沿鞘管被收回后心电图立即改善、症状逐渐消失.换用较小型号的封堵器闭合房间隔缺损后,没有引起任何血流动力学异常和短暂性心电图改变.随访3,6,12月没有发现心肌缺血和心绞痛发作.结论 经导管闭合房间隔缺损过程中出现的短暂ST段抬高现象,可能与所选封堵器直径过大,刺激房间隔有关.%AIM The safety and efficacy of atrial septal defect (ASD) occluder(ASDO) made in China for transeatheter closure of ASD have investigated prospectively. We report the phenomenon of transient ST-segment-elevation(TSTE) during transcatheter closure of ASD with ASDO made in China in this single-centre study. METHODS A total of 35 consecutive patients in whom a septal defect occluder (Huayishengjie Inc. , Beijing, China) was used to close a clinically significant ASD were included in our study. All procedures performed under basic or local anaesthesia

  4. 先天性心脏病封堵器治疗随访过程中彩色多普勒超声的应用%Color Doppler ultrasound in the follow-up of occluder-treated congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    张敏; 谷翔; 许向东; 王冰

    2011-01-01

    BACRGROUND: Currently, occluders, instead of traditional surgeries, are used for treatment of atrial septal defect, ventricular septal defect, patent ductus arteriosus due to congenital heart disease. As a result, color Doppler ultrasound is widely used in the follow-up of occlusion therapy.OBJECTIVE: To assess the value of color Doppler ultrasound in the follow-up of occluder-treated congenital heart disease.METHODS: The first author performed an electronic retrieve of Wanfang database for articles related to the follow-up of occluder-treated congenital heart disease published from January 1999 to December 2009. The keyword were "color ultrasound,congenital heart disease, atrial septal defect, ventricular septal defect, patent ductus arteriosus, occluder". Repetitive articles,reviews and Meta analysis were excluded, and finally 24 articles were included in the result analysis.RESULTS AND CONCLUSION: The appropriate occluder was chosen according to defect size and distance between the defect and the right coronary aortic valve measured based on echocardiography and left ventricular angiography. Selection of cases with appropriate indications by using color Doppler ultrasound was the key to successful occlusion. The Amplatzer occluder made of superelastic nickel-titanium memory alloy had a good biocompatibility and safety. During the follow-up of 35 years,patients receiving the implantation of the Amplatzer occluder showed no adverse effects, and the occluder position was fixed and did not shift. During the treatment of congenital heart disease with occluders, color Doppler ultrasound plays an important role in preoperative examination, intraoperative monitoring and postoperative follow-up.%背景:目前先天性心脏病(先心病)房间隔缺损、室间隔缺损、动脉导管未闭的封堵器治疗替代了传统的外科手术,彩色多普勒超声(彩超)在封堵治疗随访中得到广泛应用.目的:评价彩超在先心病封堵器治疗随访过程中

  5. Application of the AMPLATZER Vascular Plug in Endovascular Occlusion of Dialysis Accesses

    International Nuclear Information System (INIS)

    The purpose of this study was to share our initial experience with the AMPLATZER Vascular Plug (AVP) in occluding dialysis accesses. Between January 2007 and October 2008, five patients with autogenous and one patient with prosthetic accesses were referred for endovascular occlusion owing to central venous obstruction (n = 4) and dialysis-associated steal syndrome (n = 2) leading to disabling complications. We used a single AVP in two patients, double AVPs in two patients, and double AVPs and n-butyl 2-cyanoacrylate in one patient with an autogenous access. Two coils were deployed between two AVPs to occlude the prosthetic graft. Immediate success was achieved in all patients, with no complications. Mean follow-up time was 13 months (range, 1-21 months) and none of the patients had experienced symptom recurrence as of the time of writing. The AVP allows simple, precise, and reliable dialysis access occlusion without significant complications when surgical ligation is not preferred. It can be used with other embolizing agents to provide occlusion in the case of failure.

  6. Aneurysm of an Anomalous Systemic Artery Supplying the Normal Basal Segments of the Left Lower Lobe: Endovascular Treatment with the Amplatzer Vascular Plug II and Coils

    International Nuclear Information System (INIS)

    An anomalous systemic artery originating from the descending thoracic aorta supplying the normal basal segments of the lower lobe of the left lung without sequestration is a rare congenital anomaly. The published surgical treatments include lobectomy, segmentectomy, anastomosis, and ligation. In addition, endovascular treatment with coils has been reported. A second-generation occluder, the Amplatzer Vascular Plug II (AVP II), has a central plug and two occlusion disks and a finer, more densely woven nitinol wire, thus enabling faster embolization. This published case is the first successful occlusion of an aneurysm of an anomalous systemic artery with the AVP II and fibered coils, with 10 months of follow-up.

  7. Atrial Septal Defect (For Parents)

    Science.gov (United States)

    ... Video) Going to the Hospital Your Heart & Circulatory System Quiz: Heart & Circulatory System EKG (Video) What's It Like to Have Surgery? Atrial Septal Defect Ventricular Septal Defect Heart and Circulatory System Anesthesia Basics Contact Us Print Resources Send to ...

  8. Clinical experience with the percutaneously inserted Amplatz vena caval filter

    International Nuclear Information System (INIS)

    The Amplatz filter is a 14-F vena caval filter designed for percutaneous insertion and retrieval. Thirty filters were inserted. The indications for placement were anticoagulant failure (four cases) and contraindication to anticoagulation (26 cases). Radiologic, pathologic, or clinical follow-up (average, 10 months) was available in 27 patients. Results include one case of recurrent pulmonary embolism (4%), nine cases of caval thrombosis (33%), and two cases of deep venous thrombosis in the insertion leg (7%). Filter migration did not occur in any case. The Amplatz filter is easily inserted and well tolerated by the patient. Although effective in preventing recurrent pulmonary embolism, it has a relatively high incidence of caval thrombosis

  9. Coronary anastomoses over intraluminal occluders

    OpenAIRE

    Stanford, William

    1980-01-01

    A simplified technique with the use of intraluminal vessel occluders to prevent collateral flow of blood and cardioplegic solution during saphenous vein distal coronary artery anastomosis is presented here. Additional advantages of this technique are the stenting of vessels to facilitate vessel approximation and the assurance of anastomotic patency.

  10. Unexpected difficulty during transcatheter device closure of atrial septal defect associated with right aortic arch

    International Nuclear Information System (INIS)

    Right aortic arch (RAA) associated with isolated atrial septal defect (ASD) is very rare. We report successful closure of ASD associated with RAA using a 26-mm atrial septal occluder in a 30-year-old male patient. The impingement of right descending aorta in RAA caused malposition of the device in the left atrium. Deployment of the device through the right upper pulmonary vein successfully closed the defect. Follow-up evaluation by computerized tomography scan and echocardiogram showed no pulmonary venous obstruction

  11. Bilateral transrenal ureteral occlusion by means of n-butyl cyanoacrylate and AMPLATZER vascular plug

    OpenAIRE

    Grasso, Rosario F; Roberto Luigi Cazzato; Giacomo Luppi; Simona Mercurio; Francesco Giurazza; Riccardo Del Vescovo; Eliodoro Faiella; Bruno Beomonte Zobel

    2014-01-01

    AMPLATZER vascular plug is a widely used embolic agent. In the present paper, we present a case of an 86-year-old female patient who underwent bilateral ureteral occlusion by means of AMPLATZER vascular plug II coupled to n-butyl cyanoacrylate (NBCA) because of recurring pyelonephritis following cystectomy with subsequent bilateral ureterosigmoidostomy (sec. Mainz type II).

  12. Bilateral transrenal ureteral occlusion by means of n-butyl cyanoacrylate and AMPLATZER vascular plug

    Directory of Open Access Journals (Sweden)

    Rosario F Grasso

    2014-01-01

    Full Text Available AMPLATZER vascular plug is a widely used embolic agent. In the present paper, we present a case of an 86-year-old female patient who underwent bilateral ureteral occlusion by means of AMPLATZER vascular plug II coupled to n-butyl cyanoacrylate (NBCA because of recurring pyelonephritis following cystectomy with subsequent bilateral ureterosigmoidostomy (sec. Mainz type II.

  13. Amplatzer PDA occluder used in adult patent ductus arteriosus with serious pulmonary hypertension after testing balloon occlusio

    Institute of Scientific and Technical Information of China (English)

    卢才义; 魏璇; 黄丛春; 罗惠兰; 谈维洁; 毛树森

    2002-01-01

    @@ A 36-years-old female had heart palpitation and chest press for five years and the symptoms had been worsening for half a year. She was diagnosed with patent ductus arteriosus with moderate pulmonary hypertension in a local hospital 5 years before but was not operated. Physical examination showed: T 37℃, P 87?bpm, R 18?bpm and BP 130/70?mm?Hg. There was no distension of the jugular vein, and the lungs were clear. There was continuous mechanic murmur at the second intercostal space, and grade 2 systolic blowing murmur at the apex. P2 was strengthened. The liver and spleen were not enlarged and there was no edema in either leg. ECG showed a pulmonary P wave and right ventricular hypertrophy. Chest X-ray film showed pulmonary segment projection 3?cm, and the dimension of the right inferior pulmonary artery bed increased to 3?cm in diameter. On echocardiography, both atria, the pulmonary artery and the right ventricle were enlarged.

  14. A novel method of creation of a fenestration in nitinol occluder devices used in closure of hypertensive patent arterial ducts

    Directory of Open Access Journals (Sweden)

    Anil Kumar Singhi

    2016-01-01

    Full Text Available Test occlusion with a balloon is done to predict operability of large hypertensive patent ductus arteriosus (PDA. If the fall in the pulmonary artery pressures is inadequate, a complete closure is not desired. To create a predictable premeasured fenestration in a nitinol occluder device used for closing hypertensive PDA. A large nitinol occluder device was punctured with an 18G needle to advance a 0.035½ stiff guide wire through the occluder before loading it into the delivery system. The occluder with the guidewire was then deployed across the PDA. A coronary guide catheter was later threaded through the guidewire into the fabric of the device, which was still held by the delivery cable. A coronary stent was deployed across the fenestration in the occluder to keep it patent. An 8-year-old boy with Down syndrome and hypertensive PDA was hemodynamically assessed. Even though there was a fall in the pulmonary vascular resistance index and pressures on test occlusion, the pulmonary artery pressures were labile with fluctuations. A customized fenestration was made in a 16 mm muscular ventricular septal defect occluder (MVSO with a 4.5 mm bare-metal coronary stent. The pulmonary artery pressures remained at half of the aortic pressures after the procedure. This fenestration model precisely and predictably fenestrated a large occluder device used to close a hypertensive large PDA. Long-term patency of these fenestrations has to be assessed on the follow-up, and may be improved through larger fenestrations, systemic anticoagulation and use of covered stents.

  15. Transcatheter closure of tubular type patent ductus arteriosus using Amplatzer� ductal occluder II: a case report

    Directory of Open Access Journals (Sweden)

    Mulyadi M Djer

    2013-09-01

    Full Text Available Patent ductus arteriosus (PDA is a common congenital heart disease, accounting for 5-10% of all congenital heart diseases. The incidence of PDA is even higher in preterm neonates, ranging from 20-60%.1-4 Closure of PDA is indicated in all cases, except for duct-dependent congenital heart diseases or PDA with Eisenmenger syndrome.1,5,6 In small asymptomatic PDAs, closure is indicated to prevent the risk of complications, such as endarteritis, endocarditis, aneurysm of ductus arteriosus, or congestive heart failure.1,2,7 In recent years, interventional cardiology has become a gold standard therapy for the majority of PDA cases beyond neonatal age. Since its introduction in 1967, many devices and methods have been developed to allow transcatheter closure of virtually all PDAs, regardless of size or configuration. Nevertheless, the tubular shape (type C PDA, which has the highest residual shunt rate, still poses a great challenge for the interventionist.8-10 The second generation of Amplatzer® device occluders (ADO II, released in 2007, has been suggested to be effective in closing tubular PDAs.10 The purpose of this study was to report the initial clinical experience using ADO II to close a tubular type PDA in Indonesia

  16. A Complication following the Transcatheter Closure of a Muscular Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    Mustafa Karaçelik

    2015-12-01

    Full Text Available Today, congenital heart diseases may be treated without surgery through advances in interventional cardiology. However, complications such as infection and thrombus formation may develop due to foreign materials used during these procedures. Surgical intervention may be required for the removal of the device utilized for the procedure. In this case report, we present the surgical treatment of a residual ventricular septal defect (VSD that had developed in a 6-year-old patient with an apical muscular VSD closed with the Amplatzer muscular VSD device. The patient was admitted to the emergency room with complaints of abdominal pain and high fever 5 days after discharge without any cardiac symptoms. When she arrived at our clinic, she had a heart rate of 95 bpm, blood pressure of 110/70 mmHg, and temperature of 38.5ºC. Examinations of the other systems were normal, except for a 3/6 pan-systolic murmur at the mesocardiac focus on cardiac auscultation. Echocardiography showed a residual VSD, and the total pulmonary blood flow to the total systemic blood flow ratio (Qp/Qs of the residual VSD was 1.8. In the operating room, the Amplatzer device was removed easily with a blunt dissection. The VSD was closed with an autologous fresh pericardial patch. Following the pulmonary artery debanding procedure, the postoperative period was uneventful. The condition of the patient at the time of discharge and in the first postoperative month’s follow-up was good. There was no residual VSD or infection. 

  17. Alarm!!! A UFO inside the heart.

    Science.gov (United States)

    Santoro, Giuseppe; Castaldi, Biagio; Iacono, Carola; Giugno, Luca; Gaio, Gianpiero; Russo, Maria G

    2012-10-01

    An 8-year-old asymptomatic child was referred for surgical repair of coronary sinus atrial septal defect resulting in significant left-to-right shunt and right chamber volume overload. The septal fenestration was located near to its drainage site into the right atrium. Due to this seemingly favourable anatomy, transcatheter closure of the septal defect was performed using an Amplatzer Septal Occluder device. The echocardiographic postprocedural evaluation imaged the occluding device almost perpendicular to the atrial septum, seemingly floating above the mitral valve orifice, like an alien spaceship inside the heart. PMID:22955207

  18. Alveolar septal pulmonary amyloidosis: a case report

    International Nuclear Information System (INIS)

    Primary pulmonary amyloidosis is a rare diesase, and is classified as either tracheobronchial or parenchymal; the latter is also divided into nodular and diffuse alveolar septal forms. The alveolar septal form is extremely rare and usually produces reticular and nodular opacities. We describe a case of alveolar septal pulmonary amyloidosis manifested as multiple small nodules on chest radiograph and disseminated micronodules mainly in centrilobular and subpleural location without reticular opacities, on HRCT

  19. Nasal Septal Deviation and Facial Skeletal Asymmetries.

    Science.gov (United States)

    Hartman, Christopher; Holton, Nathan; Miller, Steven; Yokley, Todd; Marshall, Steven; Srinivasan, Sreedevi; Southard, Thomas

    2016-03-01

    During ontogeny, the nasal septum exerts a morphogenetic influence on the surrounding facial skeleton. While the influence of the septum is well established in long snouted animal models, its role in human facial growth is less clear. If the septum is a facial growth center in humans, we would predict that deviated septal growth would be associated with facial skeletal asymmetries. Using computed tomographic (CT) scans of n = 55 adult subjects, the purpose of this study was to test whether there is a correlation between septal deviation and facial asymmetries using three-dimensional (3D) geometric morphometric techniques. We calculated deviation as a percentage of septal volume relative to the volume of a modeled non-deviated septum. We then recorded skeletal landmarks representing the nasal, palatal, and lateral facial regions. Landmark data were superimposed using Procrustes analysis. First, we examined the correlation between nasal septal deviation and the overall magnitude of asymmetry. Next, we assessed whether there was a relationship between nasal septal deviation and more localized aspects of asymmetry using multivariate regression analysis. Our results indicate that while there was no correlation between septal deviation and the overall magnitude of asymmetry, septal deviation was associated with asymmetry primarily in the nasal floor and the palatal region. Septal deviation was unassociated with asymmetries in the lateral facial skeleton. Though we did not test the causal relationship between nasal septal deviation and facial asymmetry, our results suggest that the nasal septum may have an influence on patterns of adult facial form. PMID:26677010

  20. Graph-based matching of occluded hand gestures

    OpenAIRE

    Shamaie, Atid; Sutherland, Alistair

    2001-01-01

    Occlusion is an unavoidable subject in most machine vision areas. Recognition of partially-occluded hand gestures is an important problem. In this paper a new algorithm is proposed for the recognition of occluded and non-occluded hand gestures based on matching the Graphs of gestures in an eigenspace

  1. Photodynamic therapy for occluded biliary metal stents

    Science.gov (United States)

    Roche, Joseph V. E.; Krasner, Neville; Sturgess, R.

    1999-02-01

    In this abstract we describe the use of photodynamic therapy (PDT) to recanalize occluded biliary metal stents. In patients with jaundice secondary to obstructed metal stents PDT was carried out 72 hours after the administration of m THPC. Red laser light at 652 nm was delivered endoscopically at an energy intensity of 50 J/cm. A week later endoscopic retrograde cholangiogram showed complete recanalization of the metal stent.

  2. Transcatheter closure of small ductus arteriosus with amplatzer vascular plug

    Directory of Open Access Journals (Sweden)

    Eunhyun Cho

    2013-09-01

    Full Text Available Purpose: The purpose of this study was to share our experience of transcatheter closure of small patent ductus arteriosus (PDA by using an Amplatzer vascular plug (AVP.&lt;br&gt; Methods: We reviewed the medical records of 20 patients who underwent transcatheter closure at Samsung Medical Center and Sejong General Hospital from January 2008 to August 2012. The size and shape of the PDAs were evaluated by performing angiograms, and the PDA size and the AVP devices size were compared.&lt;br&gt;Results: The mean age of the patients was 54.9±45.7 months old. The PDAs were of type C (n=5, type D (n=12 and type E (n=3. The mean pulmonary end diameter of the PDA was 1.7±0.6 mm, and the aortic end diameter was 3.6±1.4 mm. The mean length was 7.3±1.8 mm. We used 3 types of AVP devices: AVP I (n=5, AVP II (n=7, and AVP IV (n=8. The ratio of AVP size to the pulmonary end diameter was 3.37±1.64, and AVP size/aortic end ratio was 1.72±0.97. The aortic end diameter was significantly larger in those cases repaired with AVP II than in the others (P =0.002. The AVP size did not significantly correlate with the PDA size, but did correlate with smaller ratio of AVP size to aortic end diameter (1.10±0.31, P =0.032. &lt;br&gt;Conclusion: Transcatheter closure of small PDA with AVP devices yielded satisfactory outcome. AVP II was equally effective with smaller size of device, compared to others.

  3. The Twin Amplatz Sheath Method: A Modified Technique of Percutaneous Cystolithotripsy for Large Bladder Stones in Female Patients

    Science.gov (United States)

    Kumar, Amit; Dalela, Deepansh; Dalela, Divakar; Goel, Apul; Paul, Sagorika; Sankhwar, Satya N.

    2013-01-01

    To minimize the operative time and to avoid open cystolithotomy in women with large bladder stone (>5 cm), we present here a modification of percutaneous cystolithotomy, a well-described standard procedure for urinary bladder stones. With this technique, suprapubic percutaneous access was achieved under cystoscopic guidance. The suprapubic tract was dilated and an Amplatz sheath of 30 Fr was placed. Simultaneously, the urethra was sequentially dilated with fascial dilators and a 28 Fr Amplatz sheath was guided into the bladder and the foot end of the table lowered to 20° to facilitate high-speed outflow of irrigant and stone particles. A 26.5 Fr nephroscope was passed through the suprapubic Amplatz sheath and the stone was fragmented by intracorporeal pneumatic device keeping the stone close to the proximal end of the urethral Amplatz. These maneuvers help in washing out stone fragments periurethrally and keeping the endoscopic vision clear while breaking the stone. PMID:24741433

  4. Combining rhinoplasty with septal perforation repair.

    Science.gov (United States)

    Foda, Hossam M T; Magdy, Emad A

    2006-11-01

    A combined septal perforation repair and rhinoplasty was performed in 80 patients presenting with septal perforations (size 1 to 5 cm) and external nasal deformities. The external rhinoplasty approach was used for all cases and the perforation was repaired using bilateral intranasal mucosal advancement flaps with a connective tissue interposition graft in between. Complete closure of the perforation was achieved in 90% of perforations of size up to 3.5 cm and in only 70% of perforations that were larger than 3.5 cm. Cosmetically, 95% were very satisfied with their aesthetic result. The external rhinoplasty approach proved to be very helpful in the process of septal perforation repair especially in large and posteriorly located perforations and in cases where the caudal septal cartilage was previously resected. Our results show that septal perforation repair can be safely combined with rhinoplasty and that some of the routine rhinoplasty maneuvers, such as medial osteotomies and dorsal lowering, could even facilitate the process of septal perforation repair. PMID:17131270

  5. Retrieval of occluded images using DCT phase and region merging

    OpenAIRE

    Ayyalasomayajula, Pradyumna; Grassi Pauletti, Sara; Farine, Pierre-André

    2012-01-01

    In this paper we present an efficient method for Content Based Image Retrieval (CBIR) of occluded images using DCT-phase. The proposed method utilizes a novel correlation metric for ternary-valued DCT-phase, as well as a region merging method to reconstruct the non-occluded regions in the retrieved image. The proposed image retrieval method showed good performance when tested with different datasets containing reference images, occluded images, fused images and images with different JPEG comp...

  6. Transposition of the great arteries, atrial septal defect and ventricular septal defect

    OpenAIRE

    Camilleri, Ramona

    2013-01-01

    Three-day-old baby girl, transferred to NPICU because of low saturations and a development of a murmur. Following a number of rigourous test and the appropriate investigations, she was diagnosed with Transposition of the Great Arteries (TGA), a large Atrial Septal Defect, and a malaligned Ventricular Septal Defect. She was then transferred to Great Ormond Street Hospital (GOSH) for corrective surgey.

  7. Amplatzer vascular plug as an embolic agent in different vascular pathologies: A pictorial essay

    Science.gov (United States)

    Tresley, Jonathan; Bhatia, Shivank; Kably, Issam; Poozhikunnath Mohan, Prasoon; Salsamendi, Jason; Narayanan, Govindarajan

    2016-01-01

    The Amplatzer Vascular Plug (AVP) is a cylindrical plug made of self-expanding nitinol wire mesh with precise delivery control, which can be used for a variety of vascular pathologies. An AVP is an ideal vascular occlusion device particularly in high-flow vessels, where there is high risk of migration and systemic embolization with traditional occlusion devices. We performed 28 embolizations using the AVP from 2009 to 2014 and achieved complete occlusion without complications.

  8. Application of Amplatzer vascular occluder in hepatic artery closure as a method of treatment of high-flow arterioportal fistula before liver transplantation

    OpenAIRE

    Poncyljusz, Wojciech; Pauli, Wojciech

    2012-01-01

    Summary Background: Arterioportal fistula (APF) is an abnormal, direct connection between hepatic artery or its branch and the portal vein. Fistula can be acquired or, rarely, congenital. One of the acquired causes of fistula is a liver biopsy. Patients with liver cirrhosis are particularly vulnerable to its development due to the large number of performed biopsies. APF increases mortality and morbidity of liver transplantation procedure and may be a contraindication to it. The authors presen...

  9. Extracting features to recognize partially occluded objects

    Science.gov (United States)

    Koch, Mark W.; Ramamurthy, Arjun

    1991-12-01

    Noisy objects, partially occluded objects, and objects in random positions and orientations cause significant problems for current robotic vision systems. In the past, an association graph has formed the basis for many model based matching methods. However, the association graph has many false nodes due to local and noisy features. Objects having similar local structures create many false arcs in the association graph. The maximal clique recursive and tree search procedures for finding sets of structurally compatible matches have exponential time complexity, due to these false arcs and nodes. This represents a real problem as the number of objects appearing in the scene and the model set size increase. Our approach is similar to randomized string matching algorithms. Points on edges represent the model features. A fingerprint defines a subset of model features that uniquely identify the model. These fingerprints remove the ambiguities and inconsistencies present in the association graph and eliminate the problems of Turney's connected salient features. The vision system chooses the fingerprints at random, preventing a knowledgeable adversary from constructing examples that destroy the advantages of fingerprinting. Fingerprints consist of local model features called point vectors. We have developed a heuristic approach for extracting fingerprints from a set of model objects. A list of connected and unconnected scene edges represent the scene. A Hough transform type approach matches model fingerprints to scene features. Results are given for scenes containing varying amounts of occlusion.

  10. Atrioventricular septal defects among infants in Europe

    DEFF Research Database (Denmark)

    Christensen, Nikolas; Andersen, Helle; Garne, Ester;

    2013-01-01

    OBJECTIVE: To describe the epidemiology of chromosomal and non-chromosomal cases of atrioventricular septal defects in Europe. METHODS: Data were obtained from EUROCAT, a European network of population-based registries collecting data on congenital anomalies. Data from 13 registries for the perio...

  11. RE: Endovascular Treatment of Congenital Intrahepatic Portosystemic Shunts with Amplatzer Plugs

    International Nuclear Information System (INIS)

    In our paper entitled 'Endovascular treatment of congenital portal vein fistulas with the Amplatzer occlusion device' published in the Journal of Vascular and Interventional Radiology in 2004, we already reported the use of the AVP in the treatment of an intrahepatic portosystemic venous shunt. This situation does not undervalue the quality of the reported case, but for didactic purposes, we believe it is important to state that the work of Dr. Lee confirms, as was previously reported, that these devices are useful and safe for these rare situations.

  12. RE: Endovascular Treatment of Congenital Intrahepatic Portosystemic Shunts with Amplatzer Plugs

    Energy Technology Data Exchange (ETDEWEB)

    Sierre, Sergio; Alonso, Jose; Lipsich, Jose [Hospital Nacional de Pediatria ' JP Garrahan' , Combate de los Pozos, Buenos (Argentina)

    2012-01-15

    In our paper entitled 'Endovascular treatment of congenital portal vein fistulas with the Amplatzer occlusion device' published in the Journal of Vascular and Interventional Radiology in 2004, we already reported the use of the AVP in the treatment of an intrahepatic portosystemic venous shunt. This situation does not undervalue the quality of the reported case, but for didactic purposes, we believe it is important to state that the work of Dr. Lee confirms, as was previously reported, that these devices are useful and safe for these rare situations.

  13. Transhepatic Preoperative Portal Vein Embolization Using the Amplatzer Vascular Plug: Report of Four Cases

    International Nuclear Information System (INIS)

    The Amplatzer Vascular Plug (AVP) is a device originally intended for arterial and venous embolization in peripheral vessels. From December 2004 to March 2007 we implanted a total of 8 AVPs in the portal venous system in our institution for preoperative portal vein embolization in 4 patients (55-71 years) prior to right hemihepatectomy. AVP implantation was successful in all patients. Total occlusion of the embolized portal vein branches was achieved in all patients. There were no major complications associated with the embolization

  14. Amplatzer vascular plug IV for occlusion of pulmonary arteriovenous malformations in a patient with cryptogenic stroke

    Directory of Open Access Journals (Sweden)

    Surendranath R Veeram Reddy

    2014-01-01

    Full Text Available Paradoxical embolism resulting in cryptogenic stroke has received much attention recently, with the primary focus on patent foramen ovale (PFO. However, it is essential to be vigilant in the search for other causes of paradoxical embolic events, such as pulmonary arteriovenous malformations (PAVM. We describe successful closure of pulmonary AVM with a St Jude Medical (Plymouth, MN Amplatzer TM vascular plug IV. The newer AVP-IV devices can be used for successful embolization of tortuous pulmonary AVM in remote locations where use of other traditional devices may be technically challenging.

  15. Asymmetric septal hypertrophy and hypothyroidism in children.

    OpenAIRE

    Altman, D I; Murray, J.; Milner, S.; Dansky, R; Levin, S. E.

    1985-01-01

    Any echocardiographic study of two children with hypothyroidism demonstrated the presence of asymmetric septal hypertrophy. One child died aged 11 months, and pronounced thickening of the interventricular septum was confirmed at necropsy. There was also hypertrophy of the left ventricular free wall. Histological examination showed only slight muscle fibre disarray, but there was striking vacuolation and hypertrophy of muscle fibres. In the second case, a child aged five years, the asymmetric ...

  16. Left Septal Fascicular Block: Myth Or Reality?

    OpenAIRE

    MacAlpin, Rex N.

    2003-01-01

    Anatomic studies have shown that the left bundle branch divides into three fascicles in most humans. Changes in the 12 lead ECG (electrocardiogram) due to conduction abnormalities of the left anterior fascicle and left posterior fascicle are now part of the standard repertoire of electrocardiographic interpretation. There are no standard criteria for detecting conduction defects involving the third left fascicle, the septal or median fascicle, and the very existence of such defects is still a...

  17. Could early septal involvement in the remodeling process be related to the advance hypertensive heart disease?

    Directory of Open Access Journals (Sweden)

    Fatih Yalçin

    2015-06-01

    Conclusions: LV diastolic dysfunction becomes more severe in septal wall than lateral wall in hypertensive LVH. Septal myocardial performance is more dominantly affected by hypertension possibly due to earlier septal involvement in disease course. Septal MPI is correlated moderately with septal wall thickness.

  18. The Cardiac MR Images and Causes of Paradoxical Septal Motion

    International Nuclear Information System (INIS)

    Real-time cine MRI studies using the steady-state free precession (SSFP) technique are very useful for evaluating cardiac and septal motion. During diastole, the septum acts as a compliant membrane between the two ventricles, and its position and geometry respond to even small alterations in the trans-septal pressure gradients. Abnormal septal motion can be caused by an overload of the right ventricle, delayed ventricular filling and abnormal conduction. In this study, we illustrate, based on our experiences, the causes of abnormal septal motion such as corrective surgery for tetralogy of Fallot, an atrial septal defect, pulmonary thromboembolism, mitral stenosis, constrictive pericarditis and left bundle branch block. In addition, we discuss the significance of paradoxical septal motion in the context of cardiac MR imaging

  19. The Cardiac MR Images and Causes of Paradoxical Septal Motion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Choi, Sang Il; Chun, Eun Ju [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Choi, Sung Hun [Ulsan University Hospital, Ulsan (Korea, Republic of); Park, Jae Hyung [Seoul National University Hospital, Seoul (Korea, Republic of)

    2010-10-15

    Real-time cine MRI studies using the steady-state free precession (SSFP) technique are very useful for evaluating cardiac and septal motion. During diastole, the septum acts as a compliant membrane between the two ventricles, and its position and geometry respond to even small alterations in the trans-septal pressure gradients. Abnormal septal motion can be caused by an overload of the right ventricle, delayed ventricular filling and abnormal conduction. In this study, we illustrate, based on our experiences, the causes of abnormal septal motion such as corrective surgery for tetralogy of Fallot, an atrial septal defect, pulmonary thromboembolism, mitral stenosis, constrictive pericarditis and left bundle branch block. In addition, we discuss the significance of paradoxical septal motion in the context of cardiac MR imaging.

  20. Endovascular treatment of a ruptured pulmonary artery aneurysm in a patient with Behcet's disease using the amplatzer vascular plug 4

    International Nuclear Information System (INIS)

    A pulmonary artery aneurysm is a common manifestation and the leading cause of mortality in Behcet's disease. We describe a case of spontaneous rupture of a pulmonary artery aneurysm that, due to the inadequacy of medical therapy and the disadvantages of surgery, became the ideal candidate for endovascular management and was successfully performed by using the Amplatzer Vascular Plug 4.

  1. Amplatzer occlusion of paravalvular leak of mitral mechanical prosthesis following a reoperation for thrombosed mitral mechanical prosthesis

    OpenAIRE

    Nikolic, Aleksandar; Schranz, Ditmaer; HRISTOV, Nikola; Mitrev, Zan

    2008-01-01

    We describe a case of a 46-year-old woman with dehiscence and paravalvular leak of a second-time replaced mitral mechanical prosthesis, successfully treated with Amplatzer occlusion of the paravalvular leak, thus avoiding a second reoperation and improving the patient’s symptoms.

  2. Prenatal diagnosis of fetal aortopulmonary septal defect with ventricular septal defect by two-dimension echocardiography

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Fetal aortopulmonary septal defect (APSD) is an extremely rare condition, accounting for 0.1%-0.2% of all cardiac defects in live births world wide.1 Hospital mortality is 13% and 33% for simple and complex APSD, respectively.2 This rare cardiac defect refers to a congenital malformation in the development of the arteriosus truncus septum, and is usually associated with a wide variety of other structural cardiac anomalies such as ventricular septal defect (VSD), pulmonary valve stegnosis and so on.3 Prenatal diagnosis of an APSD is possible by echocardiography.

  3. A Taxonomy of 3D Occluded Objects Recognition Techniques

    Science.gov (United States)

    Soleimanizadeh, Shiva; Mohamad, Dzulkifli; Saba, Tanzila; Al-ghamdi, Jarallah Saleh

    2016-03-01

    The overall performances of object recognition techniques under different condition (e.g., occlusion, viewpoint, and illumination) have been improved significantly in recent years. New applications and hardware are shifted towards digital photography, and digital media. This faces an increase in Internet usage requiring object recognition for certain applications; particularly occulded objects. However occlusion is still an issue unhandled, interlacing the relations between extracted feature points through image, research is going on to develop efficient techniques and easy to use algorithms that would help users to source images; this need to overcome problems and issues regarding occlusion. The aim of this research is to review recognition occluded objects algorithms and figure out their pros and cons to solve the occlusion problem features, which are extracted from occluded object to distinguish objects from other co-existing objects by determining the new techniques, which could differentiate the occluded fragment and sections inside an image.

  4. Percutaneous Transcatheter Embolization of a Large Pulmonary Arteriovenous Fistula with an Amplatzer Vascular Plug

    International Nuclear Information System (INIS)

    Percutaneous transcatheter embolization has become the treatment of choice for pulmonary arteriovenous fistulas (PAVFs), in most cases replacing surgical intervention. However, while 'classic' devices, such as intravascular coils and detachable balloons, have proved to be successful for interventional occlusions of small or medium-sized PAVFs, they are not ideal in larger fistulas because of the risk for embolization to the systemic circulation. We describe the case of a 61-year-old woman with a symptomatic huge solitary pulmonary arteriovenous fistula (4.5 cm in diameter), occupying part of the lung in the lower right lobe with two feeding arteries (10 and 4 mm in diameter, respectively), who underwent successful transcatheter closure with an Amplatzer Vascular Plug, a new device designed for the occlusion of vascular abnormalities

  5. Advantages and Disadvantages of the Amplatzer Vascular Plug IV in Visceral Embolization: Report of 50 Placements

    International Nuclear Information System (INIS)

    Purpose: We describe our initial clinical experience in artificial embolization with the Amplatzer Vascular Plug IV (VP IV), a further development of the Vascular Plug family already in routine use. Methods: Results from 50 embolization procedures conducted with the VP IV in 44 patients are summarized. Results: All 50 embolizations were successful, although two required the technique to be modified because of problems with jamming of the screw thread and thus with disconnection of the plug. This was associated with large branching angles. Conclusions: With experience, the VP IV can be used safely and effectively, and it expands the spectrum of possible embolizations in interventional radiology. Its greatest disadvantage is its relatively poor positional controllability.

  6. Thrombosis and prevention after transcatheter occlusion of atrial septal defect%房间隔缺损介入封堵术后血栓形成及其防治

    Institute of Scientific and Technical Information of China (English)

    刘倩

    2012-01-01

    目前,介入治疗已逐渐取代外科开胸手术成为房间隔缺损首选的治疗方法.但各种类型封堵器植入均有血栓形成报道,并引起脑栓塞、心肌梗死、肺栓塞等严重并发症.封堵器相关血栓形成主要与心房颤动、房间隔膨胀瘤、封堵器类型、凝血功能激活、封堵器内皮化过程等密切相关.该文总结了封堵器血栓形成的相关因素及目前房间隔缺损介入术后各种血栓预防方案,为介入封堵术后血栓防治提供理论基础及实验依据.%Transcatheter closure as an alternative to medical surgery has become a preferred therapeutic method to atrial septal defect (ASD).However,thrombopoiesis after occluder implantation has been reported comprehensively and causes a series of serious complications such as cerebral embolism、myocardial infarction,pulmonary embolism and so on.Reasons of device thrombopoiesis are closely associated with atrial fibrillation,persistent atrial septal aneurysm,occluder type,activated coagulation system and occluder endothelialization process.This paper summarizes correlation factors of occluder thrombopoiesis and current related prevention proposal after transcatheter closure of ASD,and provides theoretical and experimental foundation for prevenition of device thrombopoiesis after occluder implantation of ASD.

  7. Hemostatic completion of percutaneous nephrolithotomy using electrocauterization and a clear amplatz renal sheath

    Directory of Open Access Journals (Sweden)

    Ho Song Yu

    2016-02-01

    Full Text Available ABSTRACT Background and Purpose A tubeless PCNL can reduce postoperative pain, the need for analgesics, hospital stay, and postoperative urinary leakage. However, perioperative or delayed bleeding remains the primary postoperative concern. We demonstrate a simple and cost-effective method to develop a clear nephrostomy tract after completion of a tubeless PCNL. Materials and Methods Four consecutive patients with renal calculi >3cm underwent a tubeless PCNL. We used a 24 Fr nephroscope and a 24 Fr transurethral resectoscope. Intraoperative urologist-directed percutaneous renal access was performed under fluoroscopy. After calculi removal, active bleeders were identified via a clear Amplatz renal sheath. The sheath provided excellent visualization of the nephrostomy tract for the detection of bleeders and surrounding structures. Bleeders were electrocauterized using a roller barrel electrode. During extraction of the renal sheath, the surgeon can confirm hemostasis in the tract and apply intermittent suction. Results Bleeding primarily originated from the torn calyeceal mucosa and the parenchyma. Tract electrocauterization was successful. All patients had mild hematuria, which resolved within two days. The average hemoglobin decrease was 1.65g/dL (0.8-2.1 and no patients required a transfusion. No perioperative complications occurred. On postoperative day 2, the patients could ambulate without a Foley catheter. During three months of follow-up, delayed bleeding or percutaneous urine leakage did not occur. Conclusions Electrocauterization with a roller barrel electrode and a clear Amplatz renal sheath is an effective method to obtain hemostasis after completion of a PCNL. Our technique is cost-effective and readily adapted without the need for additional instruments.

  8. Septal stapler use during septum surgery.

    Science.gov (United States)

    Yildirim, Güven; Cingi, Cemal; Kaya, Ercan

    2013-03-01

    Although discussions regarding nasal packing are still ongoing, to eliminate any possible complications, surgeons have used nasal packing for many years. Septoplasty is one of the most frequently performed operations by head and neck surgeons. Any methods to diminish the surgical time or bring comfort to the surgeon will be well appreciated. In this study, we attempted to demonstrate the usefulness of the stapler method by comparing preoperative and postoperative results from the visual analog scale (VAS), nasal obstruction symptom evaluation (NOSE), rhinosinusitis quality of life questionnaire (RQLQ), and acoustic rhinomanometry values. In addition, we evaluated pain scores, postoperative complications, and breathing after nasal packing, stapling, and trans-septal suturing techniques. Patients were divided into three groups. In the first group, deviated cartilage was removed or repositioned and mucoperichondrial flaps were closed with a bioresorbable stapler after septoplasty. Four or five staples were placed on the septum. In the second group, the septum was sutured continuously with 4/0 Pegelak (Doğsan TR). In the third group, Merocel packs were used without any sutures and were kept for 48 h. Nasal packing leads to patient discomfort after septal surgery; however, there is no difference in patient comfort between closing the mucoperichondrial flaps by suturing the septum or using a stapler. After surgery, there were no differences between the groups in terms of successful breathing. This situation was assessed by endoscopic examination and acoustic rhinomanometry. Thus, there was no objective or subjective difference. Stapling increases the doctor's comfort level and surgical time is optimized. Although experienced surgeons can easily suture the septum, less experienced ones have some difficulty; therefore, stapling may provide more benefit to the latter. Further, four staples are sufficient to close the septum. PMID:22926990

  9. Nasal Septal Perforation Caused by Invasive Fungal Sinusitis

    Directory of Open Access Journals (Sweden)

    Wai-Tin Kuo

    2002-11-01

    Full Text Available Nasal septal perforation presents a distinct challenge to otorhinolaryngologists, and is aproblem for patients. Although it has a variety of causes, previous septal surgery is the mostcommon reason. We present a 57-year-old woman who had recurrent chronic sinusitis. Aleft nasal mass was noted and excised via endoscopic sinus surgery. Invasive aspergillosissinusitis was proven both grossly and histopathologically, and a nasal septal perforation wasalso noted during the operation. Although there has been only a single other case presentedby Siberry in 1997, we postulate that perforation of the nasal septum as with the casedescribed herein is a rare complication of invasive fungal sinusitis.

  10. Oclusão percutânea do apêndice atrial esquerdo com o Amplatzer Cardiac PlugTM na fibrilação atrial Percutaneous occlusion of left atrial appendage with the Amplatzer Cardiac PlugTM in atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Márcio José Montenegro

    2012-02-01

    , anticoagulation has several limitations and has been widely underutilized. Over 90% of thrombi identified in patients with atrial fibrillation without valvular disease originate in the left atrial appendage, whose occlusion is investigated as an alternative to anticoagulation. Objective: To determine the feasibility of percutaneous occlusion of the left atrial appendage in patients at high risk of embolic events and limitations to the use of anticoagulation. Methods: We report our initial experience with Amplatzer Cardiac PlugTM (St. Jude Medical Inc., Saint Paul, Estados Unidos in patients with nonvalvular atrial fibrillation. We selected patients at high risk of thromboembolism, major bleeding, contraindications to the use or major instability in response to the anticoagulant. The procedures were performed percutaneously under general anesthesia and transesophageal echocardiography. The primary outcome was the presence of periprocedural complications and follow-up program included clinical and echocardiographic review within 30 days and by telephone contact after nine months. Results: In five selected patients it was possible to occlude the left atrial appendage without periprocedural complications. There were no clinical events in follow-up. Conclusion: Controlled clinical trials are needed before percutaneous closure of the left atrial appendage should be considered an alternative to anticoagulation in nonvalvular atrial fibrillation. But the device has shown to be promissory in patients at high risk of embolism and restrictions on the use of anticoagulants.

  11. Drainage systems, an occluded source of sanitation related outbreaks

    OpenAIRE

    Blom, Kristina

    2015-01-01

    Background Drainage systems and its role in sanitation related outbreaks are evident but still occluded once it has been installed. This current review evaluates if drainage systems can cause infections and thus be of clinical concern. Method A review of the literature was analyzed. Papers, guidelines, and quality management systems have been considered. Results Adequate sanitation is fundamental and a prerequisite for safe life and productivity. In contrast, malfunctioning sanitation has bee...

  12. Intra-cardiac echocardiography in alcohol septal ablation

    DEFF Research Database (Denmark)

    Cooper, Robert M; Shahzad, Adeel; Newton, James;

    2015-01-01

    Alcohol septal ablation (ASA) in hypertrophic obstructive cardiomyopathy reduces left ventricular outflow tract gradients. A third of patients do not respond; inaccurate localisation of the iatrogenic infarct can be responsible. Transthoracic echocardiography (TTE) using myocardial contrast can be...

  13. Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM)

    Medline Plus

    Full Text Available Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM) You must have Javascript enabled in your web browser. View Program Transcript Click Here to view the OR-Live, Inc. Privacy Policy ...

  14. Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM)

    Science.gov (United States)

    Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM) You must have Javascript enabled in your web browser. View Program Transcript Click Here to view the OR-Live, Inc. Privacy Policy ...

  15. Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM)

    Medline Plus

    Full Text Available Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2016 BroadcastMed, Inc. All ...

  16. Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM)

    Medline Plus

    Full Text Available Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2016 BroadcastMed, Inc. All rights reserved.

  17. Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM)

    Science.gov (United States)

    Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2016 BroadcastMed, Inc. All rights reserved.

  18. Right ventricular remodeling in restrictive ventricular septal defect

    OpenAIRE

    Monreal, Gretel; Youtz, Dane J.; Phillips, Alistair B.; Eyman, Mahala E.; Gorr, Matthew W.; Velten, Christina; Lucchesi, Pamela A.; Wold, Loren E.; Gerhardt, Mark A.

    2010-01-01

    Restrictive ventricular septal defect (rVSD) presents with little/no hemodynamic aberrations despite a patent septal defect. Clinically, these patients are observed with the hope that the defect will functionally close over time without the need for surgical repair and development of heart failure. Without evidence supporting a definitive therapeutic strategy, rVSD patients may have increased risk of a poor outcome. We tested the hypothesis that rVSD results in subclinical RV diastolic dysfun...

  19. The Evaluation of 208 Ventricular Septal Defect Patients

    OpenAIRE

    Paç, F. Ayşenur; EGE, Erdal; Paç, Mustafa; Battaloğlu, Bektaş; Emmiler, Mustafa; Akpınar, Beşir; Sarı, Süleyman; Pelik, Fatma

    2001-01-01

    Venticular septal defect is the most common congenital heart defect except bicüspit aortic valve. The first description of ventricular septal defect as a clinical entity was credited to Roger in 1879. It occurs in 1.5-2 in 1000 alive birth. We studied retrospectively 208 cases of VSD seen in our medical center. The patients were evaluated according to the especially clinical data, types of VSD, closure rates, complications (AVP, AY, VSD aneurysm), and surgical therapies. Key words: Ventri...

  20. Mammoth interatrial septal aneurysm in the ICE age

    OpenAIRE

    Timperley John; Bhindi Ravinay; Ormerod Oliver J

    2007-01-01

    Abstract Background Intracardiac echocardiography (ICE) is a useful imaging modality that is now being used more widely to assist in the percutaneous closure of atrial septal defects (ASD) and patent foramen ovales (PFO). Case presentation A 42 year old lady with a history of transient ischaemic attacks and migraine underwent percutaneous closure of an ASD. Intraprocedural ICE demonstrated a mammoth billowing multiperforated interatrial septal aneurysm in association with a secondum ASD. Conc...

  1. Right Ventricular Septal Pacing: Has it come of age?

    Directory of Open Access Journals (Sweden)

    Johnson Francis

    2010-02-01

    Full Text Available Prolonged pacing from the right ventricular (RV apex has been shown to be associated with progressive left ventricular dysfunction as demonstrated by heart failure, atrial fibrillation and an increased morbidity and mortality [1-6]. This has led to an interest in alternate RV pacing sites and in particular the mid RV septum and the RV outflow tract (RVOT septum [7-11]. These sites are theoretically associated with a more physiological ventricular activation. Despite the perceived advantages of septal pacing, results to date are not confirmatory [12-18]. These studies were generally acute or extended to 6-months and the leads secured to the RVOT and thus were not necessarily septal. On review of the early work of Durrer et al in 1970 [19] the septal regions of the RVOT and mid RV are the first zones of the ventricle to depolarize, suggesting that pacing from these areas on the right side of the septum would achieve as normal a contraction pattern as possible. In contrast, the free wall of the RV is the last zone to be depolarized. When attempting to prove the physiologic and hemodynamic benefits of septal pacing, it seems illogical to choose the RVOT with a mix of both septal and free wall pacing. The potential benefits of septal pacing would possibly be negated by free wall pacing and thus it is not surprising that there has been no consistent benefit over RV apical pacing demonstrated.

  2. Zero net flux estimates of septal extracellular glucose levels and the effects of glucose on septal extracellular GABA levels

    OpenAIRE

    Krebs-Kraft, Desiree L.; Rauw, Gail; Baker, Glen B.; Parent, Marise B.

    2009-01-01

    Although hippocampal infusions of glucose enhance memory, we have found repeatedly that septal glucose infusions impair memory when γ-aminobutyric acid (GABA) receptors are activated. For instance, hippocampal glucose infusions reverse the memory-impairing effects of co-infusions of the GABA agonist muscimol, whereas septal glucose infusions exacerbate memory deficits produced by muscimol. One potential explanation for these deleterious effects of glucose in the septum is that there are highe...

  3. Tratamiento endovascular de una fuga paraprotésica mitral con dispositivo Amplatzer®

    Directory of Open Access Journals (Sweden)

    Alberto Sciegata

    2012-10-01

    Full Text Available El leak o fuga paraprotésica mitral se presenta entre el 5 y el 17% de los pacientes tratados con cirugía de reemplazo valvular. En general, los defectos son únicos, la mayoría se encuentran localizados en la región postero-medial del anillo valvular y solo la tercera parte produce reflujo de grado grave. El cierre percutáneo por vía endovascular es una alternativa terapéutica válida en pacientes con elevado riesgo para re-operación. La estrategia de abordaje depende de la localización, tamaño, morfología y relaciones adyacentes del o los defectos. El procedimiento debe ser realizado por profesionales con experiencia en el tratamiento de cardiopatías estructurales y en el manejo de estos dispositivos de cierre, y se considera imprescindible la utilización de un ecocardiograma transesofágico tridimensional. Se presenta el caso de un paciente con una fuga paraprotésica valvular mitral que fue cerrada con un dispositivo Amplatzer ® introducido en forma percutánea desde la vena femoral.

  4. The Amplatzer Vascular Plug: A Review of the Device and its Clinical Applications

    International Nuclear Information System (INIS)

    The Amplatzer Vascular Plug (AVP) is an established embolic device that can be an excellent alternative to coils or detachable balloons to embolize medium to large vessels with high flow. The device is easy to use and can be precisely deployed in the target vessel with high resistance to migration and a low recanalization rate. The technical success of this device is high, indications for use are expanding, and no absolute contraindications have been reported. Since its introduction, the AVP has grown from a single device to a group of 4 models (AVP, AVP II, AVP III, and AVP 4). Each model has a unique design and features that fit different vascular anatomies, hemodynamic situations, and clinical scenarios. Therefore, the new models cannot simply be treated as replacements for older ones. Unpredictable occlusion time remains a major shortcoming for the new models of the AVP. Large vessel size, high flow status, and coagulopathy can prolong the occlusion time, which can offset the cost benefit, reduced procedure time, and reduced radiation dose typically seen with use of the AVP alone. Coils or multiple AVPs can be used to expedite the occlusion process, and large Gelfoam particles also can be used as an adjunct to achieve rapid and reliable occlusion with minimal cost.

  5. Salt-occluded zeolite waste forms: Crystal structures and transformability

    International Nuclear Information System (INIS)

    Neutron diffraction studies of salt-occluded zeolite and zeolite/glass composite samples, simulating nuclear waste forms loaded with fission products, have revealed complex structures, with cations assuming the dual roles of charge compensation and occlusion (cluster formation). These clusters roughly fill the 6--8 angstrom diameter pores of the zeolites. Samples are prepared by equilibrating zeolite-A with complex molten Li, K, Cs, Sr, Ba, Y chloride salts, with compositions representative of anticipated waste systems. Samples prepared using zeolite 4A (which contains exclusively sodium cations) as starting material are observed to transform to sodalite, a denser aluminosilicate framework structure, while those prepared using zeolite 5A (sodium and calcium ions) more readily retain the zeolite-A structure. Because the sodalite framework pores are much smaller than those of zeolite-A, clusters are smaller and more rigorously confined, with a correspondingly lower capacity for waste containment. Details of the sodalite structures resulting from transformation of zeolite-A depend upon the precise composition of the original mixture. The enhanced resistance of salt-occluded zeolites prepared from zeolite 5A to sodalite transformation is thought to be related to differences in the complex chloride clusters present in these zeolite mixtures. Data relating processing conditions to resulting zeolite composition and structure can be used in the selection of processing parameters which lead to optimal waste forms

  6. Morphometric analysis of septal aperture of humerus

    Directory of Open Access Journals (Sweden)

    Raghavendra K, Anil kumar Reddy Y, Shirol VS, Daksha Dixit, Desai SP

    2014-04-01

    Full Text Available Introduction: Lower end of humerus shows olecranon and coronoid fossae separated by a thin bony septum, sometimes it may deficient and shows foramen which communicates both the fossae called Septal aperture, which is commonly referred as supratrochlear foramen (STF. Materials & Methods: We have studied 260 humeri (126 right side and 134 left side, measurements were taken by using vernier caliper, translucency septum was observed by keeping the lower end of humerus against the x-ray lobby. Results: A clear cut STF was observed in 19.2% bones, translucency septum was observed in 99 (91.6% humeri on the right side and 95 (93.1% humeri on the left sides respectively (Table – 1. Clinical significance: The presence of STF is always associated with the narrow medullary canal at the lower end of humerus, Supracondylar fracture of humerus is most common in paediatric age group, medullary nailing is done to treat the fractures in those cases the knowledge about the STF is very important for treating the fractures. It has been observed in x-ray of lower end of the humerus the STF is comparatively radiolucent, it is commonly seen as a type of ‘pseudolesions’ in an x-ray of the lower end of humerus and it may mistake for an osteolytic or cystic lesions. Conclusion: The present study can add data into anthropology and anatomy text books regarding STF and it gives knowledge of understanding anatomical variation of distal end of the humerus, which is significant for anthropologists, orthopaedic surgeons and radiologists in habitual clinical practice.

  7. Transesophageal echocardiographic guidance for percutaneous closure of aortic pseudoaneurysm using a type II Amplatzer vascular plug: a case report

    Science.gov (United States)

    Lee, Sangmin Maria; Sung, Kiick; Kang, I-Seok; Min, Jeong Jin; Kim, Eunhee; Park, Jiyeon; Park, Jin Hyoung

    2016-01-01

    Aortic pseudoaneurysm after cardiac surgery is a rare entity, but it is potentially fatal due to its clinical course along with higher morbidity and mortality rates. Instead of open surgical repair, percutaneous procedures have been introduced as other options for managing an aortic pseudoaneurysm. In this case report, we describe transesophageal echocardiography guidance for successful percutaneous closure of an aortic pseudoaneurysm located in the left ventricular outflow tract by using a type II Amplatzer vascular plug in a patient in whom open surgical repair was not recommended. PMID:27482320

  8. Cierre de fístula coronaria con Amplatzer vascular plug en el paciente pediátrico

    OpenAIRE

    Ricardo Gamboa; Francisco P. Mollón; Ríos Méndez,Raúl E; Gutiérrez,Diego F

    2008-01-01

    La fístula coronaria congénita es una patología poco frecuente y en general asintomática, por lo que muchas veces se diagnostica por un hallazgo incidental. Con dependencia de la repercusión hemodinámica, algunos siguen una conducta conservadora, otros indican tratamiento quirúrgico o, más recientemente, oclusión por cateterismo.Se presenta el caso de una paciente con una gran fístula coronaria-cameral, que se trató mediante embolización percutánea con dispositivo Amplatzer vascular plug. No ...

  9. [Transcatheter closure of atrial septal defect with a prototype clamshell septal umbrella: one year follow-up].

    Science.gov (United States)

    Koike, K; Echigo, S; Kumate, M; Kobayashi, T; Isoda, T; Ishii, M; Ishizawa, A; Kamiya, T; Kato, H

    1994-01-01

    Transcatheter closure of a secundum atrial septal defect was attempted using a prototype clamshell septal umbrella closure system in 11 patients (six males, five females, aged 4.4-15.0 years and weighing 16-51 kg). The balloon stretched atrial septal defects were 10.3 to 20 mm in diameter, and 23 to 40 mm diameter umbrellas were used. All patients improved clinically after the procedure. Fixed splitting of the second heart sound disappeared after closure in 10 patients, systolic murmur disappeared in nine, diastolic rumble in nine, and paradoxical ventricular septal motion in seven. Doppler color flow imaging immediately after implantation showed significant residual shunt in all patients; however, no shunt flow was observed in seven patients and minimal residual shunt was present in four one year after the procedure. Nine of 11 umbrellas demonstrated fracture of the stainless steel arm confirmed by chest radiography and cinefluorography. Arm fracture occurred between 1 week and 12 months after implantation. None of the devices were dislodged and no other complications were noted despite the fractures. Transcatheter closure of atrial septal defect is a feasible and useful procedure but the present device needs further modification. PMID:8158531

  10. Transvenous closure of large aortopulmonary collateral

    Directory of Open Access Journals (Sweden)

    Parag W Barwad

    2014-01-01

    Full Text Available Aortopulmonary collaterals (APCs are occluded either preoperatively or at the time of cardiac surgery in patients with pulmonary atresia and ventricular septal defect (PAVSD. If left untreated, APCs are an important cause of deterioration in the early postoperative period. We present here an unusual case with a large residual APC causing refractory low-output state in the early postoperative period. Usual arterial approach failed due to extensive angulation with ostial narrowing. The large residual APC was successfully closed with an Amplatzer duct occluder (ADO device delivered through the transvenous route.

  11. Huge Interatrial Septal Aneurysm: A Coincidental but Rather Fatal Finding

    Science.gov (United States)

    Tzimas, Petros; Papadopoulos, Georgios

    2011-01-01

    We report the case of a patient with a huge interatrial septal aneurysm as an intraoperative coincidental finding that led to a fatal outcome. The patient was admitted to our hospital in order to undergo elective coronary artery bypass grafting because he suffered from severe coronary artery disease. We intraoperatively diagnosed by transesophageal echocardiography a huge interatrial septal aneurysm mimicking a right atrial tumor. The aneurysm was initially resected and then coronary artery bypass grafting was successfully performed but the patient never achieved a successful separation from cardiopulmonary bypass probably because of massive embolic events. PMID:21317987

  12. Echocardiographic evaluation of ventricular septal defect haemodynamics

    Directory of Open Access Journals (Sweden)

    Miranović Vesna

    2007-01-01

    Full Text Available Introduction Ventricular septal defect (VSD is an opening in the interventricular septum. 30-50% of patients with congenital heart disease have VSD. Objective The aim of the study was to determine the dependence of the left ventricular diastolic dimension (LVD, left ventricular systolic dimension (LVS, shortening fraction (SF, left atrium (LA, pulmonary artery truncus (TPA on the body surface and compare their values among experimental, control and a group of healthy children. Values of maximal systolic gradient pressure (Pvsd of VSD were compared with children from one experimental and control group. Method Children were divided into three groups: experimental (32 children with VSD that were to go to surgery, control (20 children with VSD who did not require surgery and 40 healthy children. Measurements of LVD, LVS, SF, LA, TPA were performed in accordance to recommendations of the American Echocardiographic Association. The value of Pvsd was calculated from the maximal flow velocity (V in VSD using the following formula: Pvsd=4xVІ (mm Hg. Results For children from the experimental group, the relationship between the body surface and the variability of the LVD was explained with 56.85%, LVS with 66.15%, SF with 4.9%, TPA with 58.92%. For children from the control group, the relationship between the body surface and the variability of LVD was explained with 88.8%, LVS with 72.5%, SF with 0.42%, PA with 58.92%. For healthy children, the relationship between the body surface and the variabilitiy of the LVD was explained with 88.8%, LVS with 88.78%, SF with 5.25% and PA with 84.75%. There was a significant statistical difference between average values of Pvsd in the experimental and control group (p<0.02. Conclusion The presence of the large VSD has an influence on the enlargement of LVD, LVS, SF, TPA. The enlargement of the size of the pulmonary artery depends on the presence of VSD and there is a direct variation in the magnitude of the shunt

  13. TWO-STAGE OCCLUDED OBJECT RECOGNITION METHOD FOR MICROASSEMBLY

    Institute of Scientific and Technical Information of China (English)

    WANG Huaming; ZHU Jianying

    2007-01-01

    A two-stage object recognition algorithm with the presence of occlusion is presented for microassembly. Coarse localization determines whether template is in image or not and approximately where it is, and fine localization gives its accurate position. In coarse localization, local feature, which is invariant to translation, rotation and occlusion, is used to form signatures. By comparing signature of template with that of image, approximate transformation parameter from template to image is obtained, which is used as initial parameter value for fine localization. An objective function, which is a function of transformation parameter, is constructed in fine localization and minimized to realize sub-pixel localization accuracy. The occluded pixels are not taken into account in objective function, so the localization accuracy will not be influenced by the occlusion.

  14. Occluded Cigarette Smoke Exposure Causing Localized Chloracne-Like Comedones.

    Science.gov (United States)

    Patterson, Andrew T; Tian, Frances T; Elston, Dirk M; Kaffenberger, Benjamin H

    2015-01-01

    Many environmental acne disorders, including chloracne and oil acne, were previously thought to occur predominantly in occupational settings following polycyclic aromatic hydrocarbon exposure. Cigarette smoke has also been shown to contain a large number of these toxic polycyclic aromatic hydrocarbon components and strictly correlates with noninflammatory acneiform lesion development in postadolescent patients. We report a case of localized open comedones associated with occluded cigarette smoke exposure near the nasal cavity due to infrequently changed gauze following rhinectomy. The dermal uptake of polycyclic aromatic hydrocarbon components in cigarette smoke has the potential to function as a contributing factor in chloracne development. Several of these environmental and noninflammatory acne subtypes may share a common molecular propensity for enhanced comedogenesis originating from aryl hydrocarbon receptor pathway effects in the skin. Additional studies are needed to further elucidate the exact mechanistic pathways through which tobacco smoke impacts the integumentary system. PMID:26360246

  15. Splenic Artery Syndrome After Orthotopic Liver Transplantation: Treatment With the Amplatzer Vascular Plug

    International Nuclear Information System (INIS)

    Purpose: To evaluate the safety and efficacy of the Amplatzer vascular plug (AVP) for embolization of the splenic artery in patients with hepatic hypoperfusion after orthotopic liver transplantation (OLT). Materials and Methods: Thirteen patients (9 men and 4 women) with a mean age of 56 years (range 22–70) who developed splenic artery syndrome after OLT with decreased liver perfusion and clinically relevant impairment of liver function (increased transaminase or serum bilirubin levels, thrombocytopenia, and/or therapy-refractory ascites) were treated by embolization of the proximal third of the splenic artery using the AVP. The plugs ranged in diameter from 6 to 16 mm, and they were introduced through femoral (n = 9), axillary (n = 3), or brachial (n = 1) access using a 5F or 8F guiding catheter. Results: The plugs were successfully placed, and complete occlusion of the splenic artery was achieved in all patients. Placement of two plugs was necessary for complete occlusion in 3 of the 13 patients. Occlusion took on average 10 min (range 4–35). There was no nontarget embolization or plug migration into more distal segments of the splenic artery. All patients showed improved arterial perfusion, including the liver periphery, on postinterventional angiogram. After embolization, liver function parameters (transaminase and bilirubin levels) improved with normalization of concomitant thrombocytopenia and a decrease in ascites volume. Conclusion: Our initial experience in a small patient population with SAS suggests that the AVP enables precise embolization of the proximal splenic artery, thus providing safe and effective treatment for poor liver perfusion after OLT due to SAS.

  16. Use of the Amplatzer Type 2 Plug for Flow Redirection in Failing Autogenous Hemodialysis Fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Bozkurt, Alper, E-mail: bozkurtalper@yahoo.com; Kırbaş, İsmail, E-mail: drismailk@yahoo.com [Turgut Ozal University Hospital, Radiology Department (Turkey); Kasapoglu, Benan, E-mail: benankasapoglu@hotmail.com [Turgut Ozal University Hospital, Internal Medicine Department (Turkey); Teber, Mehmet Akif, E-mail: drteberma@hotmail.com [Ataturk Education and Training Hospital, Radiology Department (Turkey)

    2015-08-15

    PurposeTo present our experience with redirecting the outflow of mature arteriovenous fistulae (AVFs) in patients with cannulation and/or suboptimal flow problems by percutaneous intervention using the Amplatzer Vascular Plug II (AVP II).MethodsWe retrospectively reviewed patients who presented with difficulty in cannulation and/or suboptimal flow in the puncture zone of the AVF and who underwent intervention using the AVP II to redirect the outflow through a better cannulation zone from March 2009 to November 2012. The mean survival rate of all AVFs was estimated, and the effects of patient age, sex, and AVF age on the AVF survival time were determined.ResultsIn total, 31 patients (17 male and 14 female) with a mean age of 57.8 years (range, 20–79 years) were included. In 2 patients, the AVF failed within the first 15 days because of rapid thrombosis. In 9 patients, the new AVF route was working effectively until unsalvageable thrombosis developed. One of the 31 patients died 9 months before the last radiologic evaluation. The new AVF route was still being used for dialysis in the remaining 19 patients. The mean AVF survival rate was 1,061.4 ± 139.4 days (range, 788–1,334 days). Patient age, sex, and AVF age did not affect the survival time.ConclusionWe suggest that the AVP II is useful for redirecting the outflow of AVFs with cannulation problems and suboptimal flow. Patency of existing AVFs may be extended, thereby extending surgery-free or catheter intervention-free survival period.

  17. Use of the Amplatzer Type 2 Plug for Flow Redirection in Failing Autogenous Hemodialysis Fistulae

    International Nuclear Information System (INIS)

    PurposeTo present our experience with redirecting the outflow of mature arteriovenous fistulae (AVFs) in patients with cannulation and/or suboptimal flow problems by percutaneous intervention using the Amplatzer Vascular Plug II (AVP II).MethodsWe retrospectively reviewed patients who presented with difficulty in cannulation and/or suboptimal flow in the puncture zone of the AVF and who underwent intervention using the AVP II to redirect the outflow through a better cannulation zone from March 2009 to November 2012. The mean survival rate of all AVFs was estimated, and the effects of patient age, sex, and AVF age on the AVF survival time were determined.ResultsIn total, 31 patients (17 male and 14 female) with a mean age of 57.8 years (range, 20–79 years) were included. In 2 patients, the AVF failed within the first 15 days because of rapid thrombosis. In 9 patients, the new AVF route was working effectively until unsalvageable thrombosis developed. One of the 31 patients died 9 months before the last radiologic evaluation. The new AVF route was still being used for dialysis in the remaining 19 patients. The mean AVF survival rate was 1,061.4 ± 139.4 days (range, 788–1,334 days). Patient age, sex, and AVF age did not affect the survival time.ConclusionWe suggest that the AVP II is useful for redirecting the outflow of AVFs with cannulation problems and suboptimal flow. Patency of existing AVFs may be extended, thereby extending surgery-free or catheter intervention-free survival period

  18. Reoperations for occluded arterial bypasses in the lower limbs

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background We reviewed the outcomes of reoperations for 29 patients (30 limbs) who had undergone occluded arterial bypass in the lower limbs from May 1996 to September 2005. Methods The 30 lower limbs of the 29 patients with arteriosclerotic obstruction received 44 reoperations, including thrombectomy alone (group T, 27) and inflow or outflow reconstruction plus thrombectomy (group C, 17). Among the 17 operations in group C, 17.6% (3/17) were inflow reconstructions involving the axillary-femoral (1), aorta-iliac (1) and aorta-femoral (1) arteries, and 76.4% (13/17) outflow reconstructions involving the femoral-popliteal bypass-tibial (8), femoral-tibial (1), femoral-popliteal bypass-popliteal arteries below the knee (2), and the femoral-popliteal bypass-tibial-peroneal trunk (2). One patient (1 limb) underwent both inflow and outflow reconstructions with an iliac arterial stent and a graft-popliteal anastomosis patch. Polytetrafluoroethylene (PTFE) grafts were used in the inflow or outflow reconstructions abve the knee. Autovenous grafts or autovenously combined PTFE grafts were used in the outflow reconstructions below the knee. Results The percentages of Fontaine stage III and IV before primary operation and reoperation were 60% (18/30) and 86.7% (26/30), respectively (P0.05). Among 42 reoperations, 19 failed within 1 month in groups T (16) and C (3) (P0.05). The rate of limb salvage was 64.29% (18/28). Conclusions The percentages of Fontaine stage III and IV before reoperation may be much higher than those before primary operation. Thrombectomy plus inflow/outflow reconstruction creates patency better than thrombectomy alone for re-occluded bypass.

  19. AngioJet Thrombectomy for Occluded Dialysis Fistulae: Outcome Data

    International Nuclear Information System (INIS)

    This study evaluates AngioJet thrombectomy of occluded autogenous dialysis fistulae and polytetrafluoroethylene (PTFE) grafts in a UK hemodialysis population. Comparison is made with published data of alternative percutaneous thrombectomy methods. All patients with occluded dialysis fistulae who sought care at the Royal Liverpool University Hospital between October 2006 and June 2008 were included in the study. All patients were treated with the AngioJet Rheolytic Thrombectomy Device (Possis, Minneapolis, MN). Demographics, time of occlusion, adjunctive therapies, complications, and follow-up data have been prospectively recorded. A total of 64 thrombectomy procedures were performed in 48 patients. Forty-four autogenous fistulas were treated in 34 patients (19 brachiocephalic, 8 radiocephalic, and 7 transposed brachiobasilic). Twenty PTFE grafts were treated in 14 patients (9 brachioaxillary, 3 brachiocephalic loop grafts, 1 brachiobasilic, and 1 femoro-femoral). The average length of occlusion was 24 cm. Average time to intervention was 4 days. Immediate primary patency was 91%. Primary patency at 1, 3, and 6 months, respectively, was 71%, 60%, and 37%. Secondary patency at 3, 6, and 12 months was 87%, 77%, and 62%, respectively. Angioplasty was carried out in all procedures. Patients required stent insertion in 34 of the 64 thrombectomies to treat angioplasty-resistant stenoses. Complications included a puncture-site hematoma, and three angioplasty-related vein ruptures in one patient, all treated with covered stent grafts. Two cases of distal brachial arterial embolization were successfully treated by thrombosuction. AngioJet thrombectomy in dialysis access occlusion is safe and effective, comparing favorably with other methods.

  20. Familial Atrial Septal Defect and Sudden Cardiac Death

    DEFF Research Database (Denmark)

    Ellesøe, Sabrina Gade; Johansen, Morten Munk; Bjerre, Jesper Vandborg;

    2016-01-01

    OBJECTIVE: Atrial septal defect (ASD) is the second most common congenital heart defect (CHD) and is observed in families as an autosomal dominant trait as well as in nonfamilial CHD. Mutations in the NKX2-5 gene, located on chromosome 5, are associated with ASD, often combined with conduction...

  1. Chrome induced nasal septal perforation-An occupational hazard

    OpenAIRE

    Krishna, N. Joshi

    2004-01-01

    86 patients, working in a chemical factory dealing with Chrome manufacturing job, were referred by Health Inspectai to F S 1 S Hospital O PD 32 patients out of above were found to be having Nasal septal perforation and were recommended to Medical Board for consideration of compensation as cases of Occupational hazard

  2. Atrioventricular conduction after alcohol septal ablation for obstructive hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Axelsson, Anna; Weibring, Kristina; Havndrup, Ole;

    2014-01-01

    AIMS: Lesion of the atrioventricular conduction system is a well known adverse effect of alcohol septal ablation (ASA) in patients with obstructive hypertrophic cardiomyopathy (HCM). We assessed the atrioventricular conduction at long-term follow-up after ASA. METHODS: In patients with a pacemaker...

  3. Intermittent′ restrictive ventricular septal defect in Tetralogy of Fallot

    Directory of Open Access Journals (Sweden)

    Sudhir S Shetkar

    2015-01-01

    Full Text Available Ventricular septal defect (VSD in Tetralogy of Fallot (TOF is usually large and non-restrictive with equalization of right and left ventricular pressures. Restrictive VSD in TOF is rare. We present an unusual case of TOF with restriction to VSD caused by accessory tricuspid valve tissue that varied with respiration.

  4. Early Experience with the Amplatzer Vascular Plug II for Occlusive Purposes in Arteriovenous Hemodialysis Access

    International Nuclear Information System (INIS)

    The Amplatzer Vascular Plug Type II (AVP II) has proven effective in the therapeutic embolization of various vascular lesions. It benefits from very rapid occlusion of the target lesion and can be deployed, retrieved, and redeployed if required. There is no literature available on use of the AVP II in the maintenance, closure, and management of complicated arteriovenous access in hemodialysis patients. In this series, we present our clinical experience with the use of the AVP II for embolization of problematic hemodialysis access. The AVP II is a self-expandable Nitinol wire-mesh device. Mounted on a delivery wire it has the capability to be deployed, recaptured, and redeployed. In total seven patients (four males: one diabetic, all nonsmokers), with ages ranging from 44 to 81 years (mean, 63 years), were treated between July 2008 and January 2009. One patient had not started dialysis. The remaining six patients had varied histories, with the time on hemodialysis ranging from 1 to 21 years. Retrospective review of clinical notes revealed patient demographics, type of access, device size, deployment site, and outcomes. Indications for embolization included steal syndrome (one patient), high-flow tributaries (two patients), and limb swelling (four patients). All patients had clinical and sonographical follow-up to 3 months. Surgical ligation had either failed, was considered a contraindication due to concerns regarding wound healing, or was considered difficult due to complex venous anatomy. Only one device was used in each patient, ranging from 6 to 16 mm in diameter. Immediate technical success was seen in 100%. All these patients were followed up clinically in the vascular access radiology clinic at 4 weeks and 3 months. Occlusion of the treated vessel and resolution of symptoms were reconfirmed in 100% of cases at 3 months. It was also noted whether patients were having successful dialysis, if required. There were no complications. Average procedural time was 19

  5. Septo-Hippocampo-Septal Loop and Memory Formation

    Directory of Open Access Journals (Sweden)

    Fatemeh Khakpai

    2013-01-01

    Full Text Available   Cholinergic and GABAergic fibers in the medial septal/diagonal band of Broca (MS/DB area project to the hippocampus and constitute the septo-hippocampal pathway, which has been proven in learning and memory. In addition, the hippocampus has bidirectional connections with the septum, which use this relation for self-regulation of cholinergic input.   The activity of septal and hippocampal neurons is modulated by several neurotransmitters including glutamatergic neurons from the entorhinal cortex, serotonergic fibers from the raphe nucleus, dopaminergic neurons from the ventral tegmental area (VTA, histaminergic cells from the tuberomammillary nucleus and adrenergic fibers from the locus coeruleus (LC. Thus, changes in the glutamatergic, serotonergic and etc. mediated transmission in the MS/DB may influence cholinergic or GABAergic transmission in the hippocampus.

  6. [The crooked nose: correction of dorsal and caudal septal deviations].

    Science.gov (United States)

    Foda, H M T

    2010-09-01

    The deviated nose represents a complex cosmetic and functional problem. Septal surgery plays a central role in the successful management of the externally deviated nose. This study included 800 patients seeking rhinoplasty to correct external nasal deviations; 71% of these suffered from variable degrees of nasal obstruction. Septal surgery was necessary in 736 (92%) patients, not only to improve breathing, but also to achieve a straight, symmetric external nose. A graduated surgical approach was adopted to allow correction of the dorsal and caudal deviations of the nasal septum without weakening its structural support to the nasal dorsum or nasal tip. The approach depended on full mobilization of deviated cartilage, followed by straightening of the cartilage and its fixation in the corrected position by using bony splinting grafts through an external rhinoplasty approach. PMID:20809379

  7. Interventional therapy of pulmonary arteriovenous malformation by using PDA or ASD occluder

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of transcatheter occlusion of pulmonary arteriovenous malformation (PAVM) by using PDA or ASD occluder. Methods: Five patients (one male and 4 females, aged 7-21 years) with angiographically proved PAVM were included, of which diffuse capillary pattern was seen in 2, multiple saccular pattern in 2 and single saccular pattern in one. Rather huge vascular sac and thick draining vessel were seen in all five patients. Using PDA or ASD occluder, all PAVMs were occluded by transcatheter technique. Results: Technical success was achieved in all cases. After the procedure the mean oxygen saturation was increased from 75.2% to 92.7%. The symptoms of anoxia were markedly improved, or even disappeared. No serious complications occurred. Conclusion: In the treatment of PAVM with interventional procedure, especially when the lesion carries huge vascular sac and thick feeding artery, the use of PDA or ASD occluder should take precedence over other considerations. (authors)

  8. Evaluation of morphological characteristics of septal rims affecting successful transcatheter atrial septal defect closure in children and adults

    OpenAIRE

    Oflaz, Mehmet Burhan; Pac, Feyza Aysenur; Kibar, Ayse Esin; Balli, Sevket; Ece, Ibrahim

    2013-01-01

    Introduction Determining other echocardiographic predictors along with the measured atrial septal defect (ASD) size and evaluating the closure together with these predictors would increase the chance of success for transcatheter closure of ASD. Aim To evaluate echocardiographic parameters affecting defect closure in children and adult patients with secundum ASD. Material and methods In all patients, size of ASD, total length of atrial septum (TS), superior-posterior, inferior-posterior, super...

  9. Prevalence of Non-Left Anterior Descending Septal Perforator Culprit in Patients With Hypertrophic Cardiomyopathy Undergoing Alcohol Septal Ablation.

    Science.gov (United States)

    Alkhouli, Mohamad; Sajjad, Waseem; Lee, Junsoo; Fernandez, Genaro; Waits, Bryan; Schwarz, Karl Q; Cove, Christopher J

    2016-05-15

    Identifying the coronary branch that supplies the basal septum is the cornerstone for successful alcohol septal ablation (ASA). The basal septum is often supplied by septal perforator artery/arteries (SPA/SPAs) not originating from the left anterior descending (LAD) coronary artery. We aim to investigate the prevalence and significance of non-LAD septal "culprit" in patients undergoing ASA. A retrospective review of patients who underwent ASA from 2006 to 2014 was conducted. Procedural and midterm outcomes of patients who had ASA of LAD and non-LAD culprit SPA were reported. A total 89 patients were included in the analysis; 13 patients (15%) had ASA of non-LAD SPA. These patients were more likely to have a history of failed ASA, more than one SPA treated, more ethanol dose injected, longer procedures, and higher contrast use compared with those who had ASA of LAD-SPA. In-hospital outcomes, residual gradient, symptom improvement, and midterm mortality were similar in the 2 groups. In conclusion, in a cohort of patients undergoing ASA, 15% had ablation of SPA culprit that did not originate from the LAD. Half of these patients had previous unsuccessful ASA. Systematic screening for the ideal culprit SPA with nonselective coronary injection of echo contrast should be used to avoid incomplete or failed ASA. PMID:27006152

  10. Septal co-infusions of glucose with a GABAB agonist impair memory

    OpenAIRE

    Erickson, Erika J.; Watts, Kelly D; Parent, Marise B.

    2005-01-01

    Septal infusions of glucose exacerbate memory deficits produced by co-infusions of drugs that increase γ-aminobutyric acid (GABA)A receptor activity. To further understand the interaction between glucose and GABA, this experiment tested whether glucose would also potentiate spatial working memory deficits produced by septal infusions of the GABAB receptor agonist baclofen. Fifteen minutes prior to assessing spontaneous alternation (SA), male Sprague–Dawley derived rats were given septal infus...

  11. Improvement of the Technique for Transcatheter Closure of Atrial Septal Defect in Children

    Institute of Scientific and Technical Information of China (English)

    Wang Huishen; Qian Mingyang; Zhang Zhiwei

    2005-01-01

    Objectives To improve experience of procedure and success rate of interventional treatment of atrial septal defect (ASD) in children, applying the technique of controlling release of devices in the pulmonary vein (controlling two disc of device opening for subsequence) in children cases with ASD who can not be occluded by regularly interventional treatment. Methods Since 2000 year 182 child cases (male 70 and 112 female) underwent the procedure of controlling release of devices in the pulmonary vein. The patients' age was from 2 to 14years old (average 3.77±1.55). The body weight was from 9 to 48 Kg (average 21.53±10.63). When the devices were placed on the right position with difficulty and failure in some cases with short and soft rims of the defect and large defect and the angle between the device and the interval atrial septal (IAS), It could be helpful to put the device into the left upper pulmonary vein, and to make right atrium (proximal) disc opened before the left atrium (distal) disc naturally fall down.At the end the double disc of the device clamped and stood up at the right position of the IAS. After closure of ASD, patients were followed up regularly by echocardiography, X-ray and ECG in the 1,3,6,12month and 3,5 years. Results The successful rate of device implantation in the improving group (98.4%)was obviously higher than that in the regularly group (68%). The techniques improved in this group with the smaller age, the lighter weight, the larger defect and the larger device comparing with the regularly group.The velocity of the pulmonary vein before occlusion procedure was (0.54±0.15)m/s; after procedure was (0.56±0.16)m/s, P > 0.05,there were no significant difference. All cases couldn't found pulmonary congestion by follow up. Conclusions The method of controlling release of device in the pulmonary vein has been used more than 5 years in the occlusion of ASD with double disc device. It is feasible and safety. The aim of the improvement is

  12. Pulmonary edema following transcatheter closure of atrial septal defect

    Directory of Open Access Journals (Sweden)

    Keerthi Chigurupati

    2015-01-01

    Full Text Available We describe an incident of development of acute pulmonary edema after the device closure of a secundum atrial septal defect in a 52-year-old lady, which was treated with inotropes, diuretics and artificial ventilation. Possibility of acute left ventricular dysfunction should be considered after the defect closure in the middle-aged patients as the left ventricular compliance may be reduced due to increased elastic stiffness and diastolic dysfunction. Baseline left atrial pressure may be > 10 mmHg in these patients. Associated risk factors for the left ventricular dysfunction are a large Qp:Qs ratio, systemic hypertension, severe pulmonary hypertension and paroxysmal atrial fibrillation.

  13. Dysphagia Lusoria with atrial septal defect: Simultaneous repair through midline

    International Nuclear Information System (INIS)

    An aberrant right subclavian artery from the descending aorta is almost always reported as an isolated anomaly. We present the case of a four-year-old child with an anomalous origin of the right subclavian artery from the descending aorta, associated with an ostium secundum atrial septal defect. The patient underwent simultaneous repair of both the anomalies through median sternotomy, with implantation of the subclavian artery into the right common carotid artery. We believe that median sternotomy is the optimal surgical approach for the management of these lesions. Other operative approaches are also discussed

  14. Diffuse interlobular septal thickening in a coal miner

    Energy Technology Data Exchange (ETDEWEB)

    Thrumurthy, S.G.; Kearney, S.; Sissons, M.; Haider, Y. [Lancashire Teaching Hospital for NHS Funding Trust, Chorley (United Kingdom)

    2010-01-15

    Diffuse interlobular septal thickening (DIST) is an abnormality seen on high-resolution CT (HRCT) scanning of the thorax. While DIST may be present to variable extents in a number of lung conditions, it is uncommon as a predominant finding except in a few entities. This report features an ex-coal miner, thought to have coal workers' pneumoconiosis (CWP), in whom the HRCT scan showed no evidence of CWP and instead showed DIST. The patient's condition progressed incessantly towards death from severe secondary pulmonary hypertension. The case links fatal pulmonary hypertension to DIST, a pattern not previously described in coal workers.

  15. From the Heart: Interatrial Septal Aneurysm Identified on Bedside Ultrasound

    Directory of Open Access Journals (Sweden)

    Michael Butterfield

    2014-09-01

    Full Text Available A 61 year-old man presented to the Emergency Department for one day of nonspecific chest pain. Bedside echocardiogram performed by the emergency physician revealed normal systolic cardiac function but also showed a large ( > 10mm bicornuate interatrial septal aneurysm (IASA projecting into the right atrium (Figure 1, Video 1. There was no evidence of intraatrial thrombus. A formal echocardiogram performed later that day confirmed the diagnosis and also detected a patent foramen ovale (PFO with a left-to-right shunt that reversed with Valsalva maneuver. [West J Emerg Med. 2014;15(6:719–720

  16. Survival and sudden cardiac death after septal ablation for hypertrophic obstructive cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten Kvistholm; Havndrup, Ole; Hassager, Christian; Helqvist, Steffen; Kelbæk, Henning; Jørgensen, Erik; Køber, Lars; Bundgaard, Henning

    2011-01-01

    Reports of long-term survival and the risk of sudden cardiac death (SCD) after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) are sparse.......Reports of long-term survival and the risk of sudden cardiac death (SCD) after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) are sparse....

  17. Descriptive anatomy of the dominant septal perforators using Dual Source Coronary CT Angiography.

    Science.gov (United States)

    Brinjikji, Waleed; Harris, Scott R; Froemming, Adam T; Christensen, Kevin N; Lachman, Nirusha; Araoz, Philip A

    2010-01-01

    Although clinical outcomes for septal ablation in treating left ventricular outflow tract obstructions are generally favorable, a variety of complications have been reported including a high incidence of right bundle branch block. These complications may be attributed to anatomic variability of the dominant septal perforator. We used Dual Source CT Coronary Angiography (DS-CTA) to determine the location of the termination point of the dominant septal perforator as well as the distance of the termination point from the mitral annulus in patients undergoing DS-CTA. One-hundred-fourteen DS-CTA scans were retrospectively reviewed by two observers by consensus. The left ventricle was divided into anterior wall, anterioseptum, and inferioseptum. For each segment, the myocardium was divided into three layers (1) right ventricular side, (2) mid portion, and (3) left ventricular side. The zone of termination of the dominant septal perforator was identified as well as the distance of the termination point from the mitral annulus. The dominant septal perforator terminated in the right ventricular side of the anterioseptum in 86 of the 118 visualized terminations (73%) and in the left ventricular anterior wall in 6 visualized terminations (5%). On average, the dominant septal perforator terminated 26.3 +/- 8.6 mm from the mitral annulus. In the majority of cases, the dominant septal perforator terminates in the right ventricular side of anterioseptum. In addition, there is great variability in the distribution of the termination point of the dominant septal perforator from the mitral annulus. PMID:19918876

  18. Simultaneous transfemoral transcatheter mitral and tricuspid valve edge-to-edge repair (using MitraClip system) completed by atrial septal defect occlusion in a surgically inoperable patient. First-in-human report

    Science.gov (United States)

    Franz, Norbert; Ritter, Frank; Hofmann, Steffen; Stabel-Mahassine, Chourok; Warnecke, Henning; Thale, Joachim

    2015-01-01

    Transcatheter transfemoral mitral valve repair using the MitraClip system (Abbott Vascular, USA) is used in high-risk or inoperable patients with severe mitral regurgitation. We report the first-in-human simultaneous transfemoral clipping of the mitral and tricuspid valve completed by occlusion of an atrial septal defect (ASD). The procedure was performed in an 84-year-old patient in October 2015. After effective reduction of mitral and tricuspid regurgitations using the MitraClip system a PFO Occluder (St. Jude Medical, USA) was implanted. Transfemoral simultaneous mitral and tricuspid valve repair using the MitraClip system with ASD occlusion seems to be an effective therapy for high-risk or inoperable patients. PMID:26855642

  19. Simultaneous transfemoral transcatheter mitral and tricuspid valve edge-to-edge repair (using MitraClip system) completed by atrial septal defect occlusion in a surgically inoperable patient. First-in-human report.

    Science.gov (United States)

    Kowalski, Marek; Franz, Norbert; Ritter, Frank; Hofmann, Steffen; Stabel-Mahassine, Chourok; Warnecke, Henning; Thale, Joachim

    2015-12-01

    Transcatheter transfemoral mitral valve repair using the MitraClip system (Abbott Vascular, USA) is used in high-risk or inoperable patients with severe mitral regurgitation. We report the first-in-human simultaneous transfemoral clipping of the mitral and tricuspid valve completed by occlusion of an atrial septal defect (ASD). The procedure was performed in an 84-year-old patient in October 2015. After effective reduction of mitral and tricuspid regurgitations using the MitraClip system a PFO Occluder (St. Jude Medical, USA) was implanted. Transfemoral simultaneous mitral and tricuspid valve repair using the MitraClip system with ASD occlusion seems to be an effective therapy for high-risk or inoperable patients. PMID:26855642

  20. Redefining the Septal L-Strut to Prevent Collapse.

    Science.gov (United States)

    Lee, Jung-Seob; Lee, Dong Chang; Ha, Dong-Heon; Kim, Sung Won; Cho, Dong-Woo

    2016-01-01

    During septorhinoplasty, septal cartilage is frequently resected for various purposes but the L-strut is preserved. Numerous materials are inserted into the nasal dorsum during dorsal augmenation rhinoplasty without considering nasal structural safety. This study used a finite element method (FEM) to redefine the septal L-strut, to prevent collapse as pressure moved from the rhinion to the supratip breakpoint on the nasal dorsum and as the contact percentage between the caudal L-strut and the maxillary crest changed. We designed a 1-cm-wide L-strut model based on computed tomography data. At least 45% of the width of the L-strut in the inferior portion of the caudal strut must be preserved during septoplasty to stabilize the septum. In augmentation rhinoplasty, the caudal L-strut must either be preserved perfectly or reinforced to prevent collapse or distortion of the L-strut. The dorsal augmentation material must be fixed in an augmentation pocket to prevent movement of graft material toward the supratip breakpoint, which can disrupt the L-strut. We conducted a numerical analysis using a FEM to predict tissue/organ behavior and to help clinicians understand the reasons for target tissue/organ collapse and deformation. PMID:27073993

  1. Catching what we can't see: manual interception of occluded fly-ball trajectories.

    Directory of Open Access Journals (Sweden)

    Gianfranco Bosco

    Full Text Available Control of interceptive actions may involve fine interplay between feedback-based and predictive mechanisms. These processes rely heavily on target motion information available when the target is visible. However, short-term visual memory signals as well as implicit knowledge about the environment may also contribute to elaborate a predictive representation of the target trajectory, especially when visual feedback is partially unavailable because other objects occlude the visual target. To determine how different processes and information sources are integrated in the control of the interceptive action, we manipulated a computer-generated visual environment representing a baseball game. Twenty-four subjects intercepted fly-ball trajectories by moving a mouse cursor and by indicating the interception with a button press. In two separate sessions, fly-ball trajectories were either fully visible or occluded for 750, 1000 or 1250 ms before ball landing. Natural ball motion was perturbed during the descending trajectory with effects of either weightlessness (0 g or increased gravity (2 g at times such that, for occluded trajectories, 500 ms of perturbed motion were visible before ball disappearance. To examine the contribution of previous visual experience with the perturbed trajectories to the interception of invisible targets, the order of visible and occluded sessions was permuted among subjects. Under these experimental conditions, we showed that, with fully visible targets, subjects combined servo-control and predictive strategies. Instead, when intercepting occluded targets, subjects relied mostly on predictive mechanisms based, however, on different type of information depending on previous visual experience. In fact, subjects without prior experience of the perturbed trajectories showed interceptive errors consistent with predictive estimates of the ball trajectory based on a-priori knowledge of gravity. Conversely, the interceptive responses

  2. Treatment of a Common Iliac Aneurysm by Endovascular Exclusion Using the Amplatzer Vascular Plug and Femorofemoral Crossover Graft

    International Nuclear Information System (INIS)

    We report our initial experience using the Amplatzer Vascular Plug II (AVP2) in the treatment of a left common iliac aneurysm. Following investigation by computerized tomographic angiography and catheter angiography, a 79-year-old man was found to have a markedly tortuous iliac system, with a left common iliac artery aneurysm that measured 48 mm in maximal diameter. Due to the patient's age and comorbidities the surgical opinion was that conventional open repair was not suitable. However, due to the tortuous nature of the aneurysm and iliac vessels, standard endovascular repair, using either a bifurcated or an aorto-uni-iliac stent graft, was also not possible. A combined approach was used by embolizing the ipsilateral internal iliac artery using coils and excluding the aneurysm using two AVP2 occlusion devices, followed by femorofemoral crossover grafting. Total aneurysm occlusion was achieved using this method and this allowed the patient to have a much less invasive surgical procedure than with conventional open repair of common iliac aneurysms, thus avoiding potential comorbidity and mortality.

  3. Transcatheter occlusion of baffle leaks following atrial switch procedures for transposition of the great vessels (d-TGV).

    Science.gov (United States)

    Balzer, David T; Johnson, Mark; Sharkey, Angela M; Kort, Henry

    2004-02-01

    Baffle-related complications following atrial switch procedures for transposition are relatively common. Transcatheter treatment of baffle stenosis has an established role as a therapeutic modality. However, transcatheter device closure of atrial baffles leaks has rarely been reported. We report four patients who underwent device closure of baffle leaks using the Amplatzer septal occluder following atrial switch procedures in order to demonstrate the safety and utility of this method of treatment and to establish its role as a suitable alternative to surgical closure. PMID:14755824

  4. Percutaneous closure of a coronary fistula with single Amplatzer Vascular Plug II in a five-month-old female: The youngest case report.

    Science.gov (United States)

    Gulgun, Mustafa; Slack, Michael

    2016-02-01

    Coronary artery fistula (CAF) is a rare clinical abnormality characterized by a connection between one or more coronary arteries and an adjacent cardiac chamber or vascular structure. Although CAF complications are more common in older children over time, there is still no consensus in terms of treatment indications in children with asymptomatic fistula. We describe an asymptomatic infant diagnosed with a severely dilated right coronary artery and a coronary-cameral fistula treated successfully by transcatheter device closure. The Amplatzer Vascular Plug II appears to be safe, effective and relatively easy to use for CAF closure in infants. PMID:26852309

  5. Detection of Occluded Face Image using Mean Based Weight Matrix and Support Vector Machine

    Directory of Open Access Journals (Sweden)

    R. S.D. Wahida Banu

    2012-01-01

    Full Text Available Problem statement: Face occlusion is a very challenging problem in face recognition. The performance of face recognition system decreases drastically due to the presence of partial occlusion on the face. Extracting discriminative features to achieve accurate detection versus computational overhead in extracting the features, which affects the classification speed, would be a sustained problem. The objective of this study is to segment the human face into non-occluded and occluded part of the occluded human face image. In General, for face detection special facial features are extracted. In the proposed study a simplified algorithm to extract the features is developed. Approach: An algorithm which enables the automatic detection of the presence of occlusions on the face would be a useful tool to increase the performances of the system. The face image was preprocessed to enhance the input face images in order to reduce the loss of classification performance due to changes in facial appearance. The experiment also balances both illumination and facial expression changes. Results: In this study, a Mean Based Weight Matrix (MBWM algorithm has been proposed to enhance the performance by 4.25% than the LBP method. Conclusion: The proposed model has been tested on occluded face images with a dataset obtained from the MIT face database.

  6. 18 CFR 270.302 - Occluded natural gas produced from coal seams.

    Science.gov (United States)

    2010-04-01

    ... produced from coal seams. 270.302 Section 270.302 Conservation of Power and Water Resources FEDERAL ENERGY... produced from coal seams. A person seeking a determination that natural gas is occluded natural gas produced from coal seams must file an application with the jurisdictional agency which contains...

  7. Endoscopic management of occluded biliary uncovered metal stents:A multicenter experience

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos; Kostas Fasoulas; Stefanos Atmatzidis; Christos Zavos; Jannis Kountouras; Athanasios Beltsis; Grigoris Chatzimavroudis; Dimitris Paikos; George Paroutoglou; Dimitris Kapetanos; Sotiris Terzoudis; Georgia Lazaraki; Ioannis Pilpilidis

    2011-01-01

    AIM:To compare diverse endoscopic interventions in the management of occluded uncovered self-expanding metal stents(SEMSs)that had been placed for palliative treatment of unresectable malignant biliary obstruction.METHODS:A retrospective review was undertaken in 4 tertiary endoscopic centers to determine optimal management of different types of occluded SEMSs.The technical success of performed treatment in occluded SEMSs,the patency of the stent,the need for re-intervention and the financial costs of each treatment were analyzed.RESULTS:Fifty four patients were included in the analysis;21 received Hanaro,19 Wallstent and 14 Flexus.For the relief of obstruction,a plastic stent was inserted in 24 patients,a second SEMS in 25 and mechanical cleaning was performed in 5 patients.The overall median second patency rates between second SEMSs and plastic stents did not differ(133 d for SEMSs vs 106 d for plastic stents;P = 0.856).Similarly,no difference was found between the overall survival of SEMS and plastic stent groups,and no procedure-related complications occurred.Incremental cost analysis showed that successive plastic stenting was a cost-saving strategy at least in Greece.CONCLUSION:Insertion of uncovered SEMSs or plastic stents is a safe and effective treatment for occluded uncovered SEMSs;insertion of plastic stents appears to be the most cost-effective strategy.

  8. Use of the Stingray Re-Entry System in Two Complex Cases of Occluded Superficial Femoral Arteries

    OpenAIRE

    Khusrow Niazi; Erin M. Galbraith; Marc Del Rosario

    2011-01-01

    Totally occluded infrainguinal arterial disease presents formidable challenges to endovascular revascularization. A variety of devices have been made available to make the crossing of these lesions more amenable to endovascular techniques. We discuss the novel use of a device that has been developed for crossing occluded coronary arteries, the Stingray Re-Entry System.

  9. [Axillary approach for surgical closure of atrial septal defect].

    Science.gov (United States)

    Gil-Jaurena, J M; Castillo, R; Zabala, J I; Conejo, L; Cuenca, V; Picazo, B

    2013-08-01

    Mid-line sternotomy is the routine approach for surgical repair of congenital heart diseases. However, its noticeable scar is a constant reminder of having undergone heart surgery. Several alternative approaches have been developed for simple cardiac conditions to hide the scar. Our series, consisting of 26 patients with axillary closure of atrial septal defect, is presented. The median age was 5.45 years (range 3-13), and median weight was 19.84 Kg. (range 13-37). The defect was closed directly in 13 cases, and with an autologous pericardial patch in the other 13. The number of surgical steps and time taken were the same as in median sternotomy. Functional recovery, intensive care unit stay, and hospital discharge were also standard. The cosmetic result, assessed both by patients and relatives, was excellent. PMID:23462094

  10. Does asymptomatic septal agenesis exist? A review of 34 cases

    International Nuclear Information System (INIS)

    Primary septal agenesis (PSA) is a rare brain malformation that can be isolated or part of developmental brain abnormalities (holoprosencephaly, septo-optic dysplasia or cortical malformation). Such associated malformation can be subtle, leading to difficulties in the prenatal management of PSA. Moreover, the neurological prognosis of isolated PSA remains debatable. The aims of the study were to specify the patterns and frequency of brain malformations associated with septal agenesis (SA), to identify the clinical prognosis, and to discuss the aetiology of PSA with the new insights provided by molecular genetics. The study consisted of a 14-year retrospective review of brain MRI in 34 patients having PSA (mean age, 5 years). Chiasm and optic nerves were not evaluated. Post-hydrocephalus SA or incomplete data were excluded. The clinical data were correlated to the MRI patterns. The study disclosed 82.5% associated lesions with MRI (28/34): 11 neuronal migration disorders, 9 holoprosencephalies (HP), 7 pituitary stalk interruptions, 1 corpus callosum partial agenesis; 17.5% (6/34) of cases were apparently isolated PAS. Clinically, the patients had motor dysfunction in 68% (23/34), mental retardation in 65% (22/34), blindness in 24% (8/34), endocrinological defects in 21% (7/34) and epilepsy in 18% (6/34) of cases. Nine percent of patients (3/34) were neurologically normal (including one with scoliosis and two infants younger than 2 years at the last follow-up). Patients with bilateral cortical anomalies and HP (even if mild) had the worst neurological prognosis. A severe motor impairment was present without evidence of hemispheric anomaly in 12% of patients (4/34). Interestingly, the frontal lobes were involved in 90% of cortical anomalies and HP, supporting the malformative aetiology of PSA. PSA rarely appears isolated and severe psychomotor impairment may occur in apparently isolated forms. These unfavourable results should be highlighted and need to be confirmed

  11. Does asymptomatic septal agenesis exist? A review of 34 cases

    Energy Technology Data Exchange (ETDEWEB)

    Belhocine, Ouardia; Andre, Christine; Kalifa, Gabriel; Adamsbaum, Catherine [St Vincent de Paul Hospital, Radiology Department, Paris (France)

    2005-04-01

    Primary septal agenesis (PSA) is a rare brain malformation that can be isolated or part of developmental brain abnormalities (holoprosencephaly, septo-optic dysplasia or cortical malformation). Such associated malformation can be subtle, leading to difficulties in the prenatal management of PSA. Moreover, the neurological prognosis of isolated PSA remains debatable. The aims of the study were to specify the patterns and frequency of brain malformations associated with septal agenesis (SA), to identify the clinical prognosis, and to discuss the aetiology of PSA with the new insights provided by molecular genetics. The study consisted of a 14-year retrospective review of brain MRI in 34 patients having PSA (mean age, 5 years). Chiasm and optic nerves were not evaluated. Post-hydrocephalus SA or incomplete data were excluded. The clinical data were correlated to the MRI patterns. The study disclosed 82.5% associated lesions with MRI (28/34): 11 neuronal migration disorders, 9 holoprosencephalies (HP), 7 pituitary stalk interruptions, 1 corpus callosum partial agenesis; 17.5% (6/34) of cases were apparently isolated PAS. Clinically, the patients had motor dysfunction in 68% (23/34), mental retardation in 65% (22/34), blindness in 24% (8/34), endocrinological defects in 21% (7/34) and epilepsy in 18% (6/34) of cases. Nine percent of patients (3/34) were neurologically normal (including one with scoliosis and two infants younger than 2 years at the last follow-up). Patients with bilateral cortical anomalies and HP (even if mild) had the worst neurological prognosis. A severe motor impairment was present without evidence of hemispheric anomaly in 12% of patients (4/34). Interestingly, the frontal lobes were involved in 90% of cortical anomalies and HP, supporting the malformative aetiology of PSA. PSA rarely appears isolated and severe psychomotor impairment may occur in apparently isolated forms. These unfavourable results should be highlighted and need to be confirmed

  12. Transconjunctival subperiosteal fat reposition for tear trough deformity: pedicled fat redraping versus septal reset.

    Science.gov (United States)

    Youn, Seungki; Shin, Jong In; Kim, Jeong Tae; Kim, Youn Hwan

    2014-11-01

    Fat-preserving lower blepharoplasty techniques are increasingly common, but to date there has been insufficient data comparing the results of fat repositioning and septal reset. The authors compared the aesthetic results of the 2 methods using statistical analysis. A total of 120 patients, who had undergone transconjunctival subperiosteal fat repositioning from February 2008 to April 2009, were included. Group 1 (71 patients) underwent fat reposition with pedicled infraorbital fat redraping. Group 2 (49 patients) underwent septal reset to reposition the underlying fat. Documentation of the results with grading (grade 0-III) by 2 surgeons was done, and the results were evaluated for clinical improvement.Septal reset showed statistical significance on grade improvement compared to direct fat manipulation methods in the patients with grade II and grade III deformities. Septal reset also showed a trend for a higher degree of improvement compared to the latter. There were no major postoperative complications. PMID:23722575

  13. Short-term prognosis and risk factors of ventricular septal rupture following acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    胡小莹

    2013-01-01

    Objective To analyze the short-term prognosis and risk factors of ventricular septal rupture(VSR)following acute myocardial infarction(AMI).Methods A total of 70 consecutive VSR patients following AMI hospitalized in

  14. Short-term prognosis and risk factors of ventricular septal rupture following acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    胡小莹

    2013-01-01

    Objective To analyze the short-term prognosis and risk factors of ventricular septal rupture(VSR)following acute myocardial infarction(AMI).Methods A total of 70 consecutive VSR patients following AMI

  15. Ventricular Septal Defect Spontaneous Close Induced by Transcatheter: A Case Report

    Institute of Scientific and Technical Information of China (English)

    Qilian Xie; Jun Wang; Lei Gao; Zhen Wang; Milin Zhang; Kunshen Liu

    2007-01-01

    Congenital ventricular septal defect (VSD) spontaneous close induced by transcatheter treatment is rare and has not yet been reported.We report on one case of VSD spontaneous close induced by transcatheter treatment in a 10 years old girl.

  16. Left Anterolateral Thoracotomy for Simultaneous Correction of Ventricular Septal Defect and Coarctation of the Aorta

    OpenAIRE

    Chu, Shu-Hsun; Chou, Nai-Kuan; Chou, Tsai-Fwu; Wang, Shoei-Shen

    1994-01-01

    Three patients with ventricular septal defect and coarctation of the aorta were treated successfully by simultaneous correction of both anomalies through a single incision via a left transsternal anterolateral thoracotomy. (Texas Heart Institute Journal 1994; 21:158-60)

  17. Classification of Atrial Septal Defect and Ventricular Septal Defect with Documented Hemodynamic Parameters via Cardiac Catheterization by Genetic Algorithms and Multi-Layered Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Mustafa Yıldız

    2012-08-01

    Full Text Available Introduction: We aimed to develop a classification method to discriminate ventricular septal defect and atrial septal defect by using severalhemodynamic parameters.Patients and Methods: Forty three patients (30 atrial septal defect, 13 ventricular septal defect; 26 female, 17 male with documentedhemodynamic parameters via cardiac catheterization are included to study. Such parameters as blood pressure values of different areas,gender, age and Qp/Qs ratios are used for classification. Parameters, we used in classification are determined by divergence analysismethod. Those parameters are; i pulmonary artery diastolic pressure, ii Qp/Qs ratio, iii right atrium pressure, iv age, v pulmonary arterysystolic pressure, vi left ventricular sistolic pressure, vii aorta mean pressure, viii left ventricular diastolic pressure, ix aorta diastolicpressure, x aorta systolic pressure. Those parameters detected from our study population, are uploaded to multi-layered artificial neuralnetwork and the network was trained by genetic algorithm.Results: Trained cluster consists of 14 factors (7 atrial septal defect and 7 ventricular septal defect. Overall success ratio is 79.2%, andwith a proper instruction of artificial neural network this ratio increases up to 89%.Conclusion: Parameters, belonging to artificial neural network, which are needed to be detected by the investigator in classical methods,can easily be detected with the help of genetic algorithms. During the instruction of artificial neural network by genetic algorithms, boththe topology of network and factors of network can be determined. During the test stage, elements, not included in instruction cluster, areassumed as in test cluster, and as a result of this study, we observed that multi-layered artificial neural network can be instructed properly,and neural network is a successful method for aimed classification.

  18. Surgical Outcome and Complications of Nasal Septal Perforation Repair with Temporal Fascia and Periosteal Grafts

    OpenAIRE

    Paula Virkkula; Mäkitie, Antti A.; Seija I. Vento

    2015-01-01

    AIMS Surgical treatment of nasal septal perforation remains a challenging field of rhinology. A large variety of techniques and grafts with promising results have been introduced for perforation repair. However, the use of fascia or fascia with periosteum has not been previously evaluated for a large sample of patients. METHODS During the years 2007–2014, 105 operations were performed and 98 patients were treated for nasal septal perforation at the Department of Otorhinolaryngology—Head and N...

  19. Delayed Ventricular Septal Rupture after Percutaneous Coronary Intervention in Acute Myocardial Infarction

    OpenAIRE

    Park, Ji Young; Park, Seong Hoon; Oh, Ji Young; Kim, In Je; Lee, Yu Hyun; Park, Si Hoon; Kwon, Ki Hwan

    2005-01-01

    In the era before reperfusion therapy, ventricular septal rupture complicated 1~3% of acute myocardial infarctions (AMI) usually 3-5 days after onset. Studies have reported a positive correlation between the incidence of septal perforation and total occlusion of the coronary arteries. A 70-year old female patient was referred to the emergency room with the diagnosis of acute anterior myocardial infarction (MI) and recent cerebral infarction. The coronary angiogram showed a 90% stenosis at the...

  20. Asymmetric septal hypertrophy - a marker of hypertension in aortic stenosis (a SEAS substudy)

    DEFF Research Database (Denmark)

    Tuseth, Nora; Cramariuc, Dana; Rieck, Ashild E;

    2010-01-01

    Some patients with aortic stenosis develop asymmetric septal hypertrophy (ASH) that may influence the surgical approach and is associated with higher perioperative morbidity. The aim of this analysis was to characterize further this subtype of aortic stenosis patients.......Some patients with aortic stenosis develop asymmetric septal hypertrophy (ASH) that may influence the surgical approach and is associated with higher perioperative morbidity. The aim of this analysis was to characterize further this subtype of aortic stenosis patients....

  1. Ectopic Adrenocorticotropic Hormone-Secreting Bronchial Carcinoid Diagnosed by Balloon-Occluded Pulmonary Arterial Sampling.

    Science.gov (United States)

    Yotsukura, Masaya; Kohno, Mitsutomo; Asakura, Keisuke; Kamiyama, Ikuo; Ohtsuka, Takashi; Hayashi, Yuichiro; Kurihara, Isao; Nakatsuka, Seishi; Asamura, Hisao

    2016-05-01

    We present the case of a 50-year-old man with Cushing syndrome caused by an ectopic adrenocorticotropic hormone (ACTH)-secreting tumor. A small nodule was located in close association with the lateral segmental branch of the pulmonary artery in the left upper lobe. Blood samples were obtained from various branches of the pulmonary artery by balloon-occluded retrograde sampling for the measurement of location-specific serum ACTH levels. After confirmation that the pulmonary nodule was responsible for the increased ACTH secretion, lobectomy was performed. This report demonstrates the usefulness of balloon-occluded retrograde pulmonary arterial sampling for the preoperative diagnosis of an ACTH-producing tumor whose diagnosis is difficult to confirm. PMID:27106427

  2. Transcatheter closure of a giant coronary artery fistula with patent duct occluder

    Institute of Scientific and Technical Information of China (English)

    ZHOU Tao; SHEN Xiang-qian; FANG Zhen-fei; ZHOU Sheng-hua; QI Shu-shan; L(U) Xiao-ling

    2006-01-01

    @@ Coronary artery fistula (CAF), an uncommon form of congenital heart disease, is characterized by abnormal communication between a coronary artery and a cardiac chamber or vessel.1 This disease is often found incidentally in asymptomatic individuals,and leads to cardiac failure, myocardial ischemia and angina, infective endocarditis, and heart rupture in later life. Both surgical repair and transcatheter closure were effective and safe in the treatment of CAF,2 but percutaneous management of CAF can obviate median sternotomy and cardiopulmonary bypass, and there may be less morbidity with transcatheter embolization techniques,3,4 including the use of occluders or microcoils. We report a successful percutaneous closure of a giant CAF from the left coronary artery to the right ventricle using patent duct occluder.

  3. In Vitro Ability of a Novel Nanohydroxyapatite Oral Rinse to Occlude Dentine Tubules

    OpenAIRE

    Hill, Robert G.; Xiaohui Chen; David G. Gillam

    2015-01-01

    Objectives. The aim of the study was to investigate the ability of a novel nanohydroxyapatite (nHA) desensitizing oral rinse to occlude dentine tubules compared to selected commercially available desensitizing oral rinses. Methods. 25 caries-free extracted molars were sectioned into 1 mm thick dentine discs. The dentine discs (n = 25) were etched with 6% citric acid for 2 minutes and rinsed with distilled water, prior to a 30-second application of test and control oral rinses. Evaluation was ...

  4. Reuse of Occluded Veins During Permanent Pacemaker Lead Extraction: A New Indication for Femoral Lead Extraction

    OpenAIRE

    Staniforth, Andrew D; Schilling, Richard J

    2002-01-01

    Objectives: This study examined the utility of a novel technique for reuse of thrombosed veins when extracting permanent pacemaker leads via a femoral vein approach. Background: Although lead extraction permanent pacemaker using a femoral approach has advantages over the subclavian approach, it cannot be used to provide access for a new lead using currently employed techniques. This is important because up to 23% of patients have occluded veins after permanent pacemaker implantation. M...

  5. Ameliorating effects of two extracts of Nigella sativa in middle cerebral artery occluded rat

    OpenAIRE

    Mohammad Akhtar; Aliyu Muhammad Maikiyo; Razia Khanam; Mohd Mujeeb; Mohd Aqil; Abul Kalam Najmi

    2012-01-01

    Purpose: Aqueous and hydroalcoholic extracts of Nigella sativa (400 mg/kg, orally) for 7 days were administered and evaluated for their neuroprotective effects on middle cerebral artery occluded (MCAO) rats. Materials and Methods: Cerebral ischemia was induced by middle cerebral artery occlusion for 2 h followed by reperfusion for 22 h. After 24 h of ischemia, grip strength, locomotor activity tests were performed in the surgically operated animals. After behavioral tests, animals were immedi...

  6. Sympathetic and cardiovascular responses to venous distension in an occluded limb

    OpenAIRE

    Cui, Jian; Leuenberger, Urs A.; Gao, Zhaohui; Sinoway, Lawrence I.

    2011-01-01

    We recently showed that a fixed volume (i.e., 40 ml) of saline infused into the venous circulation of an arterially occluded vascular bed increases muscle sympathetic nerve activity (MSNA) and blood pressure. In the present report, we hypothesized that the volume and rate of infusion would influence the magnitude of the sympathetic response. Blood pressure, heart rate, and MSNA were assessed in 13 young healthy subjects during forearm saline infusions (arrested circulation). The effects of di...

  7. Percutaneous coronary intervention in the Occluded Artery Trial: Procedural success, hazard, and outcomes over 5 years

    OpenAIRE

    Buller, C; Rankin, J.; Carere, R; P. Buszman; Pfisterer, M.; Dzavik, V; Thomas, B.; Forman, S.; Ruzyllo, W; Mancini, G.; Michalis, L; de Abreu, G.; Lamas, G.; Hochman, J

    2009-01-01

    BACKGROUND: The Occluded Artery Trial (OAT) was a 2,201-patient randomized clinical trial comparing routine stent-based percutaneous coronary intervention (PCI) versus optimal medical therapy alone in stable myocardial infarction (MI) survivors with persistent infarct-related artery occlusion identified day 3 to 28 post MI. Intent-to-treat analysis showed no difference between strategies with respect to the incidence of new class IV congestive heart failure, MI, or death. The influence of PCI...

  8. Association of interatrial septal abnormalities with cardiac impulse conduction disorders in adult patients: experience from a tertiary center in Kosovo.

    Directory of Open Access Journals (Sweden)

    Zaim Gashi

    2011-06-01

    Full Text Available Interatrial septal disorders, which include: atrial septal defect, patent foramen ovale and atrial septal aneurysm, are frequent congenital anomalies found in adult patients. Early detection of these anomalies is important to prevent their hemodynamic and/or thromboembolic consequences. The aims of this study were: to assess the association between impulse conduction disorders and anomalies of interatrial septum; to determine the prevalence of different types of interatrial septum abnormalities; to assess anatomic, hemodynamic, and clinical consequences of interatrial septal pathologies. Fifty-three adult patients with impulse conduction disorders and patients without ECG changes but with signs of interatrial septal abnormalities, who were referred to our center for echocardiography, were included in a prospective transesophageal echocardiography study. Intera trial septal anomalies were detected in around 85% of the examined patients.

  9. Template occluded SBA-15: An effective dissolution enhancer for poorly water-soluble drug

    International Nuclear Information System (INIS)

    The aim of the present work was to improve the dissolution rate of piroxicam by inclusion into template occluded SBA-15. Our strategy involves directly introducing piroxicam into as-prepared SBA-15 occluded with P123 (EO20PO70EO20) by self assembling method in acetonitrile/methylene chloride mixture solution. Ultraviolet spectrometry experiment and thermogravimetric analysis-differential scanning calorimetry (TG-DSC) profiles show that the piroxicam and P123 contents in the inclusion compound are 12 wt% and 28 wt%, respectively. X-ray powder diffraction and DSC analysis reveal that the included piroxicam is arranged in amorphous form. N2 adsorption-desorption experiment indicates that the piroxicam has been introduced to the mesopores instead of precipitating at the outside of the silica material. The inclusion compound was submitted to in vitro dissolution tests, the results show that the piroxicam dissolve from template occluded inclusion compound more rapidly, than these from the piroxicam crystalline and template removed samples in all tested conditions. Thus a facile method to improve the dissolution rate of poorly water-soluble drug was established, and this discovery opens a new avenue for the utilization of templates used for the synthesis of mesoporous materials.

  10. Total and occluded residual gas content inside the nuclear fuel pellets

    International Nuclear Information System (INIS)

    This work describes three techniques available to measure total and occluded residual gases inside the UO2 nuclear fuel pellets. Hydrogen is the major gas compound inside these pellets, due to sintering fabrication process but Nitrogen is present as well, due to storage atmosphere fuel. The total and occluded residual gas content inside these pellets is a mandatory requirement in a quality control to assure the well function of the pellets inside the nuclear reactor. This work describes the Gas Extractor System coupled with mass spectrometry GES/MS, the Gas Extractor System coupled with gas chromatography GES/GC and the total Hydrogen / Nitrogen H/N analyzer as well. In the GES, occlude gases in the UO2 pellets is determinate using a high temperature vacuum extraction system, in which the minimum limit of detection is in the range 0.002 cc/g. The qualitative and quantitative determination of the amount of gaseous components employs a mass spectrometry or a gas chromatography technique. The total Hydrogen / Nitrogen analyzer employ a thermal conductivity gas detector linked to a gaseous extractor furnace which has a detection limit is in the range 0.005 cc/g. The specification for the residual gas analyses in the nuclear fuel pellets is 0.03 cc/g, all techniques satisfy the requirement but not the nature of the gases due to reaction with the reactor cladding. The present work details the chemical reaction among Hydrogen / Nitrogen and nuclear reactor cladding. (author)

  11. Device Closure of Small Ventricular Septal Defects: When and Why?

    Directory of Open Access Journals (Sweden)

    IB Vijayalakshmi

    2014-10-01

    Full Text Available Ventricular septal defect (VSD accounts for approximately 20-30 % of all forms of congenital heart disease (CHD. They were traditionally closed surgically in the past. The surgery though safe carries the risk of morbidity, complete heart block, wound infection and thoracotomy scar on the chest. On weighing the risk and benefit, the small VSDs were not submitted to surgery in the past. So for many years it has been taught that the small VSDs are to be left alone and surgery is not recommended. Many clinicians believed in spontaneous closure of VSDs. Hence they advised the parents to wait for spontaneous closure till the child is 9 years old. But what if the VSD does not close by 10 years is the question. Are they normal as grown up congenital heart (GUCH. The Jane Somerville GUCH unit showed that spontaneous closure occurred only in 10% between the age of 17 and 45 (mean - 27 years in small VSDs in adults. What is worth noting is about 25% had serious complications: infective endocarditis (11%, progressive aortic regurgitation (5%, age-related symptomatic arrhythmias (8.5% like atrial fibrillation. This means that asymptomatic small VSDs in childhood is not necessarily benign during adult life. This raises the question, when we have a safe non-surgical device closure available to close the small VSDs, should we put the future lives of the young in danger by not giving the benefit of technology to them?

  12. MORTAL PULPOTOMY ON CHILDREN WITH VENTRICULAR SEPTAL DEFECT

    Directory of Open Access Journals (Sweden)

    Devi N. R. Devy

    2006-04-01

    Full Text Available Congenital heart disease is a condition of heart anomaly found since birth. The most common is ventricular septal defect whereby an aperture is found in the partition of heart chamber. It is estimated that 40,000 newborn in Indonesia have this defective condition. Dental treatment for patients with such condition must be undertaken in a very cautious way. Tooth with multiple caries can potentially lead to endocarditis bacteria. As such, dentist must be watchful on dental treatment that may worsen the patient’s condition. To prevent endocarditis bacteria, a prophylaxis antibiotic is required as recommended by the American Heart Association (AHA. In this particular case, a dental treatment was undertaken to a child patient with congenital heart disease. Previously, the patient has undergone dental treatment in the form of multiple extractions under general anesthesia before conducting cardiac surgery. In this case the treatment includes mortal pulpotomy, GIC restoration, and fissure sealant – all conducted in one visit under general anesthesia. A year after the treatment, there are no complaints from the patient and no irregularity on x-ray results.

  13. Association of interatrial septal abnormalities with cardiac impulse conduction disorders in adult patients: experience from a tertiary center in Kosovo

    OpenAIRE

    Zaim Gashi; Masar Gashi; Gani Dragusha; Tefik Bekteshi; Dardan Koçinaj; Nebih Musliu; Aurora Bakalli; Ejup Pllana

    2011-01-01

    Interatrial septal disorders, which include: atrial septal defect, patent foramen ovale and atrial septal aneurysm, are frequent congenital anomalies found in adult patients. Early detection of these anomalies is important to prevent their hemodynamic and/or thromboembolic consequences. The aims of this study were: to assess the association between impulse conduction disorders and anomalies of interatrial septum; to determine the prevalence of different types of interatrial septum abnormaliti...

  14. Association of interatrial septal abnormalities with cardiac impulse conduction disorders in adult patients: experience from a tertiary center in Kosovo.

    Science.gov (United States)

    Bakalli, Aurora; Pllana, Ejup; Koçinaj, Dardan; Bekteshi, Tefik; Dragusha, Gani; Gashi, Masar; Musliu, Nebih; Gashi, Zaim

    2011-01-01

    INTERATRIAL SEPTAL DISORDERS, WHICH INCLUDE: atrial septal defect, patent foramen ovale and atrial septal aneurysm, are frequent congenital anomalies found in adult patients. Early detection of these anomalies is important to prevent their hemodynamic and/or thromboembolic consequences. The aims of this study were: to assess the association between impulse conduction disorders and anomalies of interatrial septum; to determine the prevalence of different types of interatrial septum abnormalities; to assess anatomic, hemodynamic, and clinical consequences of interatrial septal pathologies. Fifty-three adult patients with impulse conduction disorders and patients without ECG changes but with signs of interatrial septal abnormalities, who were referred to our center for echocardiography, were included in a prospective transesophageal echocardiography study. Interatrial septal anomalies were detected in around 85% of the examined patients. Patent foramen ovale was encountered in 32% of the patients, and in combination with atrial septal aneurysm in an additional 11.3% of cases. Atrial septal aneurysm and atrial septal defect were diagnosed with equal frequency in 20.7% of our study population. Impulse conduction disorders were significantly more suggestive of interatrial septal anomalies than clinical signs and symptoms observed in our patients (84.91% vs 30.19%, P=0.002). Right bundle branch block was the most frequent impulse conduction disorder, found in 41 (77.36%) cases. We conclude that interatrial septal anomalies are highly associated with impulse conduction disorders, particularly with right bundle branch block. Impulse conduction disorders are more indicative of interatrial septal abnormalities in earlier stages than can be understood from the patient's clinical condition. PMID:21977304

  15. Complete Atrioventricular Septal Defect and Pulmonary Stenosis Diagnosed in a 49-Year-Old Woman after 10 Uneventful Births

    OpenAIRE

    Altin, Firat H.; Yildiz, Okan; Karacalilar, Mehmet; Tosun, Oyku; Kocyigit, Ozgen Ilgaz; Erek, Ersin

    2015-01-01

    Atrioventricular septal defects constitute 4% of all congenital cardiac malformations. Patients with complete atrioventricular septal defect rarely survive for decades without surgical treatment. Pulmonary stenosis can provide a delicate balance between the pulmonary and systemic circulations and thereby increase longevity. We present the case of a 49-year-old woman whose complete atrioventricular septal defect and associated pulmonary stenosis were diagnosed only after she had given birth to...

  16. Oclusão do apêndice atrial esquerdo com o Amplatzer Cardiac Plug em pacientes com fibrilação atrial Left atrial appendage closure with the Amplatzer Cardiac Plug in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Ênio Eduardo Guérios

    2012-06-01

    Full Text Available FUNDAMENTO: A oclusão percutânea do apêndice atrial esquerdo (OAAE surgiu como alternativa à anticoagulação oral (AO para prevenção do acidente vascular cerebral (AVC em pacientes com fibrilação atrial não-valvular (FANV. OBJETIVO: Relatar os resultados imediatos e o seguimento clínico de pacientes submetidos a OAAE com o Amplatzer Cardiac Plug (ACP em um único centro de referência. MÉTODOS: Oitenta e seis pacientes consecutivos com FANV, contra-indicação à AO e escore CHADS2= 2,6±1,2 foram submetidos a OAAE com implante de ACP. Realizou-se seguimento clínico e ecocardiográfico no mínimo 4 meses após o implante. RESULTADOS: Todos os implantes foram guiados apenas por angiografia. O sucesso do procedimento foi de 99% (1 insucesso por tamponamento cardíaco e consequente suspensão da OAAE. Houve 4 complicações maiores (o tamponamento já referido, 2 AVCs transitórios e uma embolização com retirada percutânea da prótese e duas menores (um derrame pericárdico sem tamponamento e uma pequena comunicação interatrial evidenciada no seguimento. Houve 1 óbito hospitalar após 6 dias, não relacionado à intervenção. Todos os outros pacientes receberam alta sem AO. Após seguimento de 25,9 pacientes-ano (69 pacientes não houve AVCs nem embolizações tardias de próteses. O AAE estava completamente ocluído em 97% dos casos. Seis pacientes apresentaram evidência de trombo sobre a prótese, que desapareceram após reinstituição de AO por 3 meses. CONCLUSÃO: OAAE se associa a um alto índice de sucesso, um índice aceitável de complicações e resultados promissores a médio prazo, podendo ser considerada uma alternativa válida à OA na prevenção do AVC em pacientes com FANV.BACKGROUND: Percutaneous left atrial appendage closure (LAAC has emerged as an alternative to oral anticoagulation (OA for prevention of thromboembolic stroke in patients with non-valvular atrial fibrillation (NVAF. OBJECTIVE: To describe the

  17. Modulation by arginine vasopressin of glutamate excitation in the ventral septal area of the rat brain.

    Science.gov (United States)

    Disturnal, J E; Veale, W L; Pittman, Q J

    1987-01-01

    Arginine vasopressin is hypothesized to act as a neurotransmitter or neuromodulator in the ventral septal area of the rat brain. To examine this role of vasopressin further, it was applied by microiontophoresis or micropressure from multiple-barrelled micropipettes onto spontaneously active or glutamate-activated neurons. Applied in this manner, vasopressin reduced glutamate-evoked excitation in 32 of the 47 cells studied. Further, micropressure application of the vasopressin antagonist d(CH2)5Tyr(Me)AVP reversed the vasopressin effects. In contrast, administration of vasopressin had no effect on excitations evoked by acetylcholine iontophoresis or on the spontaneous activity of the majority of the ventral septal neurons studied. These observations suggest that vasopressin may be acting on a V1-like receptor on specific neurons in the ventral septal area as a modulator of glutamate actions. Evoked responses were also obtained in the same population of ventral septal cells following stimulation of a variety of limbic areas. Inhibitory input onto most of the vasopressin responsive neurons studied was obtained following electrical stimulation of the paraventricular nucleus and bed nucleus of the stria terminalis, two cell groupings that are potential sources of vasopressin to the ventral septal area. Thus, the similarity in action of exogenously applied vasopressin and the evoked responses following paraventricular nucleus and bed nucleus stimulation suggests that vasopressin may be a neurotransmitter in this pathway. PMID:3567716

  18. Percutaneous Treatment of a Jejunovaginal Fistula Using a Combination of the Amplatzer Vascular Plug II and N-Butyl-2-Cyanoacrylate: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Kyung; Kwak, Hyo Sung; Han, Young Min [Dept. of Radiology, Chonbuk National University School of Medicine and Hospital, Chonju (Korea, Republic of); Kim, Young Kon [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-04-15

    Treatment for an enterovaginal fistula should consider the location of an intestinal fistula. Most rectovaginal fistulas develop in the lower third of the vagina and can be treated surgically. Jejunovaginal fistulas can spontaneously close during conservative management. We report the first use of the Amplatzer vascular plug II (AVP II; AGA Medical Corp, Golden Valley, MN, USA) and the use of an N-butyl-2-cyanoacrylate (NBCA; Histoacryl, Braun, Melsungen, Germany)- iodized oil (Lipiodol Ultra-Fluid, Guerbet, Aulnay-sous-Bois, France) mixture for treatment of a patient with a jejunovaginal fistula which failed to close after conservative management. The patient did not have any vaginal discharge one day later after deployment of the AVP II.

  19. Percutaneous Treatment of a Jejunovaginal Fistula Using a Combination of the Amplatzer Vascular Plug II and N-Butyl-2-Cyanoacrylate: A Case Report

    International Nuclear Information System (INIS)

    Treatment for an enterovaginal fistula should consider the location of an intestinal fistula. Most rectovaginal fistulas develop in the lower third of the vagina and can be treated surgically. Jejunovaginal fistulas can spontaneously close during conservative management. We report the first use of the Amplatzer vascular plug II (AVP II; AGA Medical Corp, Golden Valley, MN, USA) and the use of an N-butyl-2-cyanoacrylate (NBCA; Histoacryl, Braun, Melsungen, Germany)- iodized oil (Lipiodol Ultra-Fluid, Guerbet, Aulnay-sous-Bois, France) mixture for treatment of a patient with a jejunovaginal fistula which failed to close after conservative management. The patient did not have any vaginal discharge one day later after deployment of the AVP II.

  20. Endoscopic management of occluded metal biliary stents:Metal versus 10F plastic stents

    Institute of Scientific and Technical Information of China (English)

    Won; Jae; Yoon; Ji; Kon; Ryu; Jung; Won; Lee; Dong-Won; Ahn; Yong-Tae; Kim; Yong; Bum; Yoon; Sang; Myung; Woo; Woo; Jin; Lee

    2010-01-01

    AIM:To compare the efficacy of self-expandable metal stents(SEMSs) with 10F plastic stents(PSs) in the endoscopic management of occluded SEMSs.METHODS:We retrospectively reviewed the medical records of 56 patients who underwent SEMS insertion for palliation of unresectable malignant biliary obstruction between 2000 and 2007 and subsequent endoscopic retrograde biliary drainage(ERBD) with SEMS or PS for initial SEMS occlusion between 2000 and 2008.RESULTS:Subsequent ERBD with SEMS was performed in 29 patient...

  1. Smaller Calcite Lattice Deformation Caused by Occluded Organic Material in Coccoliths than in Mollusk Shell

    DEFF Research Database (Denmark)

    Froelich, Simon; Sørensen, H.O.; Hakim, S.S.;

    2015-01-01

    The growth and nucleation of biominerals are directed and affected by associated biological molecules. In this paper, we investigate the influence of occluded biomolecules on biogenic calcite from the coccolithophorid Pleurochrysis carterae and from chalk, a rock composed predominantly of fossil...... suggests that the interaction between biomolecules and calcite is not as tight in the coccoliths as in the shell. Although the shape of chalk has been preserved over millions of years, no major influence on the crystal lattice was observed in the chalk samples....

  2. Nasal airway and septal variation in unilateral and bilateral cleft lip and palate.

    Science.gov (United States)

    Starbuck, John M; Friel, Michael T; Ghoneima, Ahmed; Flores, Roberto L; Tholpady, Sunil; Kula, Katherine

    2014-10-01

    Cleft lip and palate (CLP) affects the dentoalveolar and nasolabial facial regions. Internal and external nasal dysmorphology may persist in individuals born with CLP despite surgical interventions. 7-18 year old individuals born with unilateral and bilateral CLP (n = 50) were retrospectively assessed using cone beam computed tomography. Anterior, middle, and posterior nasal airway volumes were measured on each facial side. Septal deviation was measured at the anterior and posterior nasal spine, and the midpoint between these two locations. Data were evaluated using principal components analysis (PCA), multivariate analysis of variance (MANOVA), and post-hoc ANOVA tests. PCA results show partial separation in high dimensional space along PC1 (48.5% variance) based on age groups and partial separation along PC2 (29.8% variance) based on CLP type and septal deviation patterns. MANOVA results indicate that age (P = 0.007) and CLP type (P ≤ 0.001) significantly affect nasal airway volume and septal deviation. ANOVA results indicate that anterior nasal volume is significantly affected by age (P ≤ 0.001), whereas septal deviation patterns are significantly affected by CLP type (P ≤ 0.001). Age and CLP type affect nasal airway volume and septal deviation patterns. Nasal airway volumes tend to be reduced on the clefted sides of the face relative to non-clefted sides of the face. Nasal airway volumes tend to strongly increase with age, whereas septal deviation values tend to increase only slightly with age. These results suggest that functional nasal breathing may be impaired in individuals born with the unilateral and bilateral CLP deformity. PMID:24976342

  3. Percutaneous repair of post-myocardial infarction ventricular septal defect: current approaches and future perspectives.

    Science.gov (United States)

    Baldasare, Maria D; Polyakov, Mark; Laub, Glenn W; Costic, Joseph T; McCormick, Daniel J; Goldberg, Sheldon

    2014-12-01

    Post-myocardial infarction ventricular septal defect is a devastating complication of ST-elevation myocardial infarction. Although surgical intervention is considered the gold standard for treatment, it carries high morbidity and mortality rates. We present 2 cases that illustrate the application of percutaneous closure of a post-myocardial infarction ventricular septal defect: the first in a patient who had undergone prior surgical closure and then developed a new shunt, and the second as a bridge to definitive surgery in a critically ill patient. PMID:25593526

  4. Percutaneous septal ablation for left mid-ventricular obstructive hypertrophic cardiomyopathy: a case report

    Directory of Open Access Journals (Sweden)

    Alioglu Emin

    2006-04-01

    Full Text Available Abstract Background Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHC is a rare type of cardiomyopathy. The diagnosis is based on the hourglass appearance on the left ventriculogram and the presence of pressure gradient between apical and basal chamber of the ventriculum on the hemodynamic assessment. Case presentation The present case represents successful percutaneous treatment with septal ablation to patient with MVOHC associated with systolic anterior motion of the mitral valve and obstruction at both the mid-ventricular and outflow levels. Conclusion Alcohol septal ablation has been proposed as less invasive alternatives to surgery in patients with MVOHC.

  5. Is it worth closing the atrial septal defect in patients with insignificant shunt?

    OpenAIRE

    Komar, Monika; Przewłocki, Tadeusz; Olszowska, Maria; Sobień, Bartosz; Tomkiewicz-Pająk, Lidia; Podolec, Piotr

    2014-01-01

    Introduction Closure of the atrial septal defect in patients with insignificant shunt is controversial. Aim To evaluate the outcomes of transcatheter closure of atrial septal defect (ASD) in symptomatic patients with borderline shunt. Material and methods One hundred and sixty patients (120 female, 40 male) with a mean age of 30.1 ±16.2 (20–52) years with a small ASD who underwent transcatheter closure were analyzed. All patients had a small ASD with Qp: Qs ratio ≤ 1.5, mean 1.2 ±0.9 (1.1–1.5...

  6. Determinants and importance of atrial pressure morphology in atrial septal defect.

    OpenAIRE

    Parikh, D N; J. Fisher; Moses, J W; Goldberg, H.L.; Levin, A. R.; Engle, M. A.; Borer, J S

    1984-01-01

    A prominent "v" wave relative to the "a" wave in the jugular vein and right atrial pressure tracing is considered to be a common haemodynamic sign of atrial septal defect. Since the prevalence, age relation, and haemodynamic determinants of the "v" greater than or equal to "a" wave configuration have not been studied the pressure recordings from 15 adults and 80 children with an isolated secundum atrial septal defect in sinus rhythm and from 40 adults and 55 children in sinus rhythm without s...

  7. Intravascular brachytherapy after percutaneous recanalization of occluded femoral artery: a case report

    International Nuclear Information System (INIS)

    The paper presents the use of introvascular brachytherapy after percutaneus recanalization and angioplasty of the femoral artery in a 65-year old patient with hypertension, a history of heavy smoking, and early stage diabetes. The patient was admitted to hospital with rest ischeamia of the right crus and trophic skin changes in that region. After primary pharmacological treatment angiography was performed revealing the femoro-popliteal artery to be occluded in the distal part of the adductor canal. The patency of the artery was established. Subsequently the occluded par of the artery was completely dilated without residual stenosis. Control angiography revealed good contrast flow through the dilated artery and correct configuration of the arteries below the open and dilated part of the femoro-popliteal artery. These arteries were, however, anatomically narrow. On clinical examination the pulse was present on peripheral arteries, while cyanosis of the right foot and the pain had disappeared. To prevent restenosis after angioplasty intravascular brachytherapy was performed with Microselectron192Ir. A PARIS catheter was used as the applicator. It was introduced into the artery using the same access as angiography and angioplasty. The target for irradiation was the dilated part of the artery with bilateral 1.5 cm margins - altogether 10 cm. One dose of 15 Gy was applied 2 mm from the inner surface of the arterial wall (2 mm from the applicator surface). There were no early side effects after the treatment. (author)

  8. Robust classification for occluded ear via Gabor scale feature-based non-negative sparse representation

    Science.gov (United States)

    Zhang, Baoqing; Mu, Zhichun; Li, Chen; Zeng, Hui

    2014-06-01

    The Gabor wavelets have been experimentally verified to be a good approximation to the response of cortical neurons. A new feature extraction approach is investigated for ear recognition by using scale information of Gabor wavelets. The proposed Gabor scale feature conforms to human visual perception of objects from far to near. It can not only avoid too much redundancy in Gabor features but also tends to extract more precise structural information that is robust to image variations. Then, Gabor scale feature-based non-negative sparse representation classification (G-NSRC) is proposed for ear recognition under occlusion. Compared with SRC in which the sparse coding coefficients can be negative, the non-negativity of G-NSRC conforms to the intuitive notion of combing parts to form a whole and therefore is more consistent with the biological modeling of visual data. Additionally, the use of Gabor scale features increases the discriminative power of G-NSRC. Finally, the proposed classification paradigm is applied to occluded ear recognition. Experimental results demonstrate the effectiveness of our proposed algorithm. Especially when the ear is occluded, the proposed algorithm exhibits great robustness and achieves state-of-the-art recognition performance.

  9. Enhanced reconstruction of partially occluded objects with occlusion removal in synthetic aperture integral imaging

    Institute of Scientific and Technical Information of China (English)

    Zhiliang Zhou; Yan Yuan; Xiangli Bin; Qian Wang

    2011-01-01

    @@ Synthetic aperture integral imaging provides the ability to reconstruct partially occluded objects from multi-view images.However, the reconstructed images suffer from degraded contrast due to the super-imposition of foreground defocus blur.We propose an algorithm to remove foreground occlusions before reconstructing backgrounds.Occlusions are identified by estimating the color variance on elemental im-ages and then deleting it in the final synthetic image.We demonstrate the superiority of our method by presenting experimental results as well as comparing our method with other approaches.%Synthetic aperture integral imaging provides the ability to reconstruct partially occluded objects from multi-view images. However, the reconstructed images suffer from degraded contrast due to the superimposition of foreground defocus blur. We propose an algorithm to remove foreground occlusions before reconstructing backgrounds. Occlusions are identified by estimating the color variance on elemental images and then deleting it in the final synthetic image. We demonstrate the superiority of our method by presenting experimental results as well as comparing our method with other approaches.

  10. Ventricular septal defect and double-chambered right ventricle in an alpaca.

    Science.gov (United States)

    Poser, Helen; Dalla Pria, Angela; De Benedictis, Giulia M; Stelletta, Calogero; Berlanda, Michele; Guglielmini, Carlo

    2015-03-01

    A 20-month-old male alpaca was referred for evaluation of a cardiac murmur evident since birth. Echocardiography identified a ventricular septal defect (VSD) and a fibro-muscular band causing a stenosis of the right ventricular outflow tract. Right ventricular catheterization and selective angiography confirmed the diagnosis of VSD and double-chambered right ventricle with bidirectional shunting. PMID:25595611

  11. Direct transatrial pericardiocentesis for tamponade caused by left atrial perforation after trans-septal puncture.

    Science.gov (United States)

    Picard, Fabien; Millán, Xavier; de Hemptinne, Quentin; L L'allier, Philippe

    2016-01-01

    Trans-septal puncture is associated with risks of serious complications. We report a case of an obese 52-year-old man with hypertrophic cardiomyopathy who underwent preoperative coronary angiography and cardiac catheterisation complicated by left atrial perforation. We describe a direct transatrial pericardiocentesis approach to treating cardiac tamponade. PMID:27389729

  12. Involvement of the Lateral Septal Area in the Expression of Fear Conditioning to Context

    Science.gov (United States)

    Reis, Daniel G.; Scopinho, America A.; Guimaraes, Francisco S.; Correa, Fernando M. A.; Resstel, Leonardo B. M.

    2010-01-01

    Considering the evidence that the lateral septal area (LSA) modulates defensive responses, the aim of the present study is to verify if this structure is also involved in contextual fear conditioning responses. Neurotransmission in the LSA was reversibly inhibited by bilateral microinjections of cobalt chloride (CoCl[subscript 2], 1 mM) 10 min…

  13. Difficult case of a trans-septal puncture: Use of a “SafeSept” guidewire

    Institute of Scientific and Technical Information of China (English)

    Martina; Zucchetti; Michela; Casella; Antonio; Dello; Russo; Gaetano; Fassini; Corrado; Carbucicchio; Eleonora; Russo; Vittoria; Marino; Valentina; Catto; Claudio; Tondo

    2015-01-01

    A 69-year-old man was admitted to our center to undergo catheter ablation of paroxysmal atrial fibrillation refractory to antiarrhythmic drug therapy. This procedure required access to the left atrium through the interatrial septum. During hospitalization, the patient performed routinely pre-procedure transthoracic echocardiography and gadolinium-enhanced cardiac magnetic resonance showing a normal anatomy of both the fossa ovalis and the interatrial septum. Access to the left atrium proved difficult and several unsuccessful attempts to perform the trans-septal puncture were made under both fluoroscopy and intracardiac echocardiography guidance, even with radiofrequency energy delivery. Finally, trans-septal puncture was successfully carried out using a novel nitinol J-shaped "Safe Sept" trans-septal guidewire, designed to cross the interatrial septum through the trans-septal needle thanks to a special sharp tip. Moreover, thanks to its rounded J shape that reduces the risk of atrial perforation, the "Safe Sept" guidewire, when advanced into the left atrium, becomes atraumatic.

  14. Long-term clinical outcome after alcohol septal ablation for obstructive hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Veselka, Josef; Jensen, Morten Kvistholm; Liebregts, Max;

    2016-01-01

    AIMS: The first cases of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) were published two decades ago. Although the outcomes of single-centre and national ASA registries have been published, the long-term survival and clinical outcome of the procedure are still...

  15. Cardiac troponin I degradation in serum of patients with hypertrophic obstructive cardiomyopathy undergoing percutaneous septal ablation

    DEFF Research Database (Denmark)

    Madsen, Lene H; Lund, Terje; Grieg, Zanina;

    2009-01-01

    : percutaneous transluminal septal myocardial ablation (PTSMA) of hypertrophic obstructive cardiomyopathy (HOCM). Here the iatrogenic induction of myocardial necrosis occurs in vivo, allowing us to investigate degradation of cTnI by the second. METHODS: Blood samples were obtained from 8 patients with HOCM just...

  16. Virtual Cardiac Surgery Using CFD: Application to Septal Myectomy in Obstructive Hypertrophic Cardiomyopathy

    Science.gov (United States)

    Vedula, Vijay; Mittal, Rajat; Abraham, Theodore

    2011-11-01

    Obstructive hypertrophic cardiomyopathy (HOCM) is characterized by ventricular wall thickening, diastolic dysfunction, and dynamic outflow tract obstruction, all of which strongly influence the vortex dynamics and pressure distribution in the left ventricle (LV). Severe cases of HCM are usually managed through septal myectomy where the surgeon resects the hypertrophic mass. Surgeons currently try to remove as much tissue as possible in order to optimize the post surgical result. However, excessive debulking increases the chance of ventricular septal defects, bundle branch block or complete heart block, and aneurysmal septal thinning. On the other hand, insufficient tissue removal also leads to unsatisfactory outcomes in terms of reduction of outflow tract pressure gradient. Knowing how much muscle to remove and where to remove it from could reduce the likelihood of complications and suboptimal outcomes. In the present study, we employ an immersed boundary solver to model the effect of septal myectomy for ventricles with HOCM and demonstrate the potential of such an approach for surgical planning. Computational resources were provided by the National Institute of Computational Science under Tergrid grant number TG-CTS100002.

  17. Transcoronary ablation of septal hypertrophy compared with surgery in the treatment of hypertrophic obstructive cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    姜腾勇; 吴学思; 吕强; 孟旭; 贾长琪; 张银

    2004-01-01

    @@ Transcoronary ablation of septal hypertrophy (TASH)can lead to sustained improvement in both hemodynamics and symptoms in patients with hypertrophic obstructive cardiomyopathy ( HOCM ) . 1-4 However, there have been few reports about its efficacy and safety compared with traditional surgical procedures. This study sought to compare TASH with surgery in the treatment of HOCM.

  18. Videodensitometric time-density curve change after alcohol septal ablation of obstructive hypertrophic cardiomyopathy.

    Science.gov (United States)

    Nemes, A; Kalapos, A; Sasi, V; Ungi, T; Ungi, I; Forster, T; Sepp, R

    2015-02-01

    A recently developed computerized method for estimation of myocardial perfusion, based on the analysis of the time-density curves, is demonstrated to assess myocardial blush over a selected myocardial region of interest in a patient with obstructive hypertrophic cardiomyopathy before and after alcohol septal ablation. PMID:23184598

  19. Effect of non-Newtonian characteristics of blood on magnetic particle capture in occluded blood vessel

    Energy Technology Data Exchange (ETDEWEB)

    Bose, Sayan; Banerjee, Moloy, E-mail: moloy_kb@yahoo.com

    2015-01-15

    Magnetic nanoparticles drug carriers continue to attract considerable interest for drug targeting in the treatment of cancer and other pathological conditions. Magnetic carrier particles with surface-bound drug molecules are injected into the vascular system upstream from the desired target site, and are captured at the target site via a local applied magnetic field. Herein, a numerical investigation of steady magnetic drug targeting (MDT) using functionalized magnetic micro-spheres in partly occluded blood vessel having a 90° bent is presented considering the effects of non-Newtonian characteristics of blood. An Eulerian–Lagrangian technique is adopted to resolve the hemodynamic flow and the motion of the magnetic particles in the flow using ANSYS FLUENT. An implantable infinitely long cylindrical current carrying conductor is used to create the requisite magnetic field. Targeted transport of the magnetic particles in a partly occluded vessel differs distinctly from the same in a regular unblocked vessel. Parametric investigation is conducted and the influence of the insert configuration and its position from the central plane of the artery (z{sub offset}), particle size (d{sub p}) and its magnetic property (χ) and the magnitude of current (I) on the “capture efficiency” (CE) is reported. Analysis shows that there exists an optimum regime of operating parameters for which deposition of the drug carrying magnetic particles in a target zone on the partly occluded vessel wall can be maximized. The results provide useful design bases for in vitro set up for the investigation of MDT in stenosed blood vessels. - Highlights: • Two counter rotating vortices forces the fluid flow back through the more viscous region. • The existence of strong recirculation zone just downstream side of the occlusion. • Configuration 4 produces the better efficient MDT system. • Modified Casson model predicts the highest value of CE, whereas the generalized power law gives

  20. Effect of non-Newtonian characteristics of blood on magnetic particle capture in occluded blood vessel

    International Nuclear Information System (INIS)

    Magnetic nanoparticles drug carriers continue to attract considerable interest for drug targeting in the treatment of cancer and other pathological conditions. Magnetic carrier particles with surface-bound drug molecules are injected into the vascular system upstream from the desired target site, and are captured at the target site via a local applied magnetic field. Herein, a numerical investigation of steady magnetic drug targeting (MDT) using functionalized magnetic micro-spheres in partly occluded blood vessel having a 90° bent is presented considering the effects of non-Newtonian characteristics of blood. An Eulerian–Lagrangian technique is adopted to resolve the hemodynamic flow and the motion of the magnetic particles in the flow using ANSYS FLUENT. An implantable infinitely long cylindrical current carrying conductor is used to create the requisite magnetic field. Targeted transport of the magnetic particles in a partly occluded vessel differs distinctly from the same in a regular unblocked vessel. Parametric investigation is conducted and the influence of the insert configuration and its position from the central plane of the artery (zoffset), particle size (dp) and its magnetic property (χ) and the magnitude of current (I) on the “capture efficiency” (CE) is reported. Analysis shows that there exists an optimum regime of operating parameters for which deposition of the drug carrying magnetic particles in a target zone on the partly occluded vessel wall can be maximized. The results provide useful design bases for in vitro set up for the investigation of MDT in stenosed blood vessels. - Highlights: • Two counter rotating vortices forces the fluid flow back through the more viscous region. • The existence of strong recirculation zone just downstream side of the occlusion. • Configuration 4 produces the better efficient MDT system. • Modified Casson model predicts the highest value of CE, whereas the generalized power law gives the least

  1. Association of TBX5 gene polymorphism with ventricular septal defect in the Chinese Han population

    Institute of Scientific and Technical Information of China (English)

    LIU Cai-xia; SHEN A-dong; LI Xiao-feng; JIAO Wei-wei; BAI Song; YUAN Feng; GUAN Xiao-lei; ZHANG Xin-gen; ZHANG Gui-rong; LI Zhong-zhi

    2009-01-01

    Background Congenital heart disease is a diverse group of diseases determined by genetic and environmental factors. Considerable research has been done on genes associated with development of the heart. A recent focus is the role of transcription factor TBX5 in the development of atria, left ventricle and conduction system. As part of a larger study, high density, single nucleotide polymorphism (SNP) scanning was used to explore the relationship between TBX5 gene polymorphism and susceptibility to ventricular septal defect not associated with forelimb malformation in the Chinese Han population. Methods One hundred and ninety two paediatric patients with congenital ventricular septal defect and 192 matched healthy control subjects were studied. The haplotype reconstructions were calculated by PHASE2.0 software. Haploview software was used to 15erform linkage disequilibrium assessment and defining of haplotype blocks. The algorithm used for defining of blocks was the confidence interval method. Results The TBX5 gene region can be divided into 3 haplotype blocks of 27, 15 and 2 SNPs. Strong linkage disequilibrium exists within each block. SNP rs11067075 within the TBX5 gene had significant correlation with ventricular septal defect (P=0.0037) by single marker association analysis. In addition, a 20 kb haplotype composed of 27 SNPs correlated with ventricular septal defect (P=0.05, multiple loci regression analyses based on reconstructed haplotype blocks). Conclusions TBX5 is associated with the occurrence of ventricular septal defect and may be a predisposing gene to congenital heart disease in Hart Chinese. This finding has set a direction for further genetic and functional studies.

  2. Routine preoperative cardiac catheterization necessary before repair of secundum and sinus venosus atrial septal defects

    International Nuclear Information System (INIS)

    Between January 1976 and July 1983, 217 patients with atrial septal defect underwent surgical repair at Children's Hospital. Thirty with a primum atrial septal defect and 26 who underwent cardiac catheterization elsewhere before being seen were excluded from analysis. Of the 161 remaining patients, 52 (31%) underwent preoperative cardiac catheterization, 38 because the physical examination was considered atypical for a secundum atrial septal defect and 14 because of a preexisting routine indication. One hundred nine (69%) underwent surgery without catheterization, with the attending cardiologist relying on clinical examination alone in 5, additional technetium radionuclide angiocardiography in 5, M-mode echocardiography in 13 and two-dimensional echocardiography in 43; both M-mode echocardiography and radionuclide angiography were performed in 24 and two-dimensional echocardiography and radionuclide angiography in 19. Since 1976, there has been a trend toward a reduction in the use of catheterization and use of one rather than two noninvasive or semiinvasive techniques for the detection of atrial defects. Of the 52 patients who underwent catheterization, the correct anatomic diagnosis was made before catheterization in 47 (90%). Two patients with a sinus venosus defect and one each with a sinus venosus defect plus partial anomalous pulmonary venous connection, partial anomalous pulmonary venous connection without an atrial septal defect and a sinoseptal defect were missed. Of 109 patients without catheterization, a correct morphologic diagnosis was made before surgery in 92 (84%). Nine patients with a sinus venosus defect, three with sinus venous defect and partial anomolous pulmonary venous connection, four with partial anomalous pulmonary venous return without an atrial septal defect and one with a secundum defect were incorrectly diagnosed.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Cannabinoids Occlude the HIV-1 Tat-Induced Decrease in GABAergic Neurotransmission in Prefrontal Cortex Slices.

    Science.gov (United States)

    Xu, Changqing; Hermes, Douglas J; Mackie, Ken; Lichtman, Aron H; Ignatowska-Jankowska, Bogna M; Fitting, Sylvia

    2016-06-01

    In the era of combined antiretroviral therapy (cART), human immunodeficiency virus type 1 (HIV-1) is now considered a chronic disease that specifically targets the brain and causes HIV-1-associated neurocognitive disorders (HAND). Endocannabinoids exhibit neuroprotective and anti-inflammatory properties in several central nervous system (CNS) disease models, but their effects in HAND are poorly understood. To address this issue, whole-cell recordings were performed on young (14-24 day old) C57BL/6J mice. We investigated the actions of the synthetic cannabinoid WIN55,212-2 (1 μM) and the endocannabinoid N-arachidonoyl ethanolamine (anandamide; AEA, 1 μM) in the presence of HIV-1 Tat on GABAergic neurotransmission in mouse prefrontal cortex (PFC) slices. We found a Tat concentration-dependent (5-50 nM) decrease in the frequency and amplitude of miniature inhibitory postsynaptic currents (mIPSCs). The cannabinoid 1 receptor (CB1R) antagonist rimonabant (1 μM) and zero extracellular calcium prevented the significant Tat-induced decrease in mIPSCs. Further, bath-applied WIN55,212-2 or AEA by itself, significantly decreased the frequency, but not amplitude of mIPSCs and/or spontaneous IPSCs (sIPSCs), and occluded a further downregulation of IPSCs by Tat. Pretreatment with rimonabant but not the CB2R antagonist AM630 (1 μM) prevented the WIN55,212-2- and AEA-induced decrease in IPSCs frequency without any further Tat effect. Results indicated a Tat-induced decrease in GABAergic neurotransmission, which was occluded by cannabinoids via a CB1R-related mechanism. Understanding the relationship between Tat toxicity and endocannabinoid signaling has the potential to identify novel therapeutic interventions to benefit individuals suffering from HAND and other cognitive impairments. PMID:26993829

  4. Percutaneous transvenous embolisation through the occluded sinus for transverse-sigmoid dural arteriovenous fistulas with sinus occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Naito, I.; Iwai, T.; Shimaguchi, H.; Suzuki, T.; Tomizawa, S. [Dept. of Neurosurgery, Geriatrics Research Inst. and Hospital, Maebashi (Japan); Negishi, M.; Sasaki, T. [Dept. of Neurosurgery, Gunma Univ. School of Medicine (Japan)

    2001-08-01

    We report six cases of transverse-sigmoid dural arteriovenous fistulae (TS DAVF) treated with percutaneous transvenous embolisation through the occluded sinus. All patients had sinus occlusive lesions: an isolated sinus in five cases and a distal occlusion of the affected sinus in one. Leptomeningeal retrograde venous drainage via the vein of Labbe or the sylvian vein was observed in all patients with an isolated sinus. In five patients a microcatheter was easily passed through the occluded sinus. In four of them, a complete angiographic cure was achieved by packing the sinus with coils. However, in one, sinus packing was ineffective and surgical excision of the affected sinus was necessary. The microcatheter could not be passed through the occluded sinus in one case, and direct packing of the isolated sinus was later required. In all cases, complete cure was achieved without complications. This safe, not very invasive and highly effective treatment for TS DAVF with sinus occlusion is thus worth trying when the occluded segment is relatively short. (orig.)

  5. Balloon occluded retrograde transvenous obliteration of bleeding stomal varices using sodium tetradecyl sulfate foam: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Chang; Yang, Po Sang; Lee, Yeon Soo; Kim, Hyun Jeong; Park, Gun [Dept. of Radiology, The Catholic University of Korea College of Medicine, Daejeon St. Mary' s Hospital, Daejeon (Korea, Republic of)

    2015-05-15

    A small varix is an uncommon complication with a high mortality rate occurring secondary to portal hypertension in patients with a stoma. We describe a case of recurrent stomal varix bleeding successfully managed by balloon occluded retrograde transvenous obliteration using sodium tetradecyl sulfate foam.

  6. Percutaneous transvenous embolisation through the occluded sinus for transverse-sigmoid dural arteriovenous fistulas with sinus occlusion

    International Nuclear Information System (INIS)

    We report six cases of transverse-sigmoid dural arteriovenous fistulae (TS DAVF) treated with percutaneous transvenous embolisation through the occluded sinus. All patients had sinus occlusive lesions: an isolated sinus in five cases and a distal occlusion of the affected sinus in one. Leptomeningeal retrograde venous drainage via the vein of Labbe or the sylvian vein was observed in all patients with an isolated sinus. In five patients a microcatheter was easily passed through the occluded sinus. In four of them, a complete angiographic cure was achieved by packing the sinus with coils. However, in one, sinus packing was ineffective and surgical excision of the affected sinus was necessary. The microcatheter could not be passed through the occluded sinus in one case, and direct packing of the isolated sinus was later required. In all cases, complete cure was achieved without complications. This safe, not very invasive and highly effective treatment for TS DAVF with sinus occlusion is thus worth trying when the occluded segment is relatively short. (orig.)

  7. Balloon occluded retrograde transvenous obliteration of bleeding stomal varices using sodium tetradecyl sulfate foam: A case report

    International Nuclear Information System (INIS)

    A small varix is an uncommon complication with a high mortality rate occurring secondary to portal hypertension in patients with a stoma. We describe a case of recurrent stomal varix bleeding successfully managed by balloon occluded retrograde transvenous obliteration using sodium tetradecyl sulfate foam.

  8. THE FIRST EXPERIENCE OF LEFT ATRIAL APPENDAGE OCCLUDING DEVICES IMPLANTATION FOR PREVENTION OF STROKE IN THE STATE RESEARCH CENTRE FOR PREVENTIVE MEDICINE

    Directory of Open Access Journals (Sweden)

    K. V. Davtyan

    2015-09-01

    Full Text Available Some aspects of prevention of thromboembolic events in patients with atrial fibrillation, in particular, the use of implantable left atrial appendage occluding devices are discussed. Along with the literature review on this issue, the results of authors own experience of left atrial appendage occluding devices implantation is presented.

  9. Growth activity in human septal cartilage: age-dependent incorporation of labeled sulfate in different anatomic locations

    Energy Technology Data Exchange (ETDEWEB)

    Vetter, U.; Pirsig, W.; Heinze, E.

    1983-02-01

    Growth activity in different areas of human septal cartilage was measured by the in vitro incorporation of /sup 35/S-labeled NaSO/sub 4/ into chondroitin sulfate. Septal cartilage without perichondrium was obtained during rhinoplasty from 36 patients aged 6 to 35 years. It could be shown that the anterior free end of the septum displays high growth activity in all age groups. The supra-premaxillary area displayed its highest growth activity during prepuberty, showing thereafter a continuous decline during puberty and adulthood. A similar age-dependent pattern in growth activity was found in the caudal prolongation of the septal cartilage. No age-dependent variations could be detected in the posterior area of the septal cartilage.

  10. Simultaneous Removal of Right Lung Hydatid Cyst and Repair of Atrial Septal Defect in a Single Session.

    Science.gov (United States)

    Tong, Guang; Lin, Xi; Ma, Tao; Wang, Xiaowu; Zhang, Weida

    2016-01-01

    Hydatid cyst is the larval stage of echinococcosis caused by the canine tapeworm Echinococcus species, and the lung is the most common site of occurrence. Atrial septal defect is a common congenital heart disease with an incidence of 100 per 100,000 live births. To our knowledge, we report for the first time a case of coexistence of right lung hydatid cyst and atrial septal defect that were both treated with one-stage surgery. PMID:26694269

  11. Measurement of Atrial Septal Defect Size: A Comparative Study between Transesophageal Echocardiography and Balloon Occlusive Diameter Method

    OpenAIRE

    Bahareh Eslami; Masoumeh Lotfi-Tokaldany; Mohammad Alidoosti; Seyed Ebrahim Kassaian; Arezou Zoroufian; Elham Hakki; Mohammad Sahebjam; Mahmood Sheikhfathollahi; Alimohammad Hajizeinali; Hakimeh Sadeghian

    2010-01-01

    Background: Transcatheter closure of atrial septal defect secundum (ASD-II) has become an alternative method for surgery. We sought to compare the two-dimensional transesophageal echocardiography (TEE) method for measuring atrial septal defect with balloon occlusive diameter (BOD) in transcatheter ASD-II closure. Methods: A total of 39 patients (71.1% female, mean age: 35.31 ± 15.37 years) who underwent successful transcatheter closure of ASD-II between November 2005 and July 2008 were enroll...

  12. Double-chambered right ventricle, ventricular septal defect, patent ductus arteriosus in a dog

    International Nuclear Information System (INIS)

    A 4-month-old female mongrel puppy was presented with an anophthalmos. On physical examination, systolic murmur was heard at the 4th left intercostal space near the sternum. However the dog appeared healthy without cyanosis and had no history of exercise intolerance. The phonocardiogram revealed a pansystolic murmur and a continuous murmur on the mitral area. A systolic ejection murmur was also recorded on the pulmonic area. The electrocardiogram indicated bi-ventricular hypertrophy. Left ventricular enlargement was seen on chest radiographs. Ventricular septal defect (VSD) and patent ductus arteriosus (PDA) were diagnosed from these findings. PDA closure was performed at 2 years of age. After 2 months from the operation, the dog died during an attempted repair of the VSD. At necropsy, it was found that the double-chambered right ventricle (DCRV) was formed by an anomalous septal band. The VSD was localized on the proximal conus and was 8 mm in diameter. (author)

  13. Study Of The Effect Of Nasal- Septal Deviation On The Middle Ear Pressure

    Directory of Open Access Journals (Sweden)

    Motesaddi Zarandi M

    2003-10-01

    Full Text Available Eustachian tube connects middle ear space to the nasopharyngeal space. Upper airway obstruction, with any cause, can derange Eustachian tube function. Nasal septal deviation is one of the prevalent causes of upper airway obstruction which can affects the ventilation function of Eustachian tube."nMaterials and Methods: This study was conducted on the patients who underwent septoplasty due to severe septal deviation leading to unilateral nasal obstruction in Amiraalam hospital from summer of 1378 till the spring of 1379."nResults: There was 140 patients whose data were as: female patients 34 (24.3% male patients 106 (75.7%, mean age (22.7. Median age (20 years and mode of age (18 years of age. they were from 12 to 40 years of age."nConclusion: Comparison between preoperative and postoperative middle ear pressures shows no any significant statistical difference (p=0.798.

  14. The cristal (right superior septal) coronary artery and its relationship to anomalous left coronary origin

    International Nuclear Information System (INIS)

    The cristal artery is an occasional finding, being visible in around 3% of coronary angiograms, arising from the proximal right coronary artery (RCA) and passing downwards and forwards through the muscle of the crista superventricularis. It supplies a variable volume of the superior interventricular septum, and can contribute to collateralization of the other septal vessels. When part or all of the left coronary artery (LCA) arises anomalously from the right coronary sinus, its passage to the left may be in the same pathway as a cristal artery, bearing a tell-tale septal vessel arising from its proximal segment. This helps to differentiate it from one that has a higher pathway, running between the great vessels, and which may have a greater correlation with sudden cardiac death.

  15. The role of septal surgery in management of the deviated nose.

    Science.gov (United States)

    Foda, Hossam M T

    2005-02-01

    The deviated nose represents a complex cosmetic and functional problem. Septal surgery plays a central role in the successful management of the externally deviated nose. This study included 260 patients seeking rhinoplasty to correct external nasal deviations; 75 percent of them had various degrees of nasal obstruction. Septal surgery was necessary in 232 patients (89 percent), not only to improve breathing but also to achieve a straight, symmetrical, external nose as well. A graduated surgical approach was adopted to allow correction of the dorsal and caudal deviations of the nasal septum without weakening its structural support to the dorsum or nasal tip. The approach depended on full mobilization of deviated cartilage, followed by straightening of the cartilage and its fixation in the corrected position by using bony splinting grafts through an external rhinoplasty approach. PMID:15692343

  16. Prolonged postoperative desaturation in a child with Down syndrome and atrial septal defect

    Directory of Open Access Journals (Sweden)

    Renu Sinha

    2011-01-01

    Full Text Available We report prolonged desaturation in a child with Down syndrome (DS and atrial septal defect due to undiagnosed interstitial lung disease. An 18-month-old child with DS was scheduled for bilateral lens aspiration for cataract. The child had atrial septal defect and hypothyroidism. He also had delayed milestones and hypotonia with episodes of recurrent respiratory tract infection necessitating repeated hospitalization. Preoperative evaluation was unremarkable. General anaesthesia and controlled ventilation using proseal laryngeal mask airway was instituted. He had uneventful intraoperative period. In the postoperative period, the child had desaturation 1 hour after surgery on discontinuation of oxygen supplementation by face mask, which improved with oxygen therapy. Supplemental oxygen via face mask was continued and weaned off over several days. On further evaluation, the child was diagnosed as having interstitial lung disease. He improved and discharged from the hospital 15 days after the surgery with room air saturation of 90%.

  17. Right ventricular systolic and diastolic functions assessed by 81mKr scintigraphy and relation to ventricular septal ischemia

    International Nuclear Information System (INIS)

    Right ventricular (RV) systolic and diastolic functions were assessed in patients with previous anteroseptal myocardial infarction to ascertain the influence of interventricular septal ischemia on RV function. Gated right ventriculography with continuous infusion of krypton-81 m was performed in 12 normal subjects and 28 patients with infarction but without significant stenosis of the right coronary artery. Furthermore, RV contractile reserve by postextrasystolic potentiation was evaluated by gated radionuclide ventriculography with 99mTc-HSA. The patients with anteroseptal infarction were divided into two groups by the presence or absence of three hours' redistribution in the septal region on exercise thallium-201 myocardial scintigraphy. Two indices of systolic function (ejection fraction and the peak ejection rate) and three indices of diastolic function (1/3 diastolic filling rate, the peak filling rate and time to the peak filling rate) were derived from the right ventricular time-activity curve and its derivative curve. There was no difference in systolic function among normal subjects and patients with or without redistribution. However, diastolic function was impaired only in the patients without redistribution. The RV contractile reserve in the patients without redistribution was less than in those with it. Thus, RV systolic function was maintained in the patients with anteroseptal infarction, but contractile reserve deteriorated only in severe septal ischemia. Similarly, diastolic function was maintained in mild septal ischemia, but impaired in severe septal ischemia. We concluded that RV systolic and diastolic functions are closely related to interventricular septal ischemia. (author)

  18. Radionuclide assessment of left ventricular perfusion and function after percutaneous translumial septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy

    International Nuclear Information System (INIS)

    Objective: The purpose of this study was to evaluate the clinical value of 99Tcm-MIBI myocardial perfusion imaging (MPI) and equilibrium radionuclide angiography (ERNA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) who underwent percutaneous translumial septal myocardial ablation (PTSMA). Methods: Eight patients (5 men, 3 women) with symptomatic HOCM underwent rest 99Tcm-MIBI MPI and ERNA before and after PTSMA. The septal-to-lateral counts ratio and the extent of septal perfusion defect of the left ventricle were calculated from MPI. The left ventricular ejection fraction (EF), peak filling rate (PFR) and septal regional EF were measured from ERNA. Results: 99Tcm-MIBI MPI showed increased septa199Tcm-MIBI uptake before PTSMA in all patients, but septal perfusion defects after PTSMA in 7 patients. The count-activity ratio of the septal-to-lateral wall decreased from 1.15±0.11 to 0.76±0.14 (p0.05 ]. Conclusion: MPI and ERNA are useful for the assessment of myocardial pefusion and change of left ventricular function after PTSMA in patients with HOCM. (authors)

  19. Value of transthoracic echocardiography on guiding occlusion of soft-rim atrial septal defect%经胸超声心动图指导软缘房间隔缺损封堵的价值

    Institute of Scientific and Technical Information of China (English)

    张军; 李军; 石晶; 张玉顺; 左健; 代政学; 李寰; 朱霆

    2008-01-01

    Objective To evaluate the feasibility and effect of transthoracic echocardiography(TTE)on guiding the occlusion of the soft-rim atrial septal defect(ASD).Methods Sixty two patients with the soft-rim ASD were enrolled.The size of ASD was measured and rim of ASD was observed by TTE on various views by using color Doppler system with tissue harmonic function before occlusion,and filmy rim of ASD with flapping which could not sustain occluder was eliminated.The size of occluder was selected by integratively judging the size of ASD and"sustainable diameter of ASD"The waist size of occluder was measured after releasing occluder and compared with the longest diameter of ASD and"sustainable diameter of ASD"measured by TTE.Results The longest diameter of ASD measured by TTE before occlusion was 11-35 mm[average(21.6±5.2)mm],the "sustainable diameter of ASD"was 15-37 mm[average(25.6±5.(J)mm],the size of selected occluder was 18-44mm[average(30.7±5.5)mini and the waist size of released occluder was 13-35 mm[average(24.2±5.6)mm].Fine correlation was existed between the longest diameter of ASD measured by TTE and the waist size of released occluder(r=0.86,P<0.000I).Morever,improved correlation was found between the"sustainable diameter of ASD"measured by TTE and the waist size of released occluder(r=0.89,P<0.0001).Occluder was firmly fixed without falling in all patients.Conclusions TTE with tissue harmonic function can be used to measure the size of soft-rim ASD and the"sustainable diameter of ASD".It is a feasible,and effective method on guiding occlusion of soft-rim ASD.%目的 评价经胸超声心动图(TTE)指导软缘房间隔缺损(ASD)封堵术的可行性和作用.方法 62例软缘ASD患者,术前用彩色多普勒超声心动图结合组织谐波功能经胸测量各切面ASD大小及观察周缘软硬情况,将菲薄且来回明显摆动、无支撑力的软缘剔除测量"ASD支撑径".再根据ASD大小和"ASD支撑径"大小综合判断选择适当的

  20. Synaptic Targets of Medial Septal Projections in the Hippocampus and Extrahippocampal Cortices of the Mouse.

    Science.gov (United States)

    Unal, Gunes; Joshi, Abhilasha; Viney, Tim J; Kis, Viktor; Somogyi, Peter

    2015-12-01

    Temporal coordination of neuronal assemblies among cortical areas is essential for behavioral performance. GABAergic projections from the medial septum and diagonal band complex exclusively innervate GABAergic interneurons in the rat hippocampus, contributing to the coordination of neuronal activity, including the generation of theta oscillations. Much less is known about the synaptic target neurons outside the hippocampus. To reveal the contribution of synaptic circuits involving the medial septum of mice, we have identified postsynaptic cortical neurons in wild-type and parvalbumin-Cre knock-in mice. Anterograde axonal tracing from the septum revealed extensive innervation of the hippocampus as well as the subiculum, presubiculum, parasubiculum, the medial and lateral entorhinal cortices, and the retrosplenial cortex. In all examined cortical regions, many septal GABAergic boutons were in close apposition to somata or dendrites immunopositive for interneuron cell-type molecular markers, such as parvalbumin, calbindin, calretinin, N-terminal EF-hand calcium-binding protein 1, cholecystokinin, reelin, or a combination of these molecules. Electron microscopic observations revealed septal boutons forming axosomatic or axodendritic type II synapses. In the CA1 region of hippocampus, septal GABAergic projections exclusively targeted interneurons. In the retrosplenial cortex, 93% of identified postsynaptic targets belonged to interneurons and the rest to pyramidal cells. These results suggest that the GABAergic innervation from the medial septum and diagonal band complex contributes to temporal coordination of neuronal activity via several types of cortical GABAergic interneurons in both hippocampal and extrahippocampal cortices. Oscillatory septal neuronal firing at delta, theta, and gamma frequencies may phase interneuron activity. PMID:26631464

  1. Successful Repair of Complete Atrio-ventricular Septal Defect at the Beginning of the Second Decade

    OpenAIRE

    Ashfaq, Awais; Shah, Nilay; Siddiqui, Osama T.; Amanullah, Muhammad M.

    2013-01-01

    Complete atrio-ventricular septal defects (CAVSD) are present in about 3% of children born with congenital heart pathologies. They usually require early surgical correction, mostly in infancy, and surgery is considered to be the gold standard. It is unlikely that anyone would survive beyond the first years without severe morbidity. However, we report a case of a Pakistani girl who underwent successful surgical repair of CAVSD at the age of 11.

  2. The role of cardiac MRI in the diagnosis and management of sinus venosus atrial septal defect

    Directory of Open Access Journals (Sweden)

    Madhusudan Ganigara

    2014-01-01

    Full Text Available Sinus venosus atrial septal defects (SV-ASDs are inter-atrial communications caused by a deficiency of the common wall between the superior or inferior vena cava and the right-sided pulmonary veins. The diagnosis can be challenging, especially in adults with delayed presentation. We present images that illustrate an example of the role of cardiac magnetic resonance imaging (CMRI in the diagnosis and follow-up of a patient with SV-ASD.

  3. Successful device closure of a post-infarction ventricular septal defect

    OpenAIRE

    Jin, Seon Ah

    2016-01-01

    Si-Wan Choi,* Ji Hye Han,* Seon-Ah Jin, Mijoo Kim, Jae-Hwan Lee, Jin-Ok Jeong Division of Cardiology, Department of Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea *These authors contributed equally to this work Abstract: Ventricular septal defect (VSD) is a lethal complication of myocardial infarction. The event occurs 2–8 days after an infarction and patients should undergo emergency surgical ...

  4. Successful device closure of a post-infarction ventricular septal defect

    OpenAIRE

    Choi SW; Han JH; Jin SA; Kim M; Lee JH; Jeong JO

    2016-01-01

    Si-Wan Choi,* Ji Hye Han,* Seon-Ah Jin, Mijoo Kim, Jae-Hwan Lee, Jin-Ok Jeong Division of Cardiology, Department of Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea *These authors contributed equally to this work Abstract: Ventricular septal defect (VSD) is a lethal complication of myocardial infarction. The event occurs 2–8 days after an infarction and patients should undergo emergency surgical treatmen...

  5. Free Wall Rupture and Ventricular Septal Defect Post Acute Anterior Myocardial Infarction

    OpenAIRE

    Mohammad Sahebjam; Ali Mohammad Haji Zeinali; Maryam Semnani; Seyed Hesameddin Abbasi; Shahla Majidi; Mahmood Shirzad; Naghmeh Moshtaghi; Seyed Ebrahim Kassaian; Kyomars Abbasi; Hakimeh Sadeghian

    2007-01-01

    Myocardial free wall rupture is a catastrophic complication of acute myocardial infarction, and prognosis will depend on the prompt diagnosis by echocardiography, extension of infarct size, and prompt surgical treatment. Free wall rupture concomitant with ventricular septal defect (VSD) may be more complicated for management. A case of a 69-year-old man with myocardial free wall rupture and VSD following acute anterior myocardial infarction is presented.

  6. THE EFFECT OF SEPTAL LESION ON NALOXONE INDUCED HYPOPHAGIA IN RATS

    OpenAIRE

    Gargate

    2014-01-01

    AIM : Ventromedial hypothalamus and lateral hypothalamus are well known for their role in regulation of food intake. Septum is key component of limbic system which has reciprocal connections with lateral hypothalamus. These septal projections to lateral hypothalamus are thought to affect food intake. Opioid system is one of the systems affecting food intake. Agonists of Opioid receptors increase food intake while antagonists of these receptors decrease food intake. Als...

  7. Interventricular septal rupture after myocardial infarction despite early percutaneous coronary intervention

    OpenAIRE

    Davran Cicek; Seher Gokay; Tonguc Saba; Ismail Sapmaz; Haldun Muderrisoglu

    2011-01-01

    Ventricular septal rupture (VSR) complicating acute myocardial infarction (AMI) is a serious clinical problem with high mortality rate due to cardiogenic shock or prolonged hemodynamic compromise. Despite multiple improvements in medical, interventional and surgical techniques, early and long-term prognosis after AMI related VSR still remain unpromising. We report a patient in whom an acute VSR was diagnosed 7 days after an anterior myocardial infarction treated with early primary percutaneou...

  8. Dilatation of the Great Arteries in an Infant with Marfan Syndrome and Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    L. Rozendaal

    2011-01-01

    Full Text Available We describe an infant presenting with contractures of the fingers, a large ventricular septal defect (VSD, and severe pulmonary artery dilatation. He had clinical and echocardiographic features of both neonatal or infantile Marfan syndrome (MFS and congenital contractural arachnodactyly. After surgical VSD closure, the aortic root developed progressive dilatation while the size of pulmonary artery returned to normal limits. Eventually the diagnosis of MFS was confirmed by DNA analysis.

  9. Acute oral administration of low doses of methylphenidate targets calretinin neurons in the rat septal area.

    Directory of Open Access Journals (Sweden)

    Alvaro eGarcía-Aviles

    2015-03-01

    Full Text Available Methylphenidate (MPD is a commonly administered drug to treat children suffering from attention deficit hyperactivity disorder (ADHD. Alterations in septal driven hippocampal theta rhythm may underlie attention deficits observed in these patients. Amongst others, the septo-hippocampal connections have long been acknowledged to be important in preserving hippocampal function. Thus, we wanted to ascertain if methylphenidate administration, which improves attention in patients, could affect septal areas connecting with hippocampus. We used low and orally administered methylphenidate doses (1.3; 2.7 and 5mg/Kg to rats what mimics the dosage range in humans. In our model, we observed no effect when using 1.3mg/Kg methylphenidate; whereas 2.7 and 5 mg/Kg induced a significant increase in c-fos expression specifically in the medial septum, an area intimately connected to the hippocampus. We analyzed dopaminergic areas such as nucleus accumbens and striatum, and found that only 5mg/Kg induced c-fos levels increase. In these areas tyrosine hydroxylase correlated well with c-fos staining, whereas in the medial septum the sparse tyrosine hydroxylase fibres did not overlap with c-fos positive neurons. Double immunofluorescence of c-fos with neuronal markers in the septal area revealed that co-localization with choline acethyl transferase, parvalbumin, and calbindin with c-fos did not change with MPD treatment; whereas, calretinin and c-fos double labeled neurons increased after MPD administration. Altogether, these results suggest that low and acute doses of methylphenidate primary target specific populations of caltretinin medial septal neurons.

  10. RESIDUAL DEFECTS AFTER SURGICAL REPAIR OF VENTRICULAR SEPTAL DEFECTS IN CHILDREN:

    OpenAIRE

    K Sayadpour-Zanjani; M Y Aarabi-Moghadam

    2008-01-01

    "nResidual ventricular septal defects (VSD) are major complications after cardiac surgery. We studied the incidence of this complication, risk factors for its occurrence and short-term follow-up in 179 pediatric patients that underwent surgical closure of VSD from April 2003 until May 2004. All data were gathered retrospectively except measurements of shunt ratio. Studied risk factors included age, sex, weight, height, ejection fraction, VSD size, presence of pulmonary stenosis (PS), res...

  11. Hybrid Procedure for Pulmonary Atresia with Ventricular Septal Defect in a Low Birth Weight Neonate

    OpenAIRE

    Park, Ji Young; Seo, Dong-Man; Shin, Hong Ju; Kim, Soo-Jin; Son, Jae Sung

    2013-01-01

    Cardiac surgery in neonates with congenital heart disease has progressed dramatically in the past three decades. However, low-birth-weight neonates with congenital heart disease continue to challenge the intellectual and technical skills of healthcare professionals. We present a case of a low-birth-weight neonate with pulmonary atresia and a ventricular septal defect, in whom palliation was achieved with a right ventricular outflow tract stent using a hybrid procedure.

  12. Coronary sinus type atrial septal defect in a child with pulmonary atresia and Ebstein's anomaly.

    OpenAIRE

    Russell, G A; Stovin, P G

    1985-01-01

    At birth an infant was found to have an unusual series of abnormalities with a coronary sinus type atrial septal defect complicating pulmonary atresia with an intact ventricular septum and Ebstein's anomaly. The functionally important anomalies were diagnosed by echocardiography and cardiac catheterisation. The coronary sinus defect and Ebstein's anomaly were detected only at necropsy. Although only a single case, the features of this heart favour Bull's revised classification of pulmonary at...

  13. The role of cardiac MRI in the diagnosis and management of sinus venosus atrial septal defect

    International Nuclear Information System (INIS)

    Sinus venosus atrial septal defects (SV-ASDs) are inter-atrial communications caused by a deficiency of the common wall between the superior or inferior vena cava and the right-sided pulmonary veins. The diagnosis can be challenging, especially in adults with delayed presentation. We present images that illustrate an example of the role of cardiac magnetic resonance imaging (CMRI) in the diagnosis and follow-up of a patient with SV-ASD

  14. Papillary muscle hypertrophy as a structural abnormality in patients with asymmetric septal hypertrophy

    OpenAIRE

    Mehmet Kanadaţý; Esmeray Acartürk

    2003-01-01

    Introduction: Asymmetric septal hypertrophy (ASH) is the most classical abnormality in hypertrophic cardiomy-opathy (HCM). Segmental hypertrophy of the left ventricle is less frequently observed. Some cases with papillary muscle hypertrophy (PMH) particularly associated with apical HCM and also ASH has been reported. Aim of the study: The aim of this study was to determine the frequency of PMH in patients with ASH. Material and methods: Two-dimensional echocardiographic examinations were perf...

  15. TYMPANOPLASTY WITH SEPTAL CARTILAGE AND CORTICAL MASTOID BONE IN CHOLESTEATOMA PATIENTS

    Directory of Open Access Journals (Sweden)

    Biram Singh

    2015-12-01

    Full Text Available OBJECTIVE This study was conducted to find out the ideal graft between septal cartilage and cortical mastoid bone in Farrior’s type 3 tympanoplasty in cholesteatoma patients in terms of hearing improvement, graft status and recurrence rate of the disease after canal wall down mastoidectomy. METHODS This randomized controlled trial was conducted in a tertiary care centre and the procedure and data collections were carried out for one and a half calendar year with effect from September 2007 and each case was followed up for 6 months. The data were entered and calculated statistically using SPSS16 for windows. RESULTS The study shows significant hearing improvement in both the groups. The tympanoplasty type 3 with cortical mastoid bone had air bone gap less than 20dB in 40% of patients. In septal cartilage, tympanoplasty group air bone gap less than 20dB was observed in 36.4%. Retraction of graft developed in 1(2.4% out of 20 patients among cortical mastoid bone tympanoplasty group. Among 22 patients of septal cartilage tympanoplasty type 3, 2(4.8% patients had cartilage resorption and 3(7.1% had graft displacement. Of the total 42 patients, 2(4.8% developed recurrence of the disease. CONCLUSION Cholesteatoma management is controversial. Canal wall down mastoidectomy can reduce the recurrence of disease. The cortical mastoid bone and septal cartilage grafts can provide hearing improvement after tympanoplasty type 3. There is no significant difference in hearing improvement between the two grafts.

  16. Hippocampal infusions of pyruvate reverse the memory-impairing effects of septal muscimol infusions

    OpenAIRE

    Krebs, Desiree L.; Parent, Marise B.

    2005-01-01

    Hippocampal infusions of glucose reverse memory deficits in spontaneous alternation and in a continuous multiple trial inhibitory avoidance task. The current experiments tested whether glucose metabolism may participate in these effects of glucose. Specifically, these experiments determined whether the glycolytic metabolite pyruvate would mimic these effects of glucose. Male Sprague–Dawley rats were given septal infusions of vehicle or the gamma-aminobutyric acid (GABA) receptor agonist musci...

  17. The effect of changing attitudes to Down's syndrome in the management of complete atrioventricular septal defects

    OpenAIRE

    Amark, K.; Sunnegardh, J

    1999-01-01

    OBJECTIVES—To describe the evaluation, decision making, and care of children with a complete atrioventricular septal defect (CAVSD).
STUDY DESIGN—Retrospective study of 136 consecutive cases from 1970 to 1996.
RESULTS—A total of 115 (85%) children had Down's syndrome. Denial of surgery without obvious medical reasons was more common in the early years, as was parental refusal of offered surgery and institutional care of the children. Improved results in later years encour...

  18. EPIDURAL ANESTHESIA FOR CESAREAN SECTION IN ATRIAL SEPTAL DEFECT WITH PULMONARY HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Rashmi

    2015-07-01

    Full Text Available Pregnant patients with atrial septal defect (ASD with pulmonary hypertension , occasionally present for anaesthesia . These patients are considered high risk for anaesthesia due to increased chances of per i operative cardiovascular complications . Anaesthesia requires intensive cardiovascular mo nitoring and maintenance of stable pulmonary and systemic haemodynamics . Here is a case of second gravida for LSCS which was managed under epidural anaesthesia successfully

  19. Masking of Pressure Overload in a Patient with Pulmonary Thromboembolism Accompanied by Atrial Septal Aneurysm

    OpenAIRE

    Yu, Tae Kyung; Kim, Woo Shik; Kim, Weon

    2011-01-01

    A pulmonary thromboembolism (PTE) causes a dramatic pressure overload to the right heart. Previous case reports have shown that elevated right atrial pressure secondary to a PTE can cause right-to-left shunting in the presence of an atrial septal aneurysm (ASA). A 57-year-old female with diabetes, hypertension, and an old cerebral infarction was admitted to our hospital with acute PTE. Initial transthoracic echocardiography (TTE) showed an ASA swing from the right side to the left side, and r...

  20. Ventricular septal rupture caused by myocardial bridge, solved by interventional closure device

    OpenAIRE

    Zóka, András; Andréka, Péter; Becker, Dávid; Fontos, Géza; Merkely, Béla; Szabó, György; Szatmári, András; Bárczi, György

    2012-01-01

    Myocardial bridging is a common coronary anomaly, which is generally described as a benign phenomenon. However, a growing number of studies consider this anomaly a relevant pathophysiological phenomenon with serious pathological consequences. Here we report on the case of an 88-year-old woman suffering from myocardial infarction and ventricular septal rupture, lacking any recognizable coronary disease except for a myocardial bridge causing the systolic compression of the left anterior descend...

  1. Fechamento de perfuração septal nasal em coelhos com celulose bacteriana Nasal septal perforation closure with bacterial cellulose in rabbits

    Directory of Open Access Journals (Sweden)

    Eulógio Emílio Martinez Neto

    2010-08-01

    Full Text Available Biomateriais podem ser válidos à somação de tecido e estrutura para o fechamento da perfuração do septo nasal. OBJETIVO: Testar celulose produzida pela bactéria Acetobacter xylinum associada à cola biológica no fechamento de perfurações septais em coelhos. Comparar histologicamente fibrose, inflamação, congestão vascular, integridade do enxerto e fechamento da perfuração septal. MATERIAL E MÉTODO: Quinze coelhos foram distribuídos em dois grupos: Controle (5 coelhos e celulose - Bionext® associado à cola de fibrina - Tissucol® (10 coelhos. Foi realizada uma perfuração cirúrgica no septo nasal em todos os coelhos. Nos animais do grupo Bionext® foi realizado o fechamento da perfuração com a colocação de celulose e aplicação de cola de fibrina. RESULTADOS: Dois coelhos foram a óbito. No grupo com celulose ocorreu o fechamento de duas perfurações e em 4 casos a celulose manteve-se impactada entre os bordos das perfurações. No grupo controle não ocorreu fechamento da perfuração septal em nenhum dos coelhos operados. CONCLUSÃO: Não houve diferença estatística significante nos quesitos inflamação aguda, congestão vascular e fibrose, avaliado histologicamente. Nos casos onde o enxerto se manteve posicionado, não houve alteração quanto à sua integridade. Pode ser útil à somação do arsenal terapêutico como base para re-epitelização dos bordos da perfuração.Alloplastic materials can be used together with tissue and structure to close nasal septal perforation. AIM: to test cellulose use in the closure of septal perforation in rabbits and to compare fibrosis, inflammation, vascular congestion and graft integrity. MATERIALS AND METHODS: Fifteen rabbits. The rabbits were divided into two groups: Control: Five rabbits and Bionext® and fibrin glue Tissucol®: Ten rabbits. Septal perforations were done in all of them. In the Bionext® group the closure was performed with the placement of cellulose

  2. Evaluation of the occluded carbon within husk phytoliths of 35 rice cultivars

    Science.gov (United States)

    Sun, Xing; Liu, Qin; Gu, Jie; Chen, Xiang; Zhu, Keya

    2016-01-01

    Rice is a well-known silicon accumulator. During its periods of growth, a great number of phytoliths are formed by taking up silica via the plant roots. Concurrently, carbon in those phytoliths is sequestrated by a mechanism of long-term biogeochemical processes within the plant. Phytolith occluded C (PhytOC) is very stable and can be retained in soil for longer than a millennium. In this study, we evaluated the carbon biosequestration within the phytoliths produced in rice seed husks of 35 rice cultivars, with the goal of finding rice cultivars with relatively higher phytolith carbon sequestration efficiencies. The results showed that the phytolith contents ranged from 71.6 mg•g‒1 to 150.1 mg•g‒1, and the PhytOC contents ranged from 6.4 mg•g‒1 to 38.4 mg•g‒1, suggesting that there was no direct correlation between the PhytOC content and the content of rice seed husk phytoliths (R = 0.092, p>0.05). Of all rice cultivars, six showed a higher carbon sequestration efficiency in phytolith seed husks. Additionally, the carbon biosequestration within the rice seed husk phytoliths was approximately 0.45‒3.46 kg-e-CO2•ha‒1•yr‒1. These rates indicate that rice cultivars are a potential source of carbon biosequestration which could contribute to the global carbon cycle and climate change.

  3. Lifting the Humic Veil: A Novel Approach to Quantitating Occluded Iron in Peat Porewater

    Science.gov (United States)

    Veverica, T. J.; Kane, E. S.; Marcarelli, A. M.; Green, S. A.

    2014-12-01

    Anaerobic conditions common in peatlands lead microbes to reduce alternative electron acceptors for respiration in the order of their energetic yield: nitrate, manganese, ferric iron (Fe[III]), sulfate, and CO2. Many studies of peatland respiration report high CO2 fluxes that cannot be completely explained by measured pathways of microbial metabolism: it appears that an unquantified pool of electron acceptors is driving respiration and the efflux of CO2. The notion that undetected iron reduction may be an important contributing factor to these fluxes has been proposed, but has yet to be addressed. Among the possible causes for this anomaly is the widespread use of colorimetric assays for iron quantitation and speciation. Peat porewater contains high concentrations of dissolved humic and fulvic acids that occlude Fe(III), blocking colorimetric complex formation, potentially leading to an underestimate of Fe(III) in these challenging analytical matrices. We evaluated a novel ionic liquid extraction method in a variety of temperate peatland porewater samples and compared these results to data acquired simultaneously using colorimetric methods. We found a >50% average improvement in accuracy for total iron quantitation using ionic liquid extraction. Moreover, ionic liquid extraction of peat porewater consistently recovered Fe(III) whereas colorimetric methods detected 50-100% less, suggesting that DOM bound Fe(III) is not reliably detected using colorimetric assays in these systems and may represent a previously unidentified pool of electron acceptors in peat porewater.

  4. Laser scoop desobliteration: a method for minimally invasive remote recanalization of chronically occluded superficial femoral arteries

    Science.gov (United States)

    Heneweer, Carola; Siggelkow, Markus; Helle, Michael; Petzina, Rainer; Wulff, Asmus; Schaefer, Joost P.; Berndt, Rouven; Rusch, Rene; Wedel, Thilo; Klaws, Guenther; Müller-Gerbl, Magdalena; Röcken, Christoph; Jansen, Olav; Lutter, Georg; Cremer, Joachim; Groß, Justus

    2015-02-01

    Stenosis and occlusion of the superficial femoral artery (SFA) are most common in arterial occlusive disease. There are numerous interventional, surgical, and combined approaches to reconstitute maximum blood supply to the lower limb; however, despite intense clinical research, the long-term success rates are still poor. We present the first results with a catheter prototype for laser-based minimal invasive endarterectomy, called laser scoop desobliteration (LSD). The tip of a glass fiber containing a catheter was modified with a spatula head design and connected to an ultraviolet laser. It was tested in cadavers fixed with the Thiel embalming technique preserving tissue consistency, flexibility, and plasticity. After longitudinal arteriotomy of the SFA, a circular dissection between media and adventitia was performed. Then the LSD catheter was inserted and propagated with a progress of 1 mm/s. Afterward, the atheroma core, which showed a plain surface without substantial attaching tissue debris, was removed. Histological examination of the vessel wall showed that the dissection was performed at the media/adventitia interface. In summary, the constructed LSD catheter allowed a rapid and easy way to perform an endarterectomy, thereby offering an innovative approach in the treatment of chronic occluded SFA.

  5. The Incidence of Hepatocellular Carcinoma after Balloon-Occluded Retrograde Transvenous Obliteration

    Directory of Open Access Journals (Sweden)

    Keiji Yokoyama

    2015-01-01

    Full Text Available Balloon-occluded retrograde transvenous obliteration (BRTO is a highly effective therapy for gastric varices with liver cirrhosis. We have investigated the incidence of hepatocellular carcinoma (HCC after BRTO. We enrolled 71 patients with viral hepatitis in which HCC had not appeared with liver imaging findings at the time of BRTO. The overall survival rate after BRTO was 86.8%, 76.1%, and 50.5% at 1, 3, and 5 years. The occurrence rate of HCC after BRTO was 20.9%, 41.1%, and 60.7% at 1, 3, and 5 years, especially showing a higher occurrence of HCC at one year. Meanwhile, the occurrence rate of HCC after treatment which excluded BRTO for esophagogastric varices in patients was 6.3%, 19.2%, and 42.5% at 1, 3, and 5 years. The log-rank test revealed that the occurrence rate of HCC after treatment was significantly higher in the BRTO group compared with that in the non-BRTO group (P=0.0447. The recurrence rate of HCC after BRTO was 35.8% and 80.0% at 1 and 3 years. The present study demonstrated a high incidence of HCC after BRTO in liver cirrhosis patients with viral hepatitis infection. We have suggested the potential for BRTO to accelerate hepatocarcinogenesis.

  6. Microwave ablation versus laser ablation in occluding lateral veins in goats.

    Science.gov (United States)

    Wang, Xu-hong; Wang, Xiao-ping; Su, Wen-juan; Yuan, Yuan

    2016-02-01

    Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation (EVLA) is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation (EMA). This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA (EMA group), and the rest 6 with EVLA (EVLA group). Results of coagulation, including coagulation, fibrinolysis and platelet activation, were assessed at three or four different time points: before, immediately after, 24 h (and 48 h) after ablation. The diameter change, a measure of efficacy, was ultrasonographically measured before and 1 month after the ablation. Histological changes were grossly and microscopically evaluated immediately, 1 and 3 month(s) after the ablation. The length of the ablated vein and preoperative average diameter were comparable between the two groups. In both EMA and EVLA groups, several coagulation parameters, fibrinolysis and platelet activation parameters only underwent slight changes. Ultrasound imaging displayed that the diameter reduction of the veins treated by EMA was significantly larger than by EVLA, in consistent with the results of macroscopic examination. Microscopic examination revealed necrosis and thickening of the vein wall, and occlusion of the lumen within 3 months after ablation in both EMA and EVLA groups. It is concluded that EMA is a minimally invasive therapy, which appears to be safe and effective for treatment of lateral veins in goats. PMID:26838749

  7. Percutaneous transluminal ultrasonic angioplasty: preliminary clinical report of ultrasound plaque ablation in totally occluded peripheral arteries.

    Science.gov (United States)

    Monteverde-Grether, C; Valez y Tello de Meneses, M; Nava-López, G; Jauregui, R; Borges, J; Abundes, A; López-Cuéllar, M; Armilla, M

    1991-01-01

    Peripheral arterial obstructive disease has been treated with ultrasound ablation. Thirty two patients (pts), mean age 67 +/- 10 years underwent angiosonoplasty, with a prototype ultrasonic system, due to severe claudication (31%), rest pain (44%), rest pain and ulceration (25%). Angiosonoplasty was successful in 26/32 (81%) stenoses, (1/2 iliac, 9/2 femorals, 11/12 popliteal, 5/6 tibial). Angiography before and after angiosonoplasty confirmed that the lesions were successfully opened, (81%, p less than 0.05). A mean of 3 +/- 2 passes were required to adequately remove sufficient plaque. Balloon angioplasty was used in combination with angiosonoplasty in 11/32 (34%) occluded vessels. Complications included groin hematoma in 4 pts (12%) and vascular spasm in two patients (6%). Within 24 hours, 27/32 (94%) pts were discharged clinically improved. Reocclusion occurred in 4 pts (12%) immediately after the procedure. Ankle brachial indices significantly increased from 0.52 +/- 0.10 before to 0.70 +/- 0.12 after (p less than 0.05). In conclusion, the use of ultrasound energy to ablate atherosclerotic plaque would appear safe, and has shown no restenosis and a low incidence of complications over a six month period. PMID:1840288

  8. Endovascular treatment of a chronically occluded limb of endograft with combination TNK pharmacological and EKOS thrombolytic catheter system

    International Nuclear Information System (INIS)

    Arterial occlusion is a common and sometimes devastating medical condition related to peripheral vascular and cardiovascular disease. These patients are at severe risk of limb loss and death. Those patients with embolic phenomena are at significantly higher mortality risk than those with thrombosis. Catheter directed therapies have been used routinely for restoration of perfusion to a limb removing the thrombosis or embolic material. Limb thrombosis following endovascular graft placement is a known complication occurring within the first year of the endograft. In many institutions, endovascular treatment of aortic limb occlusions has become the initial management for acute occlusions. We describe the endovascular treatment of a chronic occluded limb utilizing a combination of pharmacological and mechanical thrombolysis using the new ultrasound enhanced EKOS catheter system. Endovascular specialists should be aware that chronically occluded endograft limbs can be successfully treated in the endovascular suite with the EKOS system without requiring more invasive surgical therapies.

  9. Resultados a longo prazo da miectomia septal no tratamento da cardiomiopatia hipertrófica Long term results of septal myectomy in the treatment of obstructive hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Luiz Augusto Ferreira Lisboa

    2011-03-01

    Full Text Available OBJETIVO: Avaliação clínica e ecocardiográfica tardia da miectomia septal cirúrgica de pacientes com cardiomiopatia hipertrófica obstrutiva (CMHO. MÉTODOS: Foram analisados, retrospectivamente, 34 pacientes adultos (média de 55,7±15,2 anos portadores de CMHO operados consecutivamente na instituição entre 1988 e 2008. Apenas quatro (11,8% pacientes tinham conhecimento de história familiar para CMHO. Nove (26,5% pacientes apresentavam insuficiência cardíaca (NYHA classe funcional IV. Trinta (88,2% pacientes apresentavam CMHO isolada e, em quatro (11,8%, a CMHO estava associada à insuficiência coronária. A técnica cirúrgica utilizada em todos os casos foi a miectomia septal transaórtica. RESULTADOS: Em 26 (76,5% pacientes, a insuficiência mitral decorrente do movimento anterior sistólico regrediu após a miectomia. Em oito (23,5% pacientes, houve necessidade de abordagem da valva mitral. Houve um (2,9% óbito hospitalar. Dois (5,9% pacientes necessitaram de marcapasso definitivo no pós-operatório. Em média, o gradiente de pico pré-operatório na via de saída do ventrículo esquerdo, que era de 84,9±29,0 mmHg, diminuiu para 27,8±12,9 mmHg no pós-operatório inicial e caiu para 19,2±11,2 mmHg no pós-operatório tardio (49,0±33,0 meses. A classe funcional (NYHA que, em média, era de 3,1±0,8 passou para 1,4±0,5 no pós-operatório. Com seguimento médio de 9,6±8,4 anos, a sobrevida foi de 87,9% e a sobrevida livre de eventos cardiovasculares foi de 77,7%. CONCLUSÃO: A miectomia septal cirúrgica pode ser realizada de modo seguro, com excelente sobrevida, melhora dos sintomas e alívio da obstrução na via de saída do ventrículo esquerdo em pacientes com CMHO. Os benefícios iniciais se mantiveram a longo prazo.OBJECTIVE: This study analyzed the clinical and echocardiographic late outcomes of surgical septal myectomy in patients with obstructive hypertrophic cardiomyopathy (OHCM. METHODS: We examined

  10. The Prevalence of Concha Bullosa and Nasal Septal Deviation and Their Relationship to Maxillary Sinusitis by Volumetric Tomography

    Directory of Open Access Journals (Sweden)

    Kyle D. Smith

    2010-01-01

    Full Text Available The objective of this study was to determine the prevalence of concha bullosa and nasal septal deviation and their potential relationships to maxillary sinusitis. 883 CT scans taken at Creighton University School of Dentistry from 2005 to 2008 were retrospectively reviewed for the presence of concha bullosa, nasal septal deviation, and maxillary sinusitis. 67.5% of patients exhibited pneumatization of at least one concha, 19.4% of patients had a deviated septum, and 50.0% had mucosal thickening consistent with maxillary sinusitis. 49.3% of patients who had concha bullosa also had evidence of maxillary sinusitis. Only 19.5% of patients with concha bullosa also had nasal septal deviation, whereas 19.7% of patients with sinusitis also presented with nasal septal deviation. Although concha bullosa is a common occurrence in the nasal cavity, there did not appear to be a statistically significant relationship between the presence of concha bullosa or nasal septal deviation and maxillary sinusitis.

  11. Hepatic Encephalopathy Secondary to Intrahepatic Portosystemic Venous Shunt: Balloon-Occluded Retrograde Transvenous Embolization with n-Butyl Cyanoacrylate and Microcoils

    International Nuclear Information System (INIS)

    We report a 70-year-old woman with hepatic encephalopathy due to an intrahepatic portosystemic venous shunt that was successfully occluded by percutaneous transcatheter embolization with n-butyl cyanoacrylate and microcoils

  12. Assessment of atrial septal defects in adults comparing cardiovascular magnetic resonance with transoesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Brown Michael A

    2010-07-01

    Full Text Available Abstract Background Many adult patients with secundum-type atrial septal defects (ASDs are able to have these defects fixed percutaneously. Traditionally, this has involved an assessment of ASD size, geometry and atrial septal margins by transoesophageal echocardiography (TOE prior to percutaneous closure. This is a semi-invasive technique, and all of the information obtained could potentially be obtained by non-invasive cardiovascular magnetic resonance (CMR. We compared the assessment of ASDs in consecutive patients being considered for percutaneous ASD closure using CMR and TOE. Methods Consecutive patients with ASDs diagnosed on transthoracic echocardiography (TTE were invited to undergo both CMR and TOE. Assessment of atrial septal margins, maximal and minimal defect dimensions was performed with both techniques. Analyses between CMR and TOE were made using simple linear regression and Bland Altman Analyses. Results Total CMR scan time was 20 minutes, and comparable to the TOE examination time. A total of 20 patients (M:F = 5:15, mean age 42.8 years ± 15.7 were included in the analyses. There was an excellent agreement between CMR and TOE for estimation of maximum defect size (R = 0.87. The anterior inferior, anterior superior and posterior inferior margins could be assessed in all patients with CMR. The posterior superior margin could not be assessed in only one patient. Furthermore, in 1 patient in whom TOE was unable to be performed, CMR was used to successfully direct percutaneous ASD closure. Conclusions CMR agrees with TOE assessment of ASDs in the work-up for percutaneous closure. Potentially CMR could be used instead of TOE for this purpose.

  13. New Coaxial Transseptal Needle for Creation of Atrial Septal Defects in Adult Sheep

    International Nuclear Information System (INIS)

    Objectives: To introduce a new transseptal (TS) needle assembled in our laboratory—the coaxial TS (CTS) needle—and describe our experience with it in creating experimental atrial septal defects (ASD) in adult sheep.BackgroundWith commercially available TS needles, we were not able to consistently perform TS puncture at the fossa ovalis in adult sheep.Material and MethodsTen adult sheep with a mean weight of 63.5 kg were used. The CTS needle consists of four components: a 9F Teflon catheter, a 14-gauge blunt curved-tip metal cannula, a 4F tapered catheter, and a 20-gauge open needle. A transjugular 5F pigtail catheter was used to display the septal anatomy by angiocardiography and was left in place to mark the level of the fossa ovalis. The septum was then probed by a transfemoral 5F curved-tip end-hole catheter. The CTS needle was aligned with the tip of the transjugular catheter, and the TS puncture was performed under fluoroscopic guidance. After documenting a left atrial position, a balloon angioplasty catheter was used for creation of the ASD. Results: A small patent foramen ovale was discovered by septal probing in one sheep. All sheep underwent successful TS punctures without complications. The ASD size ranged from 13 to 15 mm. In eight sheep, the ASD was in fossa ovalis. In the first two sheep where the needle was not well aligned with the marking catheter, the ASD was in the septum secundum. No damage to the atrial or other heart structures was found at necropsy. Conclusion: The CTS needle is a suitable needle for TS puncture and ASD creation in adult sheep. Proper alignment of the CTS needle with a catheter marking the fossa ovalis is essential for successful puncture.

  14. Alcohol septal ablation in obstructive acromegalic hypertrophic cardiomyopathy - a first case report.

    Science.gov (United States)

    Viveiros Monteiro, André; Fiarresga, António; Cacela, Duarte; de Sousa, Lídia; Ramos, Ruben; Galrinho, Ana; Branco, Luísa; Cruz Ferreira, Rui

    2016-09-01

    Acromegaly is a rare disease, mostly caused by a growth hormone (GH)-secreting benign pituitary tumor, with an increased production of GH and insulin-like growth factor 1 (IGF-1). Cardiovascular complications are common and are associated with cardiomyocyte apoptosis and concentric cardiac hypertrophy. Suppression of GH and IGF-1 appears to improve cardiac function only in the short term, with little or no decrease in left ventricular mass or improvement in cardiac function after prolonged treatment. Alcohol septal ablation (ASA) has emerged as a minimally invasive alternative to septal myectomy, with significant improvement in symptoms, gradients and left ventricular remodeling. In this report, we describe the case of a 73-year-old woman with acromegaly due to a pituitary adenoma diagnosed and treated surgically at the age of 38 but with recurrence and reoperation at the age of 50. She was referred to our cardiology department due to a three-month history of progressively worsening exercise-induced dyspnea and orthopnea under optimal medical therapy. Echocardiography and magnetic resonance imaging revealed severe basal hypertrophy of the interventricular septum (19 mm), dynamic left ventricular outflow tract obstruction with a gradient of 70 mmHg at rest and 120 mmHg with Valsalva maneuver, and systolic anterior movement (SAM). Genetic testing excluded the most frequent forms of familial hypertrophic cardiomyopathy. ASA was performed with injection of 2 cc of alcohol in the first septal branch of the left coronary artery, without complications. At one-year reassessment, significant clinical and echocardiographic improvement was noted, with disappearance of SAM. To our knowledge, there have been no previously reported cases of ASA in hypertrophic cardiomyopathy due to acromegaly. We report a case of successful ASA in acromegalic cardiomyopathy. PMID:27503591

  15. Radiation dosage accepted by children during interventional treatment for congenital ventricular septal defect

    International Nuclear Information System (INIS)

    Objective: To estimate the radiation dose to which children are exposed during cardiac catheterizations for the treatment of ventricular septal defect, to analyze the factors affecting the radiation dose and to find out the measures to decrease the radiation dose. Methods: From December 2008 to October 2009, transcatheter closure was performed in 30 children with perimembranous ventricular septal defect. During the procedure the radiation doses to the children were estimated by using thermoluminescent dosimetry (TLD). The TLD chips were calibrated before use and were attached in four measuring points,representing the radiation dose of the crystalline lens, the thyroid, the exposure field and the gonad. Results: The mean entrance dose of the crystalline lens,the thyroid,the exposure field and the gonad was (65.7 ± 48.8)μGy, (2618.2 ± 862.6)μGy, (3376.5 ± 838.4)μGy and (57.0 ± 59.4)μGy, respectively. The mean fluoroscopic time used for interventional procedure was (7.2 ± 3.0) minutes, and the mean angiographic exposures time was (6.1 ± 1.8) seconds. Conclusion: Transcatheter closure therapy for perimembranous ventricular septal defect is safe and effective. The exposure field is the region receiving the largest radiation dose, in the next place was the thyroid.Some more effective protections, such as smaller exposure field, strengthened protection of thyroid region, etc. should be taken in order to decrease the X-ray radiation dosage accepted by children as they are more sensitive to radiation exposure. (authors)

  16. Transthoracic echocardiographic guidance during transcatheter closure of atrial septal defects in children and adults.

    Science.gov (United States)

    Erdem, Abdullah; Sarıtas, Turkay; Zeybek, Cenap; Yucel, Ilker Kemal; Erol, Nurdan; Demır, Halil; Odemıs, Ender; Yalcın, Yalim; Celebı, Ahmet

    2013-01-01

    The purpose of this study was to evaluate the safety and efficacy of transcatheter atrial septal defect (ASD) closure guided by transthoracic echocardiography (TTE). Since 2004, ASD closure was performed successfully in total 337 patients. Transthoracic echocardiography guidance was used in 206 patients (61.1%) (group 1). Closure was guided by transesophageal echocardiography under general anesthesia in patients with poor transthoracic acoustic windows, defects with aneurysmatic septum and/or multiple defects in 131 patients (38.9%) (group 2). The median age (9 vs. 16 years, P acoustic windows. Performing the procedure under TTE guidance significantly reduces procedure time and also provides increased patient's comfort. PMID:21833775

  17. Secundum atrial septal defect in the adult. Clinical, haemodynamic and electrophysiological aspects.

    OpenAIRE

    Thilén, Ulf

    2009-01-01

    Atrial septal defect (ASD) is the most common congenital heart malformation diagnosed in adult life. In this thesis important clinical, haemodynamic and electrophysiological aspects of ASD in the adult are explored. The diagnostic accuracy of magnetic resonance velocity mapping (MRvm)in calculating the pulmonary/systemic flow ratio (QP/QS)was assessed (I). The mean and maximal error by MRvm was 1±1% and ≤4% respectively in the whole range of different QP/QS and repeatability showed a d...

  18. Associations Between ABCG2 Gene Polymorphisms and Isolated Septal Defects in a Han Chinese Population

    OpenAIRE

    Wang, Chuan; Xie, Liang; Li, Huaying; Li, Yifei; Mu, Dezhi; Zhou, Rong; Liu, Ruiqi; Zhou, Kaiyu; Hua, Yimin

    2014-01-01

    Breast cancer resistance protein (BCRP) in the placenta, encoded by the ABCG2 gene in humans, plays an essential role in regulating fetal exposure to toxicants and the maintenance of cellular folic acid homeostasis. This study aimed at exploring the associations between 421C>A and 34G>A polymorphisms within the ABCG2 gene of the children and isolated septal defects in a Han Chinese population. An age- and gender-matched case-control study involving 210 pairs was conducted. Genotyping of the A...

  19. Presynaptic modulation of 5-HT release in the rat septal region.

    Science.gov (United States)

    Rutz, S; Riegert, C; Rothmaier, A K; Jackisch, R

    2007-05-11

    5-HT released from serotonergic axon terminals in the septal nuclei modulates the activity of septal output neurons (e.g. septohippocampal cholinergic neurons) bearing somatodendritic 5-HT receptors. Therefore, we studied the mechanisms involved in the presynaptic modulation of 5-HT release in the lateral (LS) and medial septum (MS), and the diagonal band of Broca (DB). HPLC analysis showed that tissue concentrations of noradrenaline, dopamine and 5-HT were highest in DB (DB>MS>LS). Slices prepared from LS, MS and DB regions were preincubated with [(3)H]5-HT, superfused in the presence of 6-nitro-2-(1-piperazinyl)-quinoline (6-nitroquipazine) and electrically stimulated up to three times (first electrical stimulation period (S(1)), S(2), S(3); 360 pulses, 3 Hz, 2 ms, 26-28 mA). In all septal regions the Ca(2+)-dependent and tetrodotoxin-sensitive electrically-evoked overflow of [(3)H] was inhibited by the 5-HT(1B) agonist CP-93,129 and the alpha(2)-adrenoceptor agonist 5-bromo-6-(2-imidazolin-2-ylamino)-quinoxaline tartrate (UK-14,304). Also the mu- and kappa-opioid receptor agonists (d-Ala(2), N-Me-Phe(4), glycinol(5))-enkephalin (DAMGO) and [trans-(1S,2S(-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl) cyclohexyl]-benzenacetamide hydro-chloride] (U-50,488H), respectively, acted inhibitory (although less potently), whereas the delta-opioid receptor agonist (d-Pen(2), d-Pen(5))-enkephalin (DPDPE), the dopamine D(2) receptor agonist quinpirole and the adenosine A(1) receptor agonist N(6)-cyclopentyladenosine were all ineffective; the GABA(B) receptor agonist baclofen had weak effects. All inhibitory effects of the agonists were antagonized by the corresponding antagonists (3-[3-(dimethylamino)propyl]-4-hydroxy-N-[4-(4-pyridinyl)phenyl]benzamide dihydrochloride (GR-55,562), idazoxan, naloxone, nor-binaltorphimine), which also significantly enhanced the evoked release of 5-HT at S(1). It is concluded that 5-HT release in septal nuclei of the rat is modulated by

  20. Prenatal Isolated Ventricular Septal Defect May Not Be Associated with Trisomy 21

    OpenAIRE

    Ori Shen; Sari Lieberman; Benjamin Farber; Daniel Terner; Amnon Lahad; Ephrat Levy-Lahad

    2014-01-01

    The aim of this study was to examine if isolated fetal ventricular septal defect (VSD) is associated with trisomy 21. One hundred twenty six cases with prenatal VSD diagnosed by a pediatric cardiologist were reviewed. Cases with known risk factors for congenital heart disease, the presence of other major anomalies, soft signs for trisomy 21 or a positive screen test for trisomy 21 were excluded. Ninety two cases formed the study group. None of the cases in the study group had trisomy 21. The ...

  1. Phase image showing pseudoparadoxical septal motion in case of rupture of the chordae tendineae

    International Nuclear Information System (INIS)

    When observing a phase image with an apparent dykinetic behaviour of the intraventricular septum, a differential diagnosis between conditions with true paradoxical septal motion and conditions of apparent paradoxical movement due to other causes is necessary, like in the case reported here. In a patient with a good EF value and a high RI, ventricular wall motion has to be scrutinized by cinedisplay, since it may show a vigorous contraction and rotation of the heart to the left. A recent sudden valvular insufficiency has to be considered likely due to a myxomatous change of the mitral valvular apparatus. (orig.)

  2. Predominant location of coronary artery atherosclerosis in the left anterior descending artery. The impact of septal perforators and the myocardial bridging effect

    OpenAIRE

    Wasilewski, Jarosław; Niedziela, Jacek; Osadnik, Tadeusz; Duszańska, Agata; Sraga, Wojciech; Desperak, Piotr; Myga-Porosiło, Jolanta; Jackowska, Zuzanna; Nowakowski, Andrzej; Głowacki, Jan

    2015-01-01

    Introduction Coronary artery atherosclerosis presents characteristic patterns of plaque distribution despite systemic exposure to risk factors. We hypothesized that local hemodynamic forces induced by the systolic compression of intramuscular septal perforators could be involved in atherosclerotic processes in the left anterior descending artery (LAD) adjacent to the septal perforators’ origin. Therefore we studied the spatial distribution of atherosclerosis in coronary arteries, especially i...

  3. Successful anesthetic management of a child with blepharophimosis syndrome and atrial septal defect for reconstructive ocular surgery

    Directory of Open Access Journals (Sweden)

    Dalim Kumar Baidya

    2011-01-01

    Full Text Available Blepharophimosis syndrome is an autosomal dominant disorder characterized by eyelid malformation, involvement of reproductive system and abnormal facial morphology leading to difficult airway. We report a rare association of blepharophimosis syndrome and atrial septal defect in a 10-year-old girl who came for reconstruction surgery of eyelid. The child had dyspnea on exertion. Atrial septal defect was identified preoperatively by clinical examination and echocardiography. Anesthesia management was complicated by failure in laryngeal mask airway placement and Cobra perilaryngeal airway was subsequently used.

  4. The Effect of Nasal Septal Perforation and its Treatment on Objective Sleep and Breathing Parameters

    Science.gov (United States)

    Boynuegri, Suleyman; Cayonu, Melih; Tuna, Evrim Unsal; Kurukahvecioglu, Selma; Ozcan, Kursat Murat; Turkay, Burak; Cingi, Cemal

    2016-01-01

    Background Nasal septal perforation (NSP) may alter nasal airflow patterns and physiology. To the best of our knowledge, no studies in the English literature have investigated the effect of NSP and its treatment on polysomnographic parameters. In this study, we aimed to investigate polysomnographic parameters in patients with NSP as well as changes in those parameters after treatment of NSP. Material/Methods Nineteen patients diagnosed with NSP were included in the study. All patients had baseline and post-procedure polysomnographies (PSG) after insertion of silicone septal button for closure of NSP. Results Both median AHI [5.30 (14.40) vs. 2.40 (14.50)] and median supine AHI [10.00 (42.10) vs. 6.60 (37.00)] decreased after correction of the perforation. There was a large reduction in median supine AHI in patients with a perforation size >66 mm2 [10.10 (34.15) vs. 1.60 (28.30)]. Conclusions We conclude that NSP did not cause any deterioration in objective sleep parameters as determined by PSG, other than a decrease in REM sleep duration and an increase in supine AHI. Correction of NSP did not affect REM duration and supine AHI decreased after treatment. PMID:26878399

  5. Robotic atrial septal defect repair and endoscopic treatment of atrial fibrillation.

    Science.gov (United States)

    Argenziano, Michael; Williams, Mathew R

    2003-04-01

    Computer (robotic) enhancement has emerged as a facilitator of minimally invasive cardiac surgery and has been used to perform portions of intracardiac procedures via thoracotomy incisions. This report describes the use of the da Vinci surgical system in two totally endoscopic ("closed chest") cardiac operations: atrial septal defect closure and pulmonary vein isolation of atrial fibrillation. ASD closure: Fifteen patients underwent repair of a secundum-type atrial septal defect or patent foramen ovale by a totally endoscopic approach, utilizing the da Vinci robotic system. Cardiopulmonary bypass (CPB) was achieved peripherally. Cardioplegia was administered via the distal port of the arterial cannula after endoballoon inflation. Via three port incisions in the right chest, the entire operation including pericardiotomy; bicaval occlusion; atriotomy; atrial septopexy; and atrial closure was performed by a surgeon seated at a computer console. A fourth 15 mm port was utilized for suction and suture passage by a patient-side assistant. In one case, a recurrent shunt was identified and repaired on POD 5. Median ICU length of stay (LOS) was 20 hours, and median hospital LOS was 4 days. Atrial fibrillation surgery: This report also describes the pathway that we have pursued in the development of a totally endoscopic operation for atrial fibrillation. Beginning with animal models, we tested various ablative energy sources; methods of ablation; and minimally invasive approaches. This work has led to the development of a variety of minimally invasive surgical approaches including a totally endoscopic, robotically assisted beating heart procedure for the treatment of atrial fibrillation. PMID:12838483

  6. Off-Pump Repair of a Post Myocardial Infarction Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2014-01-01

    Full Text Available Refractory cardiogenic shock meant that traditional patch repairs requiring cardiopulmonary bypass would be poorly tolerated and external sandwich closure of post myocardial ventricular septal defect (VSD appears to be simple and effective after initial myocardial infarction (MI. The three cases presented with a VSD after of acute MI with or without thrombolysed with streptokinase during patient admission. The general condition of the three patients was poor with pulmonary edema, low cardiac output and renal failure. The heart was approached through a median sternotomy. Off-pump coronary artery bypass grafting of the coronary artery lesion was done first using octopus and beating heart surgery method and latero - lateral septal plication was performed using sandwich technique. Low cardiac output managed with intra-aortic balloon pump in these patients accompanied with inotropic drugs. Post-operative transesophageal echocardiography revealed that VSD was closed completely in one patient and in two patients small residual VSD remained. More experience is required to ascertain whether this technique will become an accepted alternative to patch repairs.

  7. Urgent hybrid approach in treatment of the acute myocardial infarction complicated by the ventricular septal rupture

    Directory of Open Access Journals (Sweden)

    Radosavljević-Radovanović Mina

    2014-01-01

    Full Text Available Introduction. Ventricular septal rupture (VSR in the acute myocardial infarction (AMI is a rare but very serious complication, still associated with high mortality, despite significant improvements in pharmacological and surgical treatment. Therefore, hybrid approaches are introduced as new therapeutical options. Case Outline. We present an urgent hybrid approach, consisting of the initial percutaneous coronary intervention (PCI of the infarct-related artery, followed by immediate surgical closure of the ventricular septal rupture, for treatment of high risk, hemodynamically unstable female patient with AMI caused by one-vessel disease and complicated by VSR and cardiogenic shock. Since the operative risk was also very high (EUROSCORE II 37%, this therapeutic decision was based on the assumption that preoperative PCI could promptly establish blood flow and thereby lessen the risks, duration and complexity of urgent cardiosurgical intervention, performed on the same day. This approach proved to be successful and the patient was discharged from the hospital on the fifteenth postoperative day in stable condition. Conclusion. In selected cases, with high operative risk and unstable hemodynamic state due to AMI complicated by VSR, urgent hybrid approach consisting of the initial PCI followed by surgical closure of VSR may represent an acceptable treatment option and contribute to the treatment of this complex group of patients.

  8. Pulmonary stenosis development and reduction of pulmonary arterial hypertension in atrioventricular septal defect: a case report

    Directory of Open Access Journals (Sweden)

    Ninet Gérard

    2009-09-01

    Full Text Available Abstract A 24-year-old patient was admitted for dyspnoea and syncope. He had a previous history of complete atrio-ventricular septal defect and trisomy 21. At the age of 6 months, in 1984, cardiac catheterization revealed a quasi-systemic pulmonary arterial hypertension with a bidirectional shunt corresponding to an Eisenmenger syndrome. Corrective cardiac surgery was not performed at this time because surgical risk was considered too high. Until the age of 20 years old, he showed few symptoms while under medical treatment. But since 2006, his functional status became worse with an increased dyspnoea, syncopes, and severe cyanosis. In these conditions, haemodynamic parameters have been re-evaluated in 2006 and 2008. They highlighted a late and progressive development of a valvular and infundibular pulmonary stenosis leading to a normalisation of pulmonary arterial pressures. At the age of 24 , the patient underwent corrective cardiac surgery which was successful. Late development of both infundibular and valvular pulmonary stenosis have not been described before in non operated congenital ventricular septal defects, but development of one or the other abnormality would be found in 8% of patients. The physiopathological mechanism of this obstruction is unclear. Nevertheless, in unoperated congenital cardiac shunt lesions, reversibility of severe pulmonary arterial hypertension should be reconidered and re-assessed during follow up.

  9. Oclusão do apêndice atrial esquerdo com o Amplatzer Cardiac Plug em pacientes com fibrilação atrial

    Directory of Open Access Journals (Sweden)

    Ênio Eduardo Guérios

    2012-06-01

    Full Text Available FUNDAMENTO: A oclusão percutânea do apêndice atrial esquerdo (OAAE surgiu como alternativa à anticoagulação oral (AO para prevenção do acidente vascular cerebral (AVC em pacientes com fibrilação atrial não-valvular (FANV. OBJETIVO: Relatar os resultados imediatos e o seguimento clínico de pacientes submetidos a OAAE com o Amplatzer Cardiac Plug (ACP em um único centro de referência. MÉTODOS: Oitenta e seis pacientes consecutivos com FANV, contra-indicação à AO e escore CHADS2= 2,6±1,2 foram submetidos a OAAE com implante de ACP. Realizou-se seguimento clínico e ecocardiográfico no mínimo 4 meses após o implante. RESULTADOS: Todos os implantes foram guiados apenas por angiografia. O sucesso do procedimento foi de 99% (1 insucesso por tamponamento cardíaco e consequente suspensão da OAAE. Houve 4 complicações maiores (o tamponamento já referido, 2 AVCs transitórios e uma embolização com retirada percutânea da prótese e duas menores (um derrame pericárdico sem tamponamento e uma pequena comunicação interatrial evidenciada no seguimento. Houve 1 óbito hospitalar após 6 dias, não relacionado à intervenção. Todos os outros pacientes receberam alta sem AO. Após seguimento de 25,9 pacientes-ano (69 pacientes não houve AVCs nem embolizações tardias de próteses. O AAE estava completamente ocluído em 97% dos casos. Seis pacientes apresentaram evidência de trombo sobre a prótese, que desapareceram após reinstituição de AO por 3 meses. CONCLUSÃO: OAAE se associa a um alto índice de sucesso, um índice aceitável de complicações e resultados promissores a médio prazo, podendo ser considerada uma alternativa válida à OA na prevenção do AVC em pacientes com FANV.

  10. Oclusão percutânea do apêndice atrial esquerdo com o Amplatzer Cardiac PlugTM na fibrilação atrial

    Directory of Open Access Journals (Sweden)

    Márcio José Montenegro

    2012-02-01

    Full Text Available Fundamento: A fibrilação atrial está associada a acidentes vasculares embólicos que frequentemente resultam em morte ou invalidez. Eficaz na redução desses eventos, a anticoagulação possui várias limitações e vem sendo amplamente subutilizada. Mais de 90% dos trombos identificados nos portadores de fibrilação atrial sem doença valvar se originam no apêndice atrial esquerdo, cuja oclusão é investigada como uma alternativa à anticoagulação. Objetivo: Determinar a viabilidade da oclusão percutânea do apêndice atrial esquerdo em pacientes com alto risco de eventos embólicos e limitações ao uso de anticoagulação. Métodos: Relatamos a experiência inicial com o Amplatzer Cardiac PlugTM (St. Jude Medical Inc., Saint Paul, Estados Unidos em pacientes com fibrilação atrial não valvar. Foram selecionados pacientes com alto risco de tromboembolia, sangramentos maiores e contraindicações ao uso ou grande labilidade na resposta ao anticoagulante. Os procedimentos foram realizados por via percutânea, sob anestesia geral e com ecocardiografia transesofágica. O desfecho primário foi a presença de complicações periprocedimento e o seguimento programado incluiu reavaliação clínica e ecocardiográfica em 30 dias e por contato telefônico após nove meses. Resultados: Nos cinco pacientes selecionados se conseguiu a oclusão do apêndice atrial esquerdo sem complicações periprocedimento. Não houve eventos clínicos no seguimento. Conclusão: Ensaios clínicos controlados são necessários antes que o fechamento percutâneo do apêndice atrial esquerdo constitua uma alternativa à anticoagulação na fibrilação atrial não associada a doença valvar. Mas o dispositivo se mostrou promissor em pacientes com alto risco de embolia e restrições ao uso de anticoagulantes.

  11. Three interventional methods in closure of patent ductus arteriosus

    International Nuclear Information System (INIS)

    Objective: To review the clinical results of three different methods in embolization of PDA. Methods: (1) Porstmann's Ivalon plugging method (2) Spring coil (3) Amplatzer ductus occluder. Results: The authors used Porstmann's method in 450 cases, Spring coil 30 cases and Amplatzer occluder 6 cases. All of them were successfully closed. Conclusions: Porstmann's method are relatively complicated, but all the equipment can be made domestically. Spring coil method is only used limitedly in small ductus, Amplatzer occluder is simple with no limitation for age and size of ductus but is expensive

  12. The Memory-Impairing Effects of Septal GABA Receptor Activation Involve GABAergic Septo-Hippocampal Projection Neurons

    Science.gov (United States)

    Krebs-Kraft, Desiree L.; Wheeler, Marina G.; Parent, Marise B.

    2007-01-01

    Septal infusions of the [gamma]-aminobutyric acid (GABA)[subscript A] agonist muscimol impair memory, and the effect likely involves the hippocampus. GABA[subscript A] receptors are present on the perikarya of cholinergic and GABAergic septo-hippocampal (SH) projections. The current experiments determined whether GABAergic SH projections are…

  13. Potts shunt in a child with end-stage pulmonary hypertension after late repair of ventricular septal defect

    DEFF Research Database (Denmark)

    Petersen, Cecilie; Helvind, Morten; Jensen, Tim; Andersen, Henrik Ørbæk

    2013-01-01

    We report on a 10-year-old boy with medically refractory pulmonary arterial hypertension (PAH) and end-stage right heart failure after closure of a ventricular septal defect. The boy was a candidate for lung transplantation (LTX), but an alternative option was to create an Eisenmenger physiology...

  14. Bacterial flora and the epidemiology of staphylococcus aureus in the nose among patients with symptomatic nasal septal perforations.

    Science.gov (United States)

    Hulterström, Anna Karin; Sellin, Mats; Monsen, Tor; Widerström, Micael; Gurram, Bharath Kumar; Berggren, Diana

    2016-06-01

    Conclusions Patients with symptomatic perforations of the nasal septum had a high prevalence of S. aureus in the nasal mucosa. Pulsed field gel electrophoresis (PFGE) analysis revealed a high genetic heterogeneity of S. aureus among both patients and controls. This indicates that presence of different strains of S. aureus can maintain a chronic inflammation in symptomatic nasal septal perforations. Objective The purpose of this study was to investigate the microbial flora around nasal septal perforations in patients having severe symptoms regarding bleeding, obstruction, and crustation associated with their perforation. Methods Twenty-five patients with untreated symptomatic nasal septal perforations were included. For culture, swabs around the perforations were collected. Bacteria were identified with standard laboratory techniques including a MALDI-TOF mass spectrometer. Epidemiological analysis was done using PFGE protocols. Bacteriological data were compared with data from a healthy control group. Results Staphylococcus aureus was present in the mucosa surrounding the nasal perforation significantly more often (p S. aureus strains revealed a high genetic heterogeneity and no specific S. aureus genotypes were associated with septal perforation. PMID:26852671

  15. Differential modulation of lateral septal vasopressin receptor blockade in spatial learning, social recognition, and anxiety-related behaviors in rats

    NARCIS (Netherlands)

    Everts, HGJ; Koolhaas, JM

    1999-01-01

    The role of lateral septal vasopressin (VP) in the modulation of spatial memory, social memory, and anxiety-related behavior was studied in adult, male Wistar rats. Animals were equipped with osmotic minipumps delivering the VP-antagonist d(CH2)5-D-Tyr(Et)VAVP (1 ng/0.5 mu l per h) bilaterally into

  16. Virtual reality 3D echocardiography in the assessment of tricuspid valve function after surgical closure of ventricular septal defect

    NARCIS (Netherlands)

    G. Bol-Raap (Goris); A.H.J. Koning (Anton); T.V. Scohy (Thierry); A.D.J. ten Harkel (Arend); F.J. Meijboom (Folkert); A.P. Kappetein (Arie Pieter); P.J. van der Spek (Peter); A.J.J.C. Bogers (Ad)

    2007-01-01

    textabstractBackground. This study was done to investigate the potential additional role of virtual reality, using three-dimensional (3D) echocardiographic holograms, in the postoperative assessment of tricuspid valve function after surgical closure of ventricular septal defect (VSD). Methods. 12 da

  17. Value of Multidimensional Modeling in Planning Surgery for a Dissecting Ventricular Septal Hematoma Following Aortic Valve Sparing Root Reimplantation.

    Science.gov (United States)

    Hossien, Abdullrazak; Gelsomino, Sandro; Mochtar, Bahremsjah; Sardari Nia, Peyman; Kats, Suzanne; Maessen, Jos

    2016-06-01

    We report a technique of multidimensional modeling (MDM) used to assist in the planning of a repair of a dissecting ventricular septal hematoma (DVSH) following a David procedure. doi: 10.1111/jocs.12757 (J Card Surg 2016;31:390-393). PMID:27151757

  18. Transseptal Guidewire Stabilization for Device Closure of a Large Pulmonary Arteriovenous Malformation

    International Nuclear Information System (INIS)

    A 46-year-old man presenting with massive hemoptysis was found to have a large pulmonary arteriovenous malformation (PAVM) in the right lung. Closure of the PAVM with an Amplatzer-type duct occluder was hampered by inability to advance the device delivery sheath into the PAVM due to vessel tortuosity and inadequate guidewire support. Atrial septal puncture was performed and a femorofemoral arteriovenous guidewire loop through the right pulmonary artery, PAVM, and left atrium was created. Traction on both ends of the guidewire loop allowed advancement of the device delivery sheath into the PAVM and successful completion of the procedure. Transseptal guidewire stabilization can be a valuable option during device closure of large PAVMs when advancement, stability, or kinking of the device delivery sheath is an issue.

  19. Experimental study on the mechanism of intrapulmonary kinetics of 123I-IMP in balloon occluded bronchus of rabbit

    International Nuclear Information System (INIS)

    To investigate the mechanism of intrapulmonary kinetics of N-isopropyl-p-123I-iodoamphetamine (123I-IMP), we performed lung scanning with 123I-IMP in 13 rabbits in which a unilateral bronchus was occluded by a balloon catheter. In 9 rabbits, on the delayed distribution images, an abnormal accumulation of 123I-IMP was detected in the hypoperfusion area of the peripheral lung field of the occluded bronchus, which was detected on lung perfusion images with 99mTc-MAA. Comparison of early (a summation image during 20 seconds immediately after injection) and delayed (a summation image from 70 to 90 minutes after injection) distribution images confirmed that during this period, 123I-IMP accumulated in the area of reduced distribution of 123I-IMP. Moreover, at the site of abnormal accumulation, washout of 123I-IMP from the lung was delayed compared with that in the normal lung field. We find this experimental study is similar to the results in 63 clinical cases, which we have reported previously, and confirm that pulmonary arterial perfusion, especially hypoperfusion, influences the intrapulmonary kinetics of 123I-IMP. (author)

  20. The analysis of the maxillary sinus volumes and the nasal septal deviation in patients with antrochoanal polyps.

    Science.gov (United States)

    Aydın, Salih; Taskin, Umit; Orhan, Israfil; Altas, Bengül; Oktay, Mehmet Faruk; Toksöz, Mehmet; Albayrak, Ramazan

    2015-11-01

    The aim of this study was to evaluate the relationship between the maxillary sinus volumes and the nasal septal deviation angles in patients with antrochoanal polyps (ACP). 76 patients who underwent ACP surgery were included in the study. Of those 36 patients who had multislice computed tomography (MSCT) were evaluated to calculate maxillary sinus volume. The records of paranasal MSCT of 36 healthy people without any paranasal sinus diseases or surgery constituted age- and gender-matched healthy controls. Maxillary sinüs volumes and septal deviation angles were calculated using the paranasal MSCT volume-rendering technique. Thirty-six patients in the ACP group were compared with 36 polyp side-matched healthy people. The mean age was 16.6 ± 6.7 years in both groups. Statistically, the mean value of the maxillary sinus volume was significantly higher in the ACP group compared with the ACP side-matched control group (15.1 ± 4.6 versus 12.0 ± 3.5 mm(3)) (p = 0.002). Furthermore, the mean value of the maxillary sinus volume in the non-polyp side (14.2 ± 4.7 mm(3)) was statistically higher in the ACP group compared with the side-matched control group volume (11.9 ± 3.8 mm(3)) (p = 0.024). In addition, Fifty-three of 76 ACP patients had septal deviation. While the septal deviation was on the same side with the ACP in 17 patients, it was on the opposite side in 36 patients. In conclusion, the maxillary sinus volumes increased in ACP patients compared with the healthy control group. Many patients had nasal septal deviation on the opposite side of the ACP. PMID:25534286

  1. Onychomycosis due to Candida parapsilosis in a Child with Ventricular Septal Defect: An Unusual Predisposition.

    Science.gov (United States)

    Hosuru Subramanya, Supram; Hamal, Deependra; Nayak, Niranjan; Gokhale, Shishir

    2016-01-01

    Candida parapsilosis is emerging as a potential pathogen for onychomycosis. A 4-year-old male child with perimembranous ventricular septal defect (VSD) was admitted with features of cystitis and was treated with broad spectrum antibiotics. Two weeks later, he developed yellowish discoloration of nails of both hands. The sloughed out nail, on microscopy, showed numerous yeast forms that were identified as Candida parapsilosis by both phenotypic and genotypic methods. Antifungal sensitivity testing of the isolate was performed by microbroth dilution method in accordance with CLSI guidelines. Patient was successfully treated with topical amphotericin B and oral fluconazole. Thus, one should have a high index of suspicion of C. parapsilosis onychomycosis, especially when the patient is in the paediatric age group, presenting with unusual predisposing condition like congenital heart disease, and is on broad spectrum antibiotics. PMID:27195165

  2. Onychomycosis due to Candida parapsilosis in a Child with Ventricular Septal Defect: An Unusual Predisposition

    Directory of Open Access Journals (Sweden)

    Supram Hosuru Subramanya

    2016-01-01

    Full Text Available Candida parapsilosis is emerging as a potential pathogen for onychomycosis. A 4-year-old male child with perimembranous ventricular septal defect (VSD was admitted with features of cystitis and was treated with broad spectrum antibiotics. Two weeks later, he developed yellowish discoloration of nails of both hands. The sloughed out nail, on microscopy, showed numerous yeast forms that were identified as Candida parapsilosis by both phenotypic and genotypic methods. Antifungal sensitivity testing of the isolate was performed by microbroth dilution method in accordance with CLSI guidelines. Patient was successfully treated with topical amphotericin B and oral fluconazole. Thus, one should have a high index of suspicion of C. parapsilosis onychomycosis, especially when the patient is in the paediatric age group, presenting with unusual predisposing condition like congenital heart disease, and is on broad spectrum antibiotics.

  3. Multimodality cardiac imaging of a ventricular septal rupture post myocardial infarction: a case report

    Directory of Open Access Journals (Sweden)

    Dhaliwal Surinder

    2012-10-01

    Full Text Available Abstract Background Ventricular septal rupture (VSR, a mechanical complication following an acute myocardial infarction (MI, is thought to result from coagulation necrosis due to lack of collateral reperfusion. Although the gold standard test to confirm left-to-right shunting between ventricular cavities remains invasive ventriculography, two-dimensional transthoracic echocardiography (TTE with color flow Doppler and cardiac MRI (CMR are reliable tests for the non-invasive diagnosis of VSR. Case presentation A 62-year-old Caucasian female presented with a late case of a VSR post inferior MI diagnosed by multimodality cardiac imaging including TTE, CMR and ventriculography. Conclusion We review the presentation, diagnosis and management of VSR post MI.

  4. Septal perfusion in left bundle branch block: case report and review of the literature

    International Nuclear Information System (INIS)

    Myocardial scintigraphy was performed three times in a 55-year-old woman with left bundle branch block (LBBB). A significant LAD stenosis had been excluded by coronary angiography. The first scintigraphy was performed with Tc-99m sestamibi after submaximal bicycle exercise and revealed a septal perfusion deficit. This deficit could not be reproduced in the following examinations after pharmacological stress testing with dipyridamole using both Tl-201 and Tc-99m sestamibi. Perfusion at rest assessed with Tl-201 was normal in all studies. It is concluded that pharmacological stress testing with dipyridamole is to be preferred in patients with LBBB. With respect to the accuracy of myocardial perfusion imaging the choice of the radiopharmaceutical plays a less important role. (orig.)

  5. Atrial septal defect: a coincidental finding on a screening medical.

    Science.gov (United States)

    Elliott, Elizabeth J

    2015-06-01

    An otherwise fit, healthy medical practitioner who was a recreational diver underwent a medical assessment for a remote posting as an Antarctic Medical Practitioner at which a coincidental finding of an atrial septal defect (ASD) was made. ASDs can have health implications in extreme environments such as high altitude and is contraindicated in scuba diving. ASDs are common, being present in 1:1,500 live births and comprise 10% of all cardiac abnormalities. In this case, a percutaneous occlusive device was inserted under general anaesthetic with subsequent improvements in the practitioner's exercise capacity, return to diving and full employment, including Antarctic deployment, and right-sided heart remodelling 18 months post closure. PMID:26165535

  6. Numerical investigation of the flow field in realistic nasal septal perforation geometry.

    Science.gov (United States)

    Faramarzi, Mohammad; Baradaranfar, Mohammad Hossein; Abouali, Omid; Atighechi, Saeid; Ahmadi, Goodarz; Farhadi, Pejman; Keshavarzian, Erfan; Behniafard, Nasim; Baradaranfar, Amin

    2014-07-01

    The computational fluid dynamics (CFD) are used to evaluate the physiological function of the nose. We evaluated the aerodynamics of the nasal cavity in a patient with septal perforation (SP), pre- and postvirtual repair. Three-dimensional nasal models were reconstructed, and then a wide range of the pressure drops and flow rates were analyzed. The airflow velocity is higher in the central region and is lower around the boundary of the SP. The air velocity in the SP increases as the pressure drop increases. Furthermore, at the anterior part of the SP, the shear stress is higher in the upper part. In addition, the repair of SP does not affect the total nasal airflow rate and the velocity contour patterns. The potential usage of the CFD technique as a predictive technique to explore the details and a preoperative assessment tool to help in clinical decision making in nasal surgery is emphasized. PMID:24988523

  7. Prenatal Isolated Ventricular Septal Defect May Not Be Associated with Trisomy 21

    Directory of Open Access Journals (Sweden)

    Ori Shen

    2014-04-01

    Full Text Available The aim of this study was to examine if isolated fetal ventricular septal defect (VSD is associated with trisomy 21. One hundred twenty six cases with prenatal VSD diagnosed by a pediatric cardiologist were reviewed. Cases with known risk factors for congenital heart disease, the presence of other major anomalies, soft signs for trisomy 21 or a positive screen test for trisomy 21 were excluded. Ninety two cases formed the study group. None of the cases in the study group had trisomy 21. The upper limit of prevalence for trisomy 21 in isolated VSD is 3%. When prenatal VSD is not associated with other major anomalies, soft markers for trisomy 21 or a positive nuchal translucency or biochemical screen, a decision whether to perform genetic amniocentesis should be individualized. The currently unknown association between isolated VSD and microdeletions and microduplications should be considered when discussing this option.

  8. Eisenmenger syndrome in a patient with ventricular septal defect: a case report

    Directory of Open Access Journals (Sweden)

    Hari Babu Ramineni

    2015-01-01

    Full Text Available Eisenmenger Syndrome (ES represents Pulmonary Arterial Hypertension (PAH associated with Congenital Heart Defects (CHD. Although patients survive until their third or fourth decades of life, the symptoms include dyspnea, cyanosis, fatigue, dizziness, and syncope. In addition, cardiac arrhythmias, a late complication are causing sudden death in patients with ES. Treatment options have been limited; however, recent successes have been achieved with the use of therapies targeted against the pathophysiological pathways that underlie PAH. The dual endothelin receptor antagonist and prostacyclins demonstrated to improve hemodynamics of the patients. This is the case of a 16 year old young female with ventricular septal defect that was admitted with increasing shortness of breath and cyanosis with clubbing which are clinical features of Eisenmenger syndrome. She was medicated with Furosemide, Sildenafil which improved her functional status. [Int J Res Med Sci 2015; 3(1.000: 376-378

  9. Device closure in adults with atrial septal defect in Shiraz, a single center registry

    Science.gov (United States)

    Ostovan, Mohammad Ali; Kojuri, Javad; Dehghani, Pooyan; Razazi, Vida; Moarref, Alireza

    2016-01-01

    Introduction: Successful closure of atrial septal defect (ASD) improves patients’ functional class and exercise capacity. In this study we evaluate the safety and feasibility of percutaneous device closure of ASDs. Methods: Two hundred fifty six patients with significant ASD according to our criteria were enrolled. The patients were treated using nitinol wire mesh transcatheter devices. Complications were followed for a median of 2.5 years. Results: Success rate was 98.4% with 3 unsuccessful cases and a mean hospital stay of 1.007 ± 0.0004 days. Complication rate was 7.42%. Size of the right ventricle (RV) annulus was significantly decreased 24 hours after intervention (P = 0.005). Conclusion: The present report demonstrates that transcatheter closure of ASD is safe and effective. PMID:27069566

  10. Echocardiographic diagnosis and necropsy findings of a congenital ventricular septal defect in a stranded harbor porpoise.

    Science.gov (United States)

    Szatmári, Viktor; Bunskoek, Paulien; Kuiken, Thijs; van den Berg, Annemarie; van Elk, Cornelis

    2016-03-30

    A live-stranded harbor porpoise Phocoena phocoena was found on the west coast of the Dutch island Texel (North Sea) and transported to a rehabilitation center for small cetaceans, where it underwent a veterinary health check. Cardiac auscultation revealed a systolic cardiac murmur with the point of maximal intensity in the right hemithorax with an intensity of IV out of VI. Transthoracic echocardiography revealed a congenital ventricular septal defect with left-to-right shunting. Because the left atrium was not dilated according to the reference range of canine left atrium to aortic ratio, the presence of congestive heart failure was considered very unlikely. Therefore, this congenital cardiac anomaly was thought to be a clinically non-relevant incidental finding and would not explain the weakness, coughing, anorexia, vomiting, and diarrhea. Because the animal was still unable to swim or eat by itself after 2 wk of supportive care, it was euthanized. Post-mortem examination confirmed the presence of a ventricular septal defect. The weight of the heart relative to the animal's length was greater than expected, using linear regression analysis on the lengths and cardiac weights of 71 other stranded wild harbor porpoises without macroscopic cardiac pathologic changes. This finding suggests that the left ventricle had an eccentric hypertrophy because of volume overload resulting from the intracardiac shunt. This is the first report of a congenital cardiac anomaly and its ante-mortem diagnosis in this species. Data presented for the other 71 harbor porpoises may provide reference values for this species. PMID:27025305

  11. The influence of septal lesions on sodium and water retention induced by Walker 256 tumor

    Directory of Open Access Journals (Sweden)

    F. Guimarães

    1999-03-01

    Full Text Available In the course of studies on the effects of septal area lesions on neuroimmunomodulation and Walker 256 tumor development, it was observed that tumor-induced sodium and water retention was less marked in lesioned than in non-lesioned rats. In the present study possible mechanisms involved in this phenomenon were investigated. The experiments were performed in septal-lesioned (LW; N = 15 and sham-operated (SW; N = 7 8-week-old male Wistar rats, which received multifocal simultaneous subcutaneous (sc inoculations of Walker 256 tumor cells about 30 days after the stereotaxic surgery. Control groups (no tumor, sham-operated food-restricted (SFR, N = 7 and lesioned food-restricted (LFR, N = 10 were subjected to a feeding pattern similar to that observed in tumor-bearing animals. Multifocal inoculation of Walker 256 tumor rapidly induces anorexia, which is paradoxically accompanied by an increase in body weight, as a result of renal Na+ and fluid retention. These effects of the tumor were also seen in LW rats, although the rise in fractional sodium balance during the early clinical period was significantly smaller than in SW rats (day 4: SW = 47.6 ± 6.4% and LW = 13.8 ± 5.2%; day 5: SW = 57.5 ± 3.5% and LW = 25.7 ± 4.8%; day 6: SW = 54.4 ± 3.8% and LW = 32.1 ± 4.4%; P<0.05, suggesting a temporary reduction in tumor-induced sodium retention. In contrast, urine output was significantly reduced in SW rats and increased in LW rats (LW up to -0.85 and SW up to 4.5 ml/100 g body weight, with no change in osmolar excretion. These temporary changes in the tumor's effects on LW rats may reflect a "reversal" of the secondary central antidiuretic response induced by the tumor (from antidiuretic to diuretic.

  12. Construction of occluded recombinant baculoviruses containing the full-length cry1Ab and cry1Ac genes from Bacillus thuringiensis

    Directory of Open Access Journals (Sweden)

    B.M. Ribeiro

    1998-06-01

    Full Text Available The administration of baculoviruses to insects for bioassay purposes is carried out, in most cases, by contamination of food surfaces with a known amount of occlusion bodies (OBs. Since per os infection is the natural route of infection, occluded recombinant viruses containing crystal protein genes (cry1Ab and cry1Ac from Bacillus thuringiensis were constructed for comparison with the baculovirus prototype Autographa californica nucleopolyhedrovirus (AcNPV. The transfer vector pAcUW2B was used for construction of occluded recombinant viruses. The transfer vector containing the crystal protein genes was cotransfected with linearized DNA from a non-occluded recombinant virus. The isolation of recombinant viruses was greatly facilitated by the reduction of background "wild type" virus and the increased proportion of recombinant viruses. Since the recombinant viruses containing full-length and truncated forms of the crystal protein genes did not seem to improve the pathogenicity of the recombinant viruses when compared with the wild type AcNPV, and in order to compare expression levels of the full-length crystal proteins produced by non-occluded and occluded recombinant viruses the full-length cry1Ab and cry1Ac genes were chosen for construction of occluded recombinant viruses. The recombinant viruses containing full-length and truncated forms of the crystal protein genes did not seem to improve its pathogenicity but the size of the larvae infected with the recombinant viruses was significantly smaller than that of larvae infected with the wild type virus.

  13. Oclusão percutânea das comunicações interventriculares: experiência inicial Interventricular septal defects percutaneous occlusion: initial experiment

    OpenAIRE

    Francisco José Araújo Chamié de Queiróz; Raul Ivo Rossi Filho; Sérgio Ramos; César Esteves; Daniel Silva Chamié de Queiróz; Paulo Renato Machado; João Carlos Tress; Stella Suzana Horowitz; Helder Paupério; Rosaura Victer

    2005-01-01

    OBJETIVO: Avaliar a experiência inicial com o fechamento percutâneo das comunicações interventriculares (CIV), em especial, das CIV perimembranosas (CIVPM) com a nova prótese de Amplatzer. MÉTODOS: Foram submetidos ao procedimento onze pacientes, seis com CIV perimembranosas (CIVPM) e cinco com CIV musculares (CIVM). Dois apresentavam infecções repetidas do trato respiratório e tinham baixo ganho ponderal. Um apresentou história prévia de endocardite infecciosa. Os demais eram assintomáticos ...

  14. A new method of phosphorus determination with an improved pretreatment of occluded iron phosphate fraction in soils

    International Nuclear Information System (INIS)

    In the sequential fractionation of phosphorus, a modified approach in the oxidation process of the occluded fraction of phosphorus (in iron oxides in soils) using redox titration in nitric medium is presented. Also a new spectrophotometric method to determine that phosphorus fraction as the phosphomolybdate complex using a mixture of isobutyl acetate and methyl isobutyl ketone to extract the formed complex into the organic phase. Radioactive tracers (32P) and sequential extraction are used to state the yield of extraction of the phosphomolybdate complex. Accuracy, precision, detection limit, and the linearity of the present method are 1.04%, 0.0322μg ml-1 respectively. The results correlate significantly with the results of the standard method of Petersen and Corey (1996), and the procedure saves time (50 min) and chemicals. (author)

  15. Endovascular Mechanical Thrombectomy of an Occluded Superior Division Branch of the Left MCA for Acute Cardioembolic Stroke

    International Nuclear Information System (INIS)

    Cardiac embolism accounts for a large proportion of ischemic stroke. Revascularization using systemic or intra-arterial thrombolysis is associated with increasing risks of cerebral hemorrhageas time passes from stroke onset. We report successful mechanicalthrombectomy from a distal branch of the middle cerebral artery (MCA)using a novel technique. A 72-year old man suffered an acute ischemic stroke from an echocardiographically proven ventricular thrombus due toa recent myocardial infarction. Intra-arterial administration of 4 mgrt-PA initiated at 5.7 hours post-ictus failed to recanalize an occluded superior division branch of the left MCA. At 6 hours,symptomatic embolic occlusion persisted. Mechanical extraction of the clot using an Attracter-18 device (Target Therapeutics, Freemont, CA) resulted in immediate recanalization of the MCA branch. Attracter-18 for acute occlusion of MCA branches may be considered in selected patients who fail conventional thrombolysis or are nearing closure of the therapeutic window for use of thrombolytic agents

  16. SUCCESSFUL ANAESTHETIC MANAGEMENT OF A PATIENT WITH PARADOXICAL VENTRICULAR SEPTAL MOTION (PVSM POSTED FOR MODIFIED RADICAL NECK DISSECTION WITH RADIAL FREE FLAP

    Directory of Open Access Journals (Sweden)

    Amruta

    2015-04-01

    Full Text Available BACKGROUND : Patients with paradoxical ventricular septal motion are a challenge to anaesthesiologist due to risk of perioperative myocardial ischaemia and sudden cardiac arrest. CASE DESCRIPTION : We present anaesthetic management of a 45year old lady with a diagnosed case of carcinoma left buccal mucosa with paradoxical ventricular septal motion posted for modified radical neck disse ction with radial free flap. CONCLUSION : Although clinical manifestations of this cardiac condition may be mild, there is certainly associated pathology of direct relevance, which carries importance in the anaesthetic management in the peri - operative perio d. Patients with paradoxical ventricular septal motion of any etiology are more prone for perioperative myocardial ischaemia and sudden cardiac arrest, because if cardiac conduction is not maintained properly then it may result in further increase in the p aradoxical ventricular septal motion

  17. Effects of septal nucleus lesion on dopamine D2 receptor expression in the prefrontal lobe, striatum, and brainstem in a rat model of schizophrenia

    Institute of Scientific and Technical Information of China (English)

    Xin Li; Shuande Li

    2008-01-01

    BACKGROUND: It has been demonstrated that the septal nucleus is involved in the pathogenesis of schizophrenia. Based on autopsies of schizophrenia patients, studies have shown a reduced number of septal nucleus neurons and gila. In addition, experimental rat models of schizophrenia have shown increased dopamine receptor D2 binding sites in the basal ganglia, septal nuclei, and substantia nigra. Previous studies have demonstrated that the septal nucleus modulates dopamine metabolic disorder and dopamine D2 receptor balance.OBJECTIVE: Dopamine D2 receptor expression in a rat model of schizophrenia, combined with antipsychotic drugs, was analyzed in the prefrontal lobe, striatum, and brainstem. In situ hybridization was used to observe the effects of stereotactic septal nucleus lesions on dopamine D2 receptor expression in the brains of methylamphetamine-treated rats. DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed in the Laboratory of General Institute of Psychosurgery, Third Hospital of Chinese PLA from November 2005 to June 2006. MATERIALS: A total of 120 healthy, adult Sprague Dawley rats, weighing approximately 200 g, were included. Methylamphetamine (Sigma, USA) and an in situ hybridization detection kit for dopamine D2 receptor (Boster, China) were also used for this study. METHODS: All rats were randomly allocated to the following 4 groups, with 30 rats in each group: normal control, simple administration, septal nucleus lesion, and sham-operated groups. In the normal control group, rats were not administered or lesioned. In the remaining 3 groups, rats were intraperitoneally administered 10 mg/kg methylamphetamine, once per day, for 15 successive days to establish a schizophrenia model. Following successful model establishment, rats from the septal nucleus lesion group were subjected to stereotactic septal nucleus lesions. The cranial bone was exposed in rats from the sham-operated group, and the septal nucleus was not

  18. Immunological tolerance to pig-serum partially inhibits the formation of septal fibrosis of the liver in Capillaria hepatica-infected rats

    OpenAIRE

    Rodrigo Guimarães Andrade; Bruna Magalhães Gotardo; Bárbara Cristina A Assis; José Mengel; Zilton A. Andrade

    2004-01-01

    Systhematized septal fibrosis of the liver can be induced in rats either by repeated intraperitoneal injections of pig-serum or by Capillaria hepatica infection. The relationship between these two etiological factors, as far as hepatic fibrosis is concerned, is not known, and present investigation attempts to investigate it. C. hepatica-induced septal fibrosis of the liver was considerably inhibited in rats previously rendered tolerant to pig-serum. Pig-serum-tolerant rats developed antibodie...

  19. Site-Specific Enhancement of γ-Aminobutyric Acid-Mediated Inhibition of Neural Activity by Ethanol in the Rat Medial Septal Area1

    OpenAIRE

    GIVENS, BENNET S.; Breese, George R.

    1990-01-01

    Because of uncertainty concerning the interaction of ethanol with γ-aminobutyric acid (GABA) receptor-mediated events, the present work was designed to investigate the effect of ethanol on GABA transmission in the rat septal area using behavioral and electrophysiological techniques. Microinjection of the GABAA agonist muscimol into the medial septal area (MSA) enhanced, and bicuculline administration antagonized, ethanol-induced impairment of the aerial righting reflex. Microinjection of thes...

  20. [Electrophysiological and behavioral features of septal seizures in cats--experimental sham-rage seizures induced by injection of kainic acid].

    Science.gov (United States)

    Hashizume, K; Tanaka, T; Yonemasu, Y

    1994-07-01

    The septal nucleus has close connections with the hippocampus and amygdala and is known to be involved in emotional behavior. We analyzed the electrophysiological and behavioral features of seizures induced by an injection of kainic acid into the lateral septal nucleus of the cat. Stereotactic surgery was performed to implant a cannula into the lateral septal nucleus to make the injection, and deep electrodes were implanted into the hippocampus and amygdala bilaterally. Seven days post operatively kainic acid, 0.5 microgram/0.5 microliter, was injected via the cannula, and three to five minutes later the cats began to exhibit head turning to the contralateral side. The seizures subsequently progressed limbic seizure status. The electroencephalogram revealed that the spike discharges started in the lateral septal nucleus, extended to the ipsilateral hippocampus and amygdala, then propagated to the contralateral side. Spontaneous sham-rage seizures occurred more than seven days after the injection. These seizure were characterized by sudden onset of aggressive and violent behavior which included hissing, biting and scratching. The electroencephalogram showed synchronization of rhythmic spikes in the ipsilateral septal nucleus, hippocampus and amygdala during such seizures. Further study of this model is important not only to understand the relationship between the septal nucleus and the hippocampus and amygdala but to understand the mechanism of sham-rage seizures. In addition, this model may be useful in understanding the emotional features of intractable complex partial seizures in man. PMID:7946621

  1. Guillain - Barre syndrome in a patient with acute myocardial infarction with ventricular septal defect repair treated with plasma exchange

    Directory of Open Access Journals (Sweden)

    Maitrey D Gajjar

    2015-01-01

    Full Text Available Guillain - Barre syndrome (GBS is an acute, frequently severe progressive illness of peripheral nervous system that is autoimmune in nature. GBS after myocardial infarction (MI with ventricular septal defect (VSD is uncommon with high mortality rate if not treated promptly. [1] We report a successful outcome of GBS post MI with VSD in a 60-year-old male patient who was on a ventilator treated successfully with therapeutic plasma exchange.

  2. Feasibility and Safety of Transthoracic Echocardiography-Guided Transcatheter Closure of Atrial Septal Defects with Deficient Superior-Anterior Rims

    OpenAIRE

    Gui-Shuang Li; Hai-De Li; Jie Yang; Wen-Quan Zhang; Zong-Shen Hou; Qing-Chen Li; Yun Zhang

    2012-01-01

    Although previous studies showed that transthoracic echocardiography (TTE) can be used to guide transcatheter closure of atrial septal defect (ASD), whether TTE can be used to guide transcatheter closure of secundum ASD with a deficient superior-anterior rim is unknown and this critical issue was addressed in the present study. A total of 280 patients with secundum ASD who underwent transcatheter ASD closure were recruited and divided into groups A and B depending on ASD superior-anterior rim...

  3. Small Left Atrial Size Complicating Percutaneous Transcatheter Device Closure of Secundum Atrial Septal Defect with Conventional Approach

    OpenAIRE

    Ko, Hong Ki; Kang, So Yeon; Yu, Jeong Jin; Ko, Jae-Kon; Kim, Young-Hwue

    2015-01-01

    Background and Objectives Transcatheter device closure becomes the first option for treating secundum atrial septal defect (ASD), but the conventional method is sometimes unsuccessful even when the defect size indicates the closure to be feasible. To increase the success rate, modified methods have been introduced and used. This study aimed to find predictors for using the modified methods in the device closure of secundum ASDs. Subjects and Methods Between October 2010 and December 2012, 92 ...

  4. Pulmonary Root Translocation with the Lecompte Maneuver: For Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Stenosis

    OpenAIRE

    Yoon, Dong Woog; Kim, Tae Ho; Shim, Man-shik; Jun, Tae-Gook; Jang, Jae Seok

    2015-01-01

    A five-month-old boy who had undergone previously transcatheter balloon atrioseptostomy at 3 days of age for complete transposition of the great arteries with ventricular septal defect and pulmonary stenosis underwent pulmonary root translocation with the Lecompte maneuver. This operation has the advantages of maintaining pulmonary valve function, preserving the capacity for growth, and avoiding problems inherent to the right ventricular to pulmonary artery conduit. This patient progressed we...

  5. Impaired exercise capacity following atrial septal defect closure: an invasive study of the right heart and pulmonary circulation

    OpenAIRE

    Santos, Mário; Systrom, David; Epstein, Stephen E.; John, Anitha; Ruiz, George; Landzberg, Michael J.; Opotowsky, Alexander R.

    2014-01-01

    Patients with early repair of an isolated atrial septal defect (ASD) are expected to have unremarkable right ventricular (RV) and pulmonary circulation physiology. Some studies, however, suggest persistent functional impairment. We aimed to examine the role of abnormal RV and pulmonary vascular response to exercise in patients who had undergone ASD closure. Using a previously published data set, we reviewed invasive exercise cardiopulmonary testing with right-sided hemodynamic data for 12 asy...

  6. Guillain — Barre syndrome in a patient with acute myocardial infarction with ventricular septal defect repair treated with plasma exchange

    OpenAIRE

    Gajjar, Maitrey D.; Nidhi M Bhatnagar; Nirav J Patel; Tarak Patel

    2015-01-01

    Guillain - Barre syndrome (GBS) is an acute, frequently severe progressive illness of peripheral nervous system that is autoimmune in nature. GBS after myocardial infarction (MI) with ventricular septal defect (VSD) is uncommon with high mortality rate if not treated promptly. [1] We report a successful outcome of GBS post MI with VSD in a 60-year-old male patient who was on a ventilator treated successfully with therapeutic plasma exchange.

  7. The Effects of the Remanining Time of Anterior Nasal Packing in Nasal Passage on Healing After Septal Surgery

    OpenAIRE

    ÇETİNKAYA, Tufan

    2001-01-01

    One of the most disturbing problems to the patient after septal surgery is the presence of nasal packing. Postoperative nasal packing use has some advantages and disadvantages. This study was performed to determine whether there's a relation between the duration of postoperative nasal packing and patient complaints. A total of 66 patients undergoing septoplasty or septorhinoplasty were included into the study. The patients were divided into two groups according to the duration of nasal packin...

  8. Serum biomarker release patterns following alcohol septal ablation for treatment of hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Foley JD

    2014-12-01

    Full Text Available Joseph D Foley,1 Craig S Miller,2 J Darrell Sneed,1 Jeffrey L Ebersole,2 Richard J Kryscio,3 John T McDevitt,4 Charles L Campbell5 1Gill Heart Institute and Division of Cardiovascular Medicine, Department of Internal Medicine, 2Department of Oral Health Practice, College of Dentistry, 3Department of Statistics, University of Kentucky, Lexington, KY, 4Departments of Bioengineering and Chemistry, Rice University, Houston, TX, USA; 5Division of Cardiololgy, University of Tennessee at Chattanooga, Erlanger Health Systems, TN, USA Abstract: Alcohol septal ablation (ASA is employed to relieve the pressure gradient associated with symptomatic hypertrophic cardiomyopathy. Serum concentrations of cardiac troponin I, creatine kinase MB band, brain natriuretic protein, matrix metalloproteinase-9, myoglobin, C-reactive protein, tumor necrosis factor-alpha, soluble CD40 ligand, interleukin-6, adiponectin, interleukin-1ß, myeloperoxidase, and soluble intercellular adhesion molecule-1 were determined at baseline and at 8, 16, 24, and 48 hours in patients with hypertrophic cardiomyopathy presenting for ASA. Comparisons were made with 107 healthy control subjects. Sixteen hours following ASA, serum levels rose over 800-fold for cardiac troponin I, 70-fold for creatine kinase MB band, and 11-fold for myoglobin (P<0.001. C-reactive protein and interleukin-6 both rose slowly and became significantly elevated at 16 and 48 hours, respectively. Matrix metalloprotease-9 rapidly increased two-fold at 8 hours, but returned to baseline thereafter. Other biomarkers evaluated either trended downward or showed little change from baseline. Among the ASA patients, baseline serum concentration of all biomarkers, except for matrix metalloproteinase-9, soluble intercellular adhesion molecule-1, and myeloperoxidase, were elevated in the ASA group compared with the controls. These findings suggest that hypertrophic cardiomyopathy is a proinflammatory and prothrombotic state. The

  9. Surgical treatment of partial atrioventricular septal defect: functional analysis of the mitral valve in the postoperative period

    Directory of Open Access Journals (Sweden)

    Josué Viana Castro Neto

    2002-11-01

    Full Text Available OBJECTIVE: To study mitral valve function in the postoperative period after correction of the partial form of atrioventricular septal defect. METHODS: Fifty patients underwent surgical correction of the partial form of atrioventricular septal defect. Their mean age was 11.8 years and 62% of the patients were males. Preoperative echocardiography showed moderate and severe mitral insufficiency in 44% of the patients. The mitral valve cleft was sutured in 45 (90% patients (group II - GII. Echocardiographies were performed in the early postoperative period, and 6 and 12 months after hospital discharge. RESULTS: The patients who had some type of arrhythmia in the postoperative period had ostium primum atrial septal defect of a larger size (2.74 x 2.08 cm. All 5 patients in group I (GI, who did not undergo closure of the cleft, had a competent mitral valve or mild mitral insufficiency in the preoperative period. One of these patients began to have moderate mitral insufficiency in the postoperative period. On the other hand, in GII, 88.8% and 82.2% of the patients had competent mitral valve or mild mitral insufficiency in the early and late postoperative periods, respectively. CONCLUSION: The mitral valve cleft was repaired in 90% of cases. Echocardiography revealed competent mitral valve or mild mitral insufficiency in 88.8% and 82.2% of GII patients in the early and late postoperative periods, respectively.

  10. Compound heterozygous or homozygous truncating MYBPC3 mutations cause lethal cardiomyopathy with features of noncompaction and septal defects

    Science.gov (United States)

    Wessels, Marja W; Herkert, Johanna C; Frohn-Mulder, Ingrid M; Dalinghaus, Michiel; van den Wijngaard, Arthur; de Krijger, Ronald R; Michels, Michelle; de Coo, Irenaeus FM; Hoedemaekers, Yvonne M; Dooijes, Dennis

    2015-01-01

    Familial hypertrophic cardiomyopathy (HCM) is usually caused by autosomal dominant pathogenic mutations in genes encoding sarcomeric or sarcomere-associated cardiac muscle proteins. The disease mainly affects adults, although young children with severe HCM have also been reported. We describe four unrelated neonates with lethal cardiomyopathy, and performed molecular studies to identify the genetic defect. We also present a literature overview of reported patients with compound heterozygous or homozygous pathogenic MYBPC3 mutations and describe their clinical characteristics. All four children presented with feeding difficulties, failure to thrive, and dyspnea. They died from cardiac failure before age 13 weeks. Features of left ventricular noncompaction were diagnosed in three patients. In the fourth, hypertrabeculation was not a clear feature, but could not be excluded. All of them had septal defects. Two patients were compound heterozygotes for the pathogenic c.2373dup p.(Trp792fs) and c.2827C>T p.(Arg943*) mutations, and two were homozygous for the c.2373dup and c.2827C>T mutations. All patients with biallelic truncating pathogenic mutations in MYBPC3 reported so far (n=21) were diagnosed with severe cardiomyopathy and/or died within the first few months of life. In 62% (13/21), septal defects or a patent ductus arteriosus accompanied cardiomyopathy. In contrast to heterozygous pathogenic mutations, homozygous or compound heterozygous truncating pathogenic MYBPC3 mutations cause severe neonatal cardiomyopathy with features of left ventricular noncompaction and septal defects in approximately 60% of patients. PMID:25335496

  11. Imaging Techniques in Percutaneous Cardiac Structural Interventions: Atrial Septal Defect Closure and Left Atrial Appendage Occlusion.

    Science.gov (United States)

    Rodríguez Fernández, Antonio; Bethencourt González, Armando

    2016-08-01

    Because of advances in cardiac structural interventional procedures, imaging techniques are playing an increasingly important role. Imaging studies show sufficient anatomic detail of the heart structure to achieve an excellent outcome in interventional procedures. Up to 98% of atrial septal defects at the ostium secundum can be closed successfully with a percutaneous procedure. Candidates for this type of procedure can be identified through a systematic assessment of atrial septum anatomy, locating and measuring the size and shape of all defects, their rims, and the degree and direction of shunting. Three dimensional echocardiography has significantly improved anatomic assessments and the end result itself. In the future, when combined with other imaging techniques such as cardiac computed tomography and fluoroscopy, 3-dimensional echocardiography will be particularly useful for procedure guidance. Percutaneous closure of the left atrial appendage offers an alternative for treating patients with atrial fibrillation and contraindication for oral anticoagulants. In the future, the clinical focus may well turn to stroke prevention in selected patients. Percutaneous closure is effective and safe; device implantation is successful in 94% to 99% of procedures. However, the procedure requires an experienced cardiac structural interventional team. At present, 3-dimensional echocardiography is the most appropriate imaging technique to assess anatomy suitability, select device type and size, guide the procedure alongside fluoroscopy, and to follow-up the patient afterwards. PMID:27354151

  12. Percutaneous Septal Ablation in Hypertrophic Obstructive Cardiomyopathy: From Experiment to Standard of Care

    Directory of Open Access Journals (Sweden)

    Lothar Faber

    2014-01-01

    Full Text Available Hypertrophic cardiomyopathy (HCM is one of the more common hereditary cardiac conditions. According to presence or absence of outflow obstruction at rest or with provocation, a more common (about 60–70% obstructive type of the disease (HOCM has to be distinguished from the less common (30–40% nonobstructive phenotype (HNCM. Symptoms include exercise limitation due to dyspnea, angina pectoris, palpitations, or dizziness; occasionally syncope or sudden cardiac death occurs. Correct diagnosis and risk stratification with respect to prophylactic ICD implantation are essential in HCM patient management. Drug therapy in symptomatic patients can be characterized as treatment of heart failure with preserved ejection fraction (HFpEF in HNCM, while symptoms and the obstructive gradient in HOCM can be addressed with beta-blockers, disopyramide, or verapamil. After a short overview on etiology, natural history, and diagnostics in hypertrophic cardiomyopathy, this paper reviews the current treatment options for HOCM with a special focus on percutaneous septal ablation. Literature data and the own series of about 600 cases are discussed, suggesting a largely comparable outcome with respect to procedural mortality, clinical efficacy, and long-term outcome.

  13. Novel and functional DNA sequence variants within the GATA5 gene promoter in ventricular septal defects

    Institute of Scientific and Technical Information of China (English)

    Ji-Ping Shan; Xiao-Li Wang; Yuan-Gang Qiao; Hong-Xin Wan Yan; Wen-Hui Huang; Shu-Chao Pang; Bo Yan

    2014-01-01

    Background: Congenital heart disease (CHD) is the most common human birth defect. Genetic causes for CHD remain largely unknown. GATA transcription factor 5 (GATA 5) is an essential regulator for the heart development. Mutations in the GATA5 gene have been reported in patients with a variety of CHD. Since misregulation of gene expression have been associated with human diseases, we speculated that changed levels of cardiac transcription factors, GATA5, may mediate the development of CHD. Methods: In this study, GATA5 gene promoter was genetically and functionally analyzed in large cohorts of patients with ventricular septal defect (VSD) (n=343) and ethnic-matched healthy controls (n=348). Results: Two novel and heterozygous DNA sequence variants (DSVs), g.61051165A>G and g.61051463delC, were identified in three VSD patients, but not in the controls. In cultured cardiomyocytes, GATA5 gene promoter activities were significantly decreased by DSV g.61051165A>G and increased by DSV g.61051463delC. Moreover, fathers of the VSD patients carrying the same DSVs had reduced diastolic function of left ventricles. Three SNPs, g.61051279C>T (rs77067995), g.61051327A>C (rs145936691) and g.61051373G>A (rs80197101), and one novel heterozygous DSV, g.61051227C>T, were found in both VSD patients and controls with similar frequencies. Conclusion: Our data suggested that the DSVs in the GATA5 gene promoter may increase the susceptibility to the development of VSD as a risk factor.

  14. Peptidomic Analysis of Amniotic Fluid for Identification of Putative Bioactive Peptides in Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    Xing Li

    2016-05-01

    Full Text Available Background: Ventricular septal defect (VSD is one of the most common congenital heart diseases and to date the role of peptides in human amniotic fluid in the pathogenesis of VSD have been rarely investigated. Methods: To gain insight into the mechanisms of protein and peptides in cardiovascular development, we constructed a comparative peptidomic profiling of human amniotic fluid between normal and VSD fetuses using a stable isobaric labeling strategy involving tandem mass tag reagents, followed by nano liquid chromatography tandem mass spectrometry. Results: We identified and quantified 692 non-redundant peptides, 183 of which were differentially expressed in the amniotic fluid of healthy and VSD fetuses; 69 peptides were up regulated and 114 peptides were down regulated. These peptides were imported into the Ingenuity Pathway Analysis (IPA and identified putative roles in cardiovascular system morphogenesis and cardiogenesis. Conclusion: We concluded that 35 peptides located within the functional domains of their precursor proteins could be candidate bioactive peptides for VSD. The identified peptide changes in amniotic fluid of VSD fetuses may advance our current understanding of congenital heart disease and these peptides may be involved in the etiology of VSD.

  15. Preoperative cardiac computed tomography for demonstration of congenital cardiac septal defect in adults

    International Nuclear Information System (INIS)

    We aimed to evaluate the role of preoperative cardiac computed tomography (CT) for adults with congenital cardiac septal defect (CSD). Sixty-five consecutive patients who underwent preoperative CT and surgery for CSD were included. The diagnostic accuracy of CT and the concordance rate of the subtype classification of CSD were evaluated using surgical findings as the reference standard. Sixty-five patients without CSD who underwent cardiac valve surgery were used as a control group. An incremental value of CT over echocardiography was described retrospectively. Sensitivity and specificity of CT for diagnosis of CSD were 95 % and 100 %, respectively. The concordance rate of subtype classification was 91 % in CT and 92 % in echocardiography. The maximum size of the defect measured by CT correlated well with surgical measurement (r = 0.82), and the limit of agreement was -0.9 ± 7.42 mm. In comparison with echocardiography, CT was able to detect combined abnormalities in three cases, and exclusively provided correct subtype classification or clarified suspected abnormal findings found on echocardiography in seven cases. Cardiac CT can accurately demonstrates CSD in preoperative adult patients. CT may have an incremental role in preoperative planning, particularly in those with more complex anatomy. (orig.)

  16. Preoperative cardiac computed tomography for demonstration of congenital cardiac septal defect in adults

    Energy Technology Data Exchange (ETDEWEB)

    Eom, Hye-Joung; Yang, Dong Hyun; Kang, Joon-Won; Lim, Tae-Hwan [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, Seoul (Korea, Republic of); Kim, Dae-Hee; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan [University of Ulsan College of Medicine, Department of Cardiology and Heart Institute, Cardiac Imaging Center, Asan Medical Center, Seoul (Korea, Republic of); Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won [University of Ulsan College of Medicine, Department of Cardiothoracic surgery, Cardiac Imaging Center, Asan Medical Center, Seoul (Korea, Republic of)

    2015-06-01

    We aimed to evaluate the role of preoperative cardiac computed tomography (CT) for adults with congenital cardiac septal defect (CSD). Sixty-five consecutive patients who underwent preoperative CT and surgery for CSD were included. The diagnostic accuracy of CT and the concordance rate of the subtype classification of CSD were evaluated using surgical findings as the reference standard. Sixty-five patients without CSD who underwent cardiac valve surgery were used as a control group. An incremental value of CT over echocardiography was described retrospectively. Sensitivity and specificity of CT for diagnosis of CSD were 95 % and 100 %, respectively. The concordance rate of subtype classification was 91 % in CT and 92 % in echocardiography. The maximum size of the defect measured by CT correlated well with surgical measurement (r = 0.82), and the limit of agreement was -0.9 ± 7.42 mm. In comparison with echocardiography, CT was able to detect combined abnormalities in three cases, and exclusively provided correct subtype classification or clarified suspected abnormal findings found on echocardiography in seven cases. Cardiac CT can accurately demonstrates CSD in preoperative adult patients. CT may have an incremental role in preoperative planning, particularly in those with more complex anatomy. (orig.)

  17. Percutaneous closure of atrial septal defects leads to normalisation of atrial and ventricular volumes

    Directory of Open Access Journals (Sweden)

    Worthley Matthew I

    2008-12-01

    Full Text Available Abstract Background Percutaneous closure of atrial septal defects (ASDs should potentially reduce right heart volumes by removing left-to-right shunting. Due to ventricular interdependence, this may be associated with impaired left ventricular filling and potentially function. Furthermore, atrial changes post-ASD closure have been poorly understood and may be important for understanding risk of atrial arrhythmia post-ASD closure. Cardiovascular magnetic resonance (CMR is an accurate and reproducible imaging modality for the assessment of cardiac function and volumes. We assessed cardiac volumes pre- and post-percutaneous ASD closure using CMR. Methods Consecutive patients (n = 23 underwent CMR pre- and 6 months post-ASD closure. Steady state free precession cine CMR was performed using contiguous slices in both short and long axis views through the ASD. Data was collected for assessment of left and right atrial, ventricular end diastolic volumes (EDV and end systolic volumes (ESV. Data is presented as mean ± SD, volumes as mL, and paired t-testing performed between groups. Statistical significance was taken as p Results There was a significant reduction in right ventricular volumes at 6 months post-ASD closure (RVEDV: 208.7 ± 76.7 vs. 140.6 ± 60.4 mL, p Conclusion ASD closure leads to normalisation of ventricular volumes and also a reduction in right atrial volume. Further follow-up is required to assess how this predicts outcomes such as risk of atrial arrhythmias after such procedures.

  18. Effect of Cigarette Smoke on Wound Healing of the Septal Mucosa of the Rat.

    Science.gov (United States)

    Trombitas, Veronica; Nagy, Alina; Berce, Cristian; Tabaran, Flaviu; Albu, Silviu

    2016-01-01

    Objectives/Hypothesis. Proper wound healing following endoscopic sinus surgery (ESS) is influenced by several factors, like cigarette smoke (CS) exposure. This study aims to assess the influence of cigarette smoke on the healing of induced septal mucosal lesion in rats. Methods. Unilateral nasal wounds were created by means of the interdental brush in seventy-four-week-old male rats. Animals were randomly divided into two groups: control group and CS exposure group, each comprising 35 animals, divided into five groups (n = 7). Animals were sacrificed in groups of seven on day 2 and then on days 5, 14, and 28 and finally on day 42 following wound induction. Results. Histological analysis of mucosal specimens shows important changes at the CS exposure group. Starting with the infiltrates of neutrophils, eosinophils, macrophages, and lymphocytes, the histological changes were continued with the Goblet cell proliferation, ciliated cells loss, fibrosis, and epithelial and subepithelial hypertrophy. Conclusion. In this experimental model of nasal wound healing we demonstrated the deleterious effects of chronic CS exposure. The adverse effects of CS exposure are firstly a postponement of the healing process and secondly the persistence of inflammation which becomes chronic. PMID:27042668

  19. Medial septal GABAergic projection neurons promote object exploration behavior and type 2 theta rhythm.

    Science.gov (United States)

    Gangadharan, Gireesh; Shin, Jonghan; Kim, Seong-Wook; Kim, Angela; Paydar, Afshin; Kim, Duk-Soo; Miyazaki, Taisuke; Watanabe, Masahiko; Yanagawa, Yuchio; Kim, Jinhyun; Kim, Yeon-Soo; Kim, Daesoo; Shin, Hee-Sup

    2016-06-01

    Exploratory drive is one of the most fundamental emotions, of all organisms, that are evoked by novelty stimulation. Exploratory behavior plays a fundamental role in motivation, learning, and well-being of organisms. Diverse exploratory behaviors have been described, although their heterogeneity is not certain because of the lack of solid experimental evidence for their distinction. Here we present results demonstrating that different neural mechanisms underlie different exploratory behaviors. Localized Cav3.1 knockdown in the medial septum (MS) selectively enhanced object exploration, whereas the null mutant (KO) mice showed enhanced-object exploration as well as open-field exploration. In MS knockdown mice, only type 2 hippocampal theta rhythm was enhanced, whereas both type 1 and type 2 theta rhythm were enhanced in KO mice. This selective effect was accompanied by markedly increased excitability of septo-hippocampal GABAergic projection neurons in the MS lacking T-type Ca(2+) channels. Furthermore, optogenetic activation of the septo-hippocampal GABAergic pathway in WT mice also selectively enhanced object exploration behavior and type 2 theta rhythm, whereas inhibition of the same pathway decreased the behavior and the rhythm. These findings define object exploration distinguished from open-field exploration and reveal a critical role of T-type Ca(2+) channels in the medial septal GABAergic projection neurons in this behavior. PMID:27208094

  20. Coblation nasal septal swell body reduction for treatment of nasal obstruction: a preliminary report.

    Science.gov (United States)

    Kim, So Jeong; Kim, Hee Tae; Park, Yun Hwi; Kim, Ju Yeon; Bae, Jung Ho

    2016-09-01

    In this paper, we present the results of coblation nasal septal swell body (NSB) reduction for the treatment of nasal obstruction in patients with abnormally thickened NSB. The study design was a retrospective clinical series conducted at a single tertiary medical center. Eight patients underwent coblation NSB reduction. Pre-operative and post-operative nasal functions were evaluated by acoustic rhinometry and subjective symptom scales. We also analyzed pre-operative CT scan images and nasal endoscopic findings. The mean maximal NSB width was 16.4 ± 2.2 mm on pre-operative coronal CT scan images. The mean visual analog scale score for nasal obstruction was decreased from preoperative 7.63 ± 0.99 points to 3.88 ± 0.92 points (postoperative 3 months), 4.16 ± 0.78 points (postoperative 6 months), and 4.63 ± 0.69 points (postoperative 1 year). Six out of the eight patients were satisfied with the clinical outcome at 1 year after the procedure. To the best of our knowledge, coblation NSB reduction has not yet been reported in the medical literature. Our results show that it can be an effective treatment modality for nasal valve narrowing in patients with abnormally thickened NSB. PMID:26912145

  1. Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

    Directory of Open Access Journals (Sweden)

    Yun Mi Kim

    2011-02-01

    Full Text Available Traumatic ventricular septal defect (VSD resulting from blunt chest injury is a very rare event. The mechanisms of traumatic VSD have been of little concern to dateuntil now, but two dominant theories have been described. In one, the rupture occurs due to acute compression of the heart; in the other, it is due to myocardial infarction of the septum. The clinical symptoms and timing of presentation are variable, so appropriate diagnosis can be difficult or delayed. Closure of traumatic VSD has been based on a combination of heart failure symptoms, hemodynamics, and defect size. Here, we present a case of a 4-year-old boy who presented with a traumatic VSD following a car accident. He showed normal cardiac structure at the time of injury, but after 8 days, his repeated echocardiography revealed a VSD. He was successfully treated by surgical closure of the VSD, and has been doing well up to the present. This report suggests that the clinician should pay great close attention to the patients injured by blunt chest trauma, keeping in mind the possibility of cardiac injury.

  2. Angiographic study of systemic-pulmonary collateral in pulmonary atresia with ventricular septal defect

    International Nuclear Information System (INIS)

    Objective: To evaluate the angiography in demonstrating the development of systemic-pulmonary collateral vessels and pulmonary arteries, and its clinical significance in pulmonary atresia with ventricular septal defect (PA + VSD). Methods: The findings of angiography of the right ventricle and aorta arch and upper portion of the descending thoracic aorta in 98 cases with PA + VSD were retrospectively studied including 63 additional selective angiography of collateral vessels. The types of systemic-pulmonary collateral vessels and the development of left and right native pulmonary arteries with or without fusion were emphatically analyzed, etc. Results: Among those 98 cases, the pulmonary arteries were supplied by patent ductus arteriosus in 14(14%), 11 of them were infants and young children; and by direct aortopulmonary collaterals in 43(44%); by multiple origin of systemic-pulmonary artery collaterals in 41(42%). 60 of 98 cases were visualized the presence of left and right native pulmonary arteries through collateral vessels. Among them, the hypoplasia of left and/or right pulmonary arteries was found. Conclusion: Angiography of right ventricle and aorta combined with necessary selective angiography of collateral vessels was still an indispensable method in the demonstration of systemic-pulmonary collateral vessels and development of pulmonary arteries, and provided the main basis for the selection of indications for interventional/surgical therapy

  3. RESIDUAL DEFECTS AFTER SURGICAL REPAIR OF VENTRICULAR SEPTAL DEFECTS IN CHILDREN:

    Directory of Open Access Journals (Sweden)

    K Sayadpour-Zanjani

    2008-12-01

    Full Text Available "nResidual ventricular septal defects (VSD are major complications after cardiac surgery. We studied the incidence of this complication, risk factors for its occurrence and short-term follow-up in 179 pediatric patients that underwent surgical closure of VSD from April 2003 until May 2004. All data were gathered retrospectively except measurements of shunt ratio. Studied risk factors included age, sex, weight, height, ejection fraction, VSD size, presence of pulmonary stenosis (PS, responsible surgeon, use of patch material for closing VSD, mean degree of hypothermia, cardiopulmonary bypass and aortic cross-clamp times, hemorrhage, documented infection, and surgical approach for defect closure. The incidence of all residual VSDs was 56% and significant ones (i.e. with Qp/Qs > 1.5 22%. The only statistically significant risk factors were higher age, weigh and height of the patients. There was notable but statistically insignificant differences in residual shunt incidence among the patients of different surgeons and with the use of different patch materials. During the median follow-up period of 9.5 months, 35% of the residual defects were closed spontaneously. Six patients underwent catheterization, three of which were candidates of residual VSD closure. As residual VSD is a hemodynamically and psychologically important complication, we recommend VSD closure at lower age and the use of intraoperative epicardial or transesophageal echocardiography to minimize its occurrence.

  4. Evaluation of atrial, ventricular and atrioventricular septal defects by cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    Cine magnetic resonance imaging (MRI) was performed on 20 patients (mean age: 5.3±4.4 years) with atrial, ventricular, or atrioventricular septal defects for evaluation of cardiac structure and blood flow. Prior to cine MRI, electrocardiographycally gated MRI using multislice scquisition was performed on all patients to localize optimal slice location. Cine-MRI was obtained with a 30 deg flip angle, 15 msec echo time, and 30 msec pulse repetition time, on a 256 x 256 or 128 x 128 acquisition matrix. Abnormalities of cardiac structure were well defined in all patients by gated cardiac imaging. In 18 of the 20 patients, cine-MRI was able to detect shunt flow, visualized as a low intensity signal in comparison with the surrounding blood flow. Cine-MRI can provide not only accurate anatomy of cardiac structures but functional assessment of the cardiac chamber, wall topology and flow relations. Cine-MRI will become an important noninvasive technique for assessment of anatomy and physiology in congenital heart disease. (author)

  5. Novel and Functional DNA Sequence Variants within the GATA6 Gene Promoter in Ventricular Septal Defects

    Directory of Open Access Journals (Sweden)

    Chunyu Li

    2014-07-01

    Full Text Available Congenital heart disease (CHD is the most common birth defect in humans. Genetic causes and underlying molecular mechanisms for isolated CHD remain largely unknown. Studies have demonstrated that GATA transcription factor 6 (GATA6 plays an essential role in the heart development. Mutations in GATA6 gene have been associated with diverse types of CHD. As GATA6 functions in a dosage-dependent manner, we speculated that changed GATA6 levels, resulting from DNA sequence variants (DSVs within the gene regulatory regions, may mediate the CHD development. In the present study, GATA6 gene promoter was genetically and functionally analyzed in large groups of patients with ventricular septal defect (VSD (n = 359 and ethnic-matched healthy controls (n = 365. In total, 11 DSVs, including four SNPs, were identified in VSD patients and controls. Two novel and heterozygous DSVs, g.22169190A>T and g.22169311C>G, were identified in two VSD patients, but in none of controls. In cultured cardiomyocytes, the activities of the GATA6 gene promoter were significantly reduced by the DSVs g.22169190A>T and g.22169311C>G. Therefore, our findings suggested that the DSVs within the GATA6 gene promoter identified in VSD patients may change GATA6 levels, contributing to the VSD development as a risk factor.

  6. Anaesthesia management of a patient with hypertrophic obstructive cardiomyopathy undergoing Morrow′s septal myectomy

    Directory of Open Access Journals (Sweden)

    Naresh Kumar Agarwal

    2007-01-01

    Full Text Available Hypertrophic obstructive cardiomyopathy (HOCM is a rare disorder. There is paucity of literature on anaesthetic management of this disorder. Aim of this case report is to highlight the anaesthetic problems encountered during management of such patients. A thirty-five year old male was admitted with atypical chest pain for last one year. X-ray chest revealed cardiomegaly (CT ratio 0.6. Electrocardiographic findings were left axis deviation with left ventricular hypertrophy. On echocardiography, there was moderate mitral regurgitation (MR, systolic anterior motion (SAM of anterior mitral leaflet and prominent systolic narrowing of left ventricle cavity. Transoesophageal echocardiography (TOE also showed an anomalous muscle bundle stretching into LV causing obstruction. Preload was kept high. Systemic vascular resistance (SVR was maintained, avoiding use of vasodilators and inotropes. Morrow′s septal myectomy was done. Anomalous muscle bundle was excised. On postoperative TOE, there was no MR and no obstruction. Optimal anaesthetic management in such patients involves maintaining adequate preload, systemic vascular resistance and minimal outflow obstruction. Other considerations are to maintain haemodynamic stability, sinus rhythm and afterload. Transoesophageal echocardiography is an extremely useful monitoring device in such patients.

  7. The effect of residual ventricular septal defects on early clinical outcome: initial experience

    International Nuclear Information System (INIS)

    Residual ventricular septal defect (VSD)after repair of isolated VSD or Fallot's tetralogy is one of the main causes of morbidity and re-operations. In this paper we have presented the results of out initial experience regarding the management of this problem. The data consists of 71 patients (22 isolated VSD and 29 fallout's tetralogy) operate during January 1991 to July, 1993. The incidence of residual VSD as shown by color doppler study at the time of discharge from hospital and at three month's follow-up was 3 out of 60 patients(73%) and 12 out of to (20%) respectively. Six out of these 12 patients were NYHA class III-IV who underwent cardiac catheterization which revealed patch dehiscence in two patients and residual right ventricular outflow tract obstruction in four patients. The two patients, with patch dehiscence were reported successfully with very good outcome. Simple color doppler mapping tends to over-diagnose residual VSDs since it can pick up small haemodynamically insignificant leaks around stitches and needle holes which seal off in due course. The findings of color doppler should, therefore, be correlated with actual clinical outcome in order to proceed with further investigation and re-operation. (author)

  8. Predominant location of coronary artery atherosclerosis in the left anterior descending artery. The impact of septal perforators and the myocardial bridging effect

    Science.gov (United States)

    Wasilewski, Jarosław; Niedziela, Jacek; Osadnik, Tadeusz; Duszańska, Agata; Sraga, Wojciech; Desperak, Piotr; Jackowska, Zuzanna; Nowakowski, Andrzej; Głowacki, Jan

    2015-01-01

    Introduction Coronary artery atherosclerosis presents characteristic patterns of plaque distribution despite systemic exposure to risk factors. We hypothesized that local hemodynamic forces induced by the systolic compression of intramuscular septal perforators could be involved in atherosclerotic processes in the left anterior descending artery (LAD) adjacent to the septal perforators’ origin. Therefore we studied the spatial distribution of atherosclerosis in coronary arteries, especially in relation to the septal perforators’ origin. Material and methods 64-slice computed tomography angiography was performed in 309 consecutive patients (92 male and 217 female) with a mean age of 59.9 years. Spatial plaque distribution in the LAD was analyzed in relation to the septal perforators’ origin. Additionally, plaque distribution throughout the coronary artery tree is discussed. Results The coronary calcium score (CCS) was positive in 164 patients (53.1%). In subjects with a CCS > 0, calcifications were more frequent in the LAD (n = 150, 91.5%) compared with the right coronary artery (RCA) (n = 94, 57.3%), circumflex branch (CX) (n = 76, 46.3%) or the left main stem (n = 42, 25.6%) (p < 0.001). Total CCS was higher in the LAD at 46.1 (IQR: 104.2) and RCA at 34.1 (IQR: 90.7) than in the CX at 16.8 (IQR: 61.3) (p = 0.007). In patients with calcifications restricted to a single vessel (n = 54), the most frequently affected artery was the LAD (n = 42, 77.8%). In patients with lesions limited to the LAD, the plaque was located mostly (n = 37, 88.1%) adjacent to the septal perforators’ origin. Conclusions We demonstrated that coronary calcifications are most frequently located in the LAD in proximity to the septal branch origin. A possible explanation for this phenomenon could be the dynamic compression of the tunneled septal branches, which may result in disturbed blood flow in the adjacent LAD segment (milking effect). PMID:26855661

  9. An in vivo assessment of the effects of using different implant abutment occluding materials on implant microleakage and the peri-implant microbiome

    Science.gov (United States)

    Rubino, Caroline

    Microleakage may be a factor in the progression of peri-implant pathology. Microleakage in implant dentistry refers to the passage of bacteria, fluids, molecules or ions between the abutment-implant interface to and from the surrounding periodontal tissues. This creates a zone of inflammation and reservoir of bacteria at the implant-abutment interface. Bone loss typically occurs within the first year of abutment connection and then stabilizes. It has not yet been definitively proven that the occurrence of microleakage cannot contribute to future bone loss or impede the treatment of peri-implant disease. Therefore, strategies to reduce or eliminate microleakage are sought out. Recent evidence demonstrates that the type of implant abutment channel occluding material can affect the amount of microleakage in an in vitro study environment. Thus, we hypothesize that different abutment screw channel occluding materials will affect the amount of observed microleakage, vis-a-vis the correlation between the microflora found on the abutment screw channel occluding material those found in the peri-implant sulcus. Additional objectives include confirming the presence of microleakage in vivo and assessing any impact that different abutment screw channel occluding materials may have on the peri-implant microbiome. Finally, the present study provides an opportunity to further characterize the peri-implant microbiome. Eight fully edentulous patients restored with at dental implants supporting screw-retained fixed hybrid prostheses were included in the study. At the initial appointment (T1), the prostheses were removed and the implants and prostheses were cleaned. The prostheses were then inserted with polytetrafluoroethylene tape (PTFE, TeflonRTM), cotton, polyvinyl siloxane (PVS), or synthetic foam as the implant abutment channel occluding material and sealed over with composite resin. About six months later (T2), the prostheses were removed and the materials collected. Paper

  10. Thrombocytopenia in Patients with Gastric Varices and the Effect of Balloon-occluded Retrograde Transvenous Obliteration on the Platelet Count

    Directory of Open Access Journals (Sweden)

    W E Saad

    2014-01-01

    Full Text Available Objectives: Gastric varices primarily occur in cirrhotic patients with portal hypertension and splenomegaly and thus are probably associated with thrombocytopenia. However, the prevalence and severity of thrombocytopenia are unknown in this clinical setting. Moreover, one-third of patients after balloon-occluded retrograde transvenous obliteration (BRTO have aggravated splenomegaly, which potentially may cause worsening thrombocytopenia. The aim of the study is to determine the prevalence and degree of thrombocytopenia in patients with gastric varices associated with gastrorenal shunts undergoing BRTO, to determine the prognostic factors of survival after BRTO (platelet count included, and to assess the effect of BRTO on platelet count over a 1-year period. Materials and Methods: This is a retrospective review of 35 patients who underwent BRTO (March 2008-August 2011. Pre- and post-BRTO platelet counts were noted. Potential predictors of bleeding and survival (age, gender, liver disease etiology, platelet count, model for end stage liver disease [MELD]-score, presence of ascites or hepatocellular carcinoma were analyzed (multivariate analysis. A total of 91% (n = 32/35 of patients had thrombocytopenia (90% of patients in patients undergoing BRTO. However, BRTO (with occlusion of the gastrorenal shunt has little effect on the platelet count. Long-term outcomes of BRTO for bleeding gastric varices using sodium tetradecyl sulfate in the USA are impressive with a 4-year variceal rebleed rate and transplant-free survival rate of 9% and 76%, respectively. Platelet count is not a predictor of higher rebleeding or patient survival after BRTO.

  11. Occluded human recognition for a leader following system using 3D range and image data in forest environment

    Science.gov (United States)

    Cho, Kuk; Ilyas, Muhammad; Baeg, Seung-Ho; Park, Sangdeok

    2014-06-01

    This paper describes the occluded target recognition and tracking method for a leader-following system by fusing 3D range and image data acquired from 3D light detection and ranging (LIDAR) and a color camera installed on an autonomous vehicle in forest environment. During 3D data processing, the distance-based clustering method has an instinctive problem in close encounters. In the tracking phase, we divide an object tracking process into three phases based on occlusion scenario; before an occlusion (BO) phase, a partially or fully occlusion phase and after an occlusion (AO) phase. To improve the data association performance, we use camera's rich information to find correspondence among objects during above mentioned three phases of occlusion. In this paper, we solve a correspondence problem using the color features of human objects with the sum of squared distance (SSD) and the normalized cross correlation (NCC). The features are integrated with derived windows from Harris corner. The experimental results for a leader following on an autonomous vehicle are shown with LIDAR and camera for improving a data association problem in a multiple object tracking system.

  12. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation

  13. A case of liver cirrhosis with bleeding from stomal varices successfully treated using balloon-occluded retrograde transvenous obliteration.

    Science.gov (United States)

    Takano, Masashi; Imai, Yukinori; Nakazawa, Manabu; Chikayama, Taku; Ando, Satsuki; Sugawara, Kayoko; Nakayama, Nobuaki; Mochida, Satoshi

    2016-06-01

    A 66-year-old male patient with liver cirrhosis because of alcohol intake underwent a Hartmann's procedure for rectal cancer. Four months later, bleeding from the sigmoid stoma occurred and persisted for 2 months. A colonoscopic examination revealed bleeding from stomal varices. Three-dimensional computed tomography (CT) imaging demonstrated the inferior mesenteric vein and left superficial epigastric vein as the feeding and drainage vessels, respectively. Balloon-occluded retrograde transvenous obliteration (B-RTO) through the left epigastric vein was performed using a microballoon catheter inserted from the right femoral vein according to the Seldinger method. A CT examination performed 2 days after the B-RTO procedure revealed that the blood flow had disappeared, with thrombosis formation in both the stomal varices and the feeding vein. No recurrent bleeding from the stoma occurred. B-RTO using a microballoon catheter is useful as a therapeutic procedure for stomal varices to prevent bleeding, since the procedure can be performed with minimal invasion using the Seldinger method. PMID:27048279

  14. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Mitsunari, E-mail: mitunari@med-shimane.u.ac.jp; Yoshizako, Takeshi, E-mail: yosizako@med.shimane-u.ac.jp; Nakamura, Tomonori, E-mail: t-naka@med.shimane-u.ac.jp; Nakamura, Megumi, E-mail: megumi@med.shimane-u.ac.jp; Yoshida, Rika, E-mail: yoshidar@med.shimane-u.ac.jp; Kitagaki, Hajime, E-mail: kitagaki@med.shimane-u.ac.jp [Shimane University Faculty of Medicine, Department of Radiology (Japan)

    2016-03-15

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

  15. Intraoperative device closure of secundum atrial septal defect associated with deficient rims with a right anterior minithora-cotomy%右胸小切口封堵缺乏边缘的Ⅱ孔型房间隔缺损

    Institute of Scientific and Technical Information of China (English)

    孙晓宁; 赵强; 陈安清; 夏利民; 周光华; 王哲; 徐德民

    2009-01-01

    Objective To evaluate the feasibility of inrtaoperative device closure of secundum atrial septal defects(ASDs) as-sociated with deficient rime using the china-made septal occluder through a right antierior minithoractomy.Methods 25 patients with deficient rims underwent an attemptes intraoperative device closure.The patients had a deficient anterior rim (n=11),a deficient anterior rim and an inferior rim (n=3),a deficient anterior rim and a posterior rim(n=4),posterior rim(n=1),deficient anterior rim and superior rim(n=1),superior rim(n=4)as assessed by transesophgeal echocardiography(TEE).54 patients with sufficient rims(>5mm)who underwent closure served as controls.For deficient inferior rim,a sticth was sewed at the inferior vena cava near right infrior pulmonary vein to enforce the umbrella.For deficient posterior rim,a sticth was sewed at the right atrium to enfoce the umbrella.Results There were no differences between the 2 grouos in ASD stretched diameter and devioe (P>0.05).Of 25patients with deficient rims,25(100%)had immediate complete closure compared with 52 of 54 patients (96%) with sufficient rims (P5衄)行右胸小切El房间隔缺损封堵治疗者作为对照组,其中女36例.男18例,平均年龄31.9岁(5-72岁).结果 无边缘组房间隔缺损直径10-38衄,平均(23.3±8.5)mm.封堵器大小为(27.9±7.8)mm(14-42衄).对照组房间隔缺损直径9.38衄,平均(23.6±7.0)mm,封堵器大小为(29.4-I-7.3)r唧(12-42m).两组房间隔缺损直径和所用封堵器大小差别无统计学意义(P>O.05).平均手术时间分别为(30±7)min和(15 4-4)rain.差别有统计学意义(P<0.c15).25例缺乏边缘者100%(25,25例)封堵成功,对照组96%(52,54例)封堵成功,2例存在轻度残余分流.随访6个月,两组封堵成功率均为100%,均无严重并发症.结论 右胸小切口可以成功封堵边缘缺乏的房间隔缺损,但需要更长期的随访评估长期的安全性和有效性.

  16. Inhibition of tumor necrosis factor-α reduces alveolar septal cell apoptosis in passive smoking rats

    Institute of Scientific and Technical Information of China (English)

    ZHANG Cheng; CAI Shan; CHEN Ping; CHEN Jian-bo; WU Jie; WU Shang-jie; ZHOU Rui

    2008-01-01

    Background Recent studies have revealed that lung cell apoptosis plays an important role in pathogenesis of cigarette-induced chronic obstructive pulmonary disease (COPD).Tumor necrosis factor alpha(TNF-α)is one of the most important cytokines which are involved in COPD.This study aimed at investigating the jnfluence of its inhibitor,recombinant human necrosis factor-alpha receptor Ⅱ:IgG Fc fusion protein(rhTNFR:Fc)on alveolar septal cell apoptosis in passive smoking rats.Methods Forty-eight rats were randomly divided into a normal control group,a passive smoking group,an rhTNFR:Fc intervention group and a sham intervention group.The passive smoking rats were treated by exposure to cigarette smoking daily for 80 days.Afcer smoking for one month the rhTNFR:Fc Intervention group was treated with rhTNFR:Fc by subcutaneous injection,the sham intervention group injected subcutaneousIv with a neutral preparation(normal saline 0.1 ml,manicol 0.8 ml,cane sugar 0.2 mg,Tris 0.024 mg as a control.Lung function was determined and the levels of TNF-α in serum and broncho-alveolar lavage fluid(BALF)were measured with enzyme-linked immunosorbnent assay (ELISA).Lung tissue sections stained by hematoxylin and eosin(HE)were observed for study of morphological alternations.Mean linear intercept(MLI)and mean alveolar numbers(MAN)were measured and the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)method was carried out to determine the percentage of positive cells and distribution of apoptotic cells.Results Increased MLI and decreased MAN were found in the passive smoking group compared with both the normal control group and the rhTNFR:Fc intervention group(P<0.05).Forced expiratory volume in 0.3 second(FEV0.3)/forced vital capacity(FVC)and peak expiratory flow(PEF)were lower in the passive smoking group than that in the normal control group(P<0.05).Compared with the sham intervention group,FEV0.3/FVC and PEF increased in the rhTNFR:Fc intervention

  17. Embolization of high-flow AVM nidus with n-butyl-2-cyanoacrylate derivative through a recanalized type 1 AmplatzerR vascular plug remaining from a previous proximal embolization: a case report

    International Nuclear Information System (INIS)

    Full text: Introduction: Arteriovenous malformation (AVM)s are well-known indications of liquid agent use to embolise the nidus, since proximal feeder embolization usually results in recurrence. Objectives and tasks: In this article, we aim to present that in a case with a previous recanalized proximal AmplatzerR vascular plug (AVP) embolization of a high flow pelvic AVM, to embolise the nidus readily with n butyl- 2-cyanoacrylate (n-BCA) derivative via recanalized AVP located in the proximal feeder is feasible. Material and methods:41-year-old male who had undergone several proximal embolization sessions by using AVP and coils due to high-flow pelvic AVM referred to our unit for a new embolization session because of recurrence established in the CT angiography examination. Results: In digital substraction angiography examination, a high flow AVM recanalization mostly fed by the anterior branches of right internal iliac artery was seen in the region of previous proximal embolization with AVP. A cobra catheter was navigated immediately proximal to the recanalized AVP and successful nidal embolization was achieved easily by using 15% n-BCA derivative diluted with iodized oil (lipiodol) via recanalized AVP. Conclusion: This case demonstrates the permeability of AVP's to liquid embolic agents, once they recanalize. In those cases, 15% n-BCA derivative diluted with iodized oil easily penetrates the recanalized AVP and enables distal nidal embolization

  18. A HAND2 Loss-of-Function Mutation Causes Familial Ventricular Septal Defect and Pulmonary Stenosis.

    Science.gov (United States)

    Sun, Yu-Min; Wang, Jun; Qiu, Xing-Biao; Yuan, Fang; Li, Ruo-Gu; Xu, Ying-Jia; Qu, Xin-Kai; Shi, Hong-Yu; Hou, Xu-Min; Huang, Ri-Tai; Xue, Song; Yang, Yi-Qing

    2016-01-01

    Congenital heart disease (CHD) is the most common developmental abnormality, and is the leading noninfectious cause of mortality in neonates. Increasing evidence demonstrates that genetic defects play an important role in the pathogenesis of CHD. However, CHD exhibits substantial heterogeneity, and the genetic determinants for CHD remain unknown in the overwhelming majority of cases. In the current study, the coding exons and flanking introns of the HAND2 gene, which encodes a basic helix-loop-helix transcription factor essential for normal cardiovascular development, were sequenced in 192 unrelated patients with CHD, and a novel heterozygous mutation, p.S65I, was identified in a patient with congenital ventricular septal defect (VSD). Genetic analysis of the index patient's pedigree revealed that the mutation was present in all seven affected family members available, but absent in the 13 unaffected family members examined. Besides, in addition to VSD, five of the proband's close relatives also had pulmonary stenosis (PS), and the proband's son also had double outlet right ventricle (DORV). The missense mutation, which altered an evolutionarily conserved amino acid, was absent in 300 unrelated, ethnically matched healthy individuals. Biological analyses using a dual-luciferase reporter assay system showed that the mutant HAND2 was associated with significantly diminished transcriptional activity. Furthermore, the mutation abolished the synergistic activation between HAND2 and GATA4, as well as NKX2.5-two other cardiac core transcriptional factors that have been causally linked to CHD. These findings indicate that HAND2 loss-of-function mutation contributes to human CHD, perhaps via its interaction with GATA4 and NKX2.5. PMID:26865696

  19. Swiss cheese ventricular septal defect with myocarditis - A rare coexistence in a neonate

    Directory of Open Access Journals (Sweden)

    A R Saboo

    2012-01-01

    Full Text Available Myocarditis is defined as acute inflammation of the myocardium, usually following a non-specific flu-like illness, and encompasses a wide range of clinical presentations ranging from mild or subclinical disease to heart failure. We report a 12-day-old healthy full-term neonate who presented with abrupt onset of congestive cardiac failure (CCF following a viral prodrome. Examination revealed persistent sinus tachycardia, lymphocytosis, gross cardiomegaly, nonspecific electrocardiogram changes with echocardiography showing Swiss cheese ventricular septal defect (VSD. VSD alone very rarely presents as early-onset cardiac failure in the absence of other precipitating factors like anemia, sepsis, hypoglycemia etc. Myocarditis, however, can mimic VSD and can present as fulminant cardiac failure in an otherwise healthy newborn. Myocarditis is usually diagnosed based on circumstantial evidence such as a recent viral infection and the sudden onset of cardiac dysfunction while ruling out other diagnostic possibilities. Elevated troponin T level is one of the most crucial noninvasive diagnostic modalities. Several trials have concluded that levels >0.055 ng/ml are statistically significant for diagnosing myocarditis in children. In our case an abrupt onset of cardiac failure following a viral prodrome and markedly elevated cardiac troponin T without sepsis and in the presence of normal coronary anatomy clinched the diagnosis of myocarditis. An early and aggressive treatment for CCF along with regular long-term follow-up plays a key role in the management of myocarditis. Role of high-dose Intravenous immunoglobulin in myocarditis has been studied by many trials with different outcomes. This is the first case report showing coexistence of VSD with myocarditis in a neonate presenting as early-onset acute cardiac failure. The report highlights the importance of screening for myocarditis in all previously normal babies presenting primarily with cardiogenic

  20. Experiences with surgical treatment of ventricle septal defect as a post infarction complication

    Directory of Open Access Journals (Sweden)

    Stich Kathrin

    2009-01-01

    Full Text Available Abstract Background Complications of acute myocardial infarction (AMI with mechanical defects are associated with poor prognosis. Surgical intervention is indicated for a majority of these patients. The goal of surgical intervention is to improve the systolic cardiac function and to achieve a hemodynamic stability. In this present study we reviewed the outcome of patients with post infarction ventricular septal defect (PVSD who underwent cardiac surgery. Methods We analysed retrospectively the hospital records of 41 patients, whose ages range from 48 to 81, and underwent a surgical treatment between 1990 and 2005 because of PVSD. Results In 22 patients concomitant coronary artery bypass grafting (CAGB was performed. In 15 patients a residual shunt was found, this required re-op in seven of them. The time interval from infarct to rupture was 8.7 days and from rupture to surgery was 23.1 days. Hospital mortality in PVSD group was 32%. The mortality of urgent repair within 3 days of intractable cardiogenic shock was 100%. The mortality of patients with an anterior VSD and a posterior VSD was 29.6% vs 42.8%, respectively. All patients who underwent the surgical repair later than day 36 survived. Conclusion Surgical intervention is indicated for a majority of patients with mechanical complications. Cardiogenic shock remains the most important factor that affects the early results. The surgical repair of PVSD should be performed 4–5 weeks after AMI. To improve surgical outcome and hemodynamics the choice of surgical technique and surgical timing as well as preoperative management should be tailored for each patient individually.

  1. A HAND2 Loss-of-Function Mutation Causes Familial Ventricular Septal Defect and Pulmonary Stenosis

    Directory of Open Access Journals (Sweden)

    Yu-Min Sun

    2016-04-01

    Full Text Available Congenital heart disease (CHD is the most common developmental abnormality, and is the leading noninfectious cause of mortality in neonates. Increasing evidence demonstrates that genetic defects play an important role in the pathogenesis of CHD. However, CHD exhibits substantial heterogeneity, and the genetic determinants for CHD remain unknown in the overwhelming majority of cases. In the current study, the coding exons and flanking introns of the HAND2 gene, which encodes a basic helix-loop-helix transcription factor essential for normal cardiovascular development, were sequenced in 192 unrelated patients with CHD, and a novel heterozygous mutation, p.S65I, was identified in a patient with congenital ventricular septal defect (VSD. Genetic analysis of the index patient’s pedigree revealed that the mutation was present in all seven affected family members available, but absent in the 13 unaffected family members examined. Besides, in addition to VSD, five of the proband’s close relatives also had pulmonary stenosis (PS, and the proband’s son also had double outlet right ventricle (DORV. The missense mutation, which altered an evolutionarily conserved amino acid, was absent in 300 unrelated, ethnically matched healthy individuals. Biological analyses using a dual-luciferase reporter assay system showed that the mutant HAND2 was associated with significantly diminished transcriptional activity. Furthermore, the mutation abolished the synergistic activation between HAND2 and GATA4, as well as NKX2.5—two other cardiac core transcriptional factors that have been causally linked to CHD. These findings indicate that HAND2 loss-of-function mutation contributes to human CHD, perhaps via its interaction with GATA4 and NKX2.5.

  2. Diagnosis of asymptomatic atrial septal aneurysms using two-dimensional color Doppler and contrast transthoracic echocardiography

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Objective To evaluate the dimensions of atrial septal aneurysm (ASA), the presence and characteristics of interatrial shunt, the movement of the wall of the aneurysm, and correlation between these findings and sign and/or symptoms suggesting embolism in Manisa, a district of a western Anatolian city of Turkey. Methods Two thousand five hundred cases were examined by routine transthoracic echocardiography (TTE) in both pediatric and adult cardiology outpatient clinics. ASA was detected in 20 cases and evaluated by two-dimensional color Doppler echocardiography (CDE). The length of the base, the maximum radius and the maximum displacement of ASA were measured. The shunt between the atria was examined by CDE. In cases where a shunt could not be found, galactose and palmitic acid was injected. Standard 12-lead electrocardiogram (ECG) and exercise stress test were also performed. Results No clinical signs or symptoms were found, suggesting a systemic or cerebral embolism. The maximum displacement of ASA was between 2 and 5 mm. All of the aneurysms were localized in the right atrium, and the walls of the aneurysm did not move beyond the base of the left atrium during the maximum displacement. Interatrial shunt was detected in 14 of 20 patients (70%) by CDE and in the remaining six cases by contrast TTE. Frequent ventricular ectopic beats were observed in one patient. Conclusions During routine TTE we observed 0.8% asymptomatic ASA in our population. The use of a contrast agent was found to be a valuable additional method in patients with ASA when the shunt could not be detected by CDE. The risk for embolism is not high when the maximum displacement of the wall of ASA was 5 mm or less and no bulge into the left atrium was observed. Based on our experience with this method, TTE is easy to perform, well-tolerated and acceptable.

  3. Nicotine induction of theta frequency oscillations in rodent medial septal diagonal band in vitro

    Institute of Scientific and Technical Information of China (English)

    Cheng-biao LU; Cheng-zhang LI; Dong-liang LI; Zaineb HENDERSON

    2013-01-01

    Aim:This study aimed to examine the role of the nicotinic receptor (nAChR) in the generation of theta oscillations (4-12 Hz) in vitro.Methods:Electrophysiological studies were performed on medial septal diagonal band area (MSDB) slices to measure theta oscillation.Immunofluorescence and confocal microscopy studies were carried out to detect α4 nAChR and β2 nAChR subunits in perfused-fixed tissue from VGluT2-GFP and GAD67-GFP transgenic mice.Results:Application of nicotine to MSDB slices produced persistent theta oscillations in which area power increased in a doseresponsive manner.This activity was inhibited by GABAA receptor antagonists and partially by ionotropic glutamate receptor antagonists,indicating the involvement of local GABAergic and glutamatergic neurons in the production of the rhythmic activity.The nicotineinduced theta activity was also inhibited selectively by non-α7*nAChR antagonists,suggesting the presence of these receptor types on GABAergic and glutamatergic neuron populatjons in the MSDB.This was confirmed by immunofluorescence and confocal microscopy studies in transgenic mice in which the GABAergic and glutamatergic neurons express green fluorescent protein (GFP),showing Iocalisation of β2 nAChR and α4 nAChR subunits,the most common constituents of non-α7*nAChRs,in both cell types in the MSDB.Conclusion:Theta activity in the MSDB may be generated by tonic stimulation of non-α7*nAChRs.

  4. Efficacy of a novel IGS system in atrial septal defect repair

    Science.gov (United States)

    Mefleh, Fuad N.; Baker, G. Hamilton; Kwartowitz, David M.

    2013-03-01

    Congenital heart disease occurs in 107.6 out of 10,000 live births, with Atrial Septal Defects (ASD) accounting for 10% of these conditions. Historically, ASDs were treated with open heart surgery using cardiopulmonary bypass, allowing a patch to be sewn over the defect. In 1976, King et al. demonstrated use of a transcatheter occlusion procedure, thus reducing the invasiveness of ASD repair. Localization during these catheter based procedures traditionally has relied on bi-plane fluoroscopy; more recently trans-esophageal echocardiography (TEE) and intra-cardiac echocardiography (ICE) have been used to navigate these procedures. Although there is a high success rate using the transcatheter occlusion procedure, fluoroscopy poses radiation dose risk to both patient and clinician. The impact of this dose to the patients is important as many of those undergoing this procedure are children, who have an increased risk associated with radiation exposure. Their longer life expectancy than adults provides a larger window of opportunity for expressing the damaging effects of ionizing radiation. In addition, epidemiologic studies of exposed populations have demonstrated that children are considerably more sensitive to the carcinogenic effects radiation. Image-guided surgery (IGS) uses pre-operative and intra-operative images to guide surgery or an interventional procedure. Central to every IGS system is a software application capable of processing and displaying patient images, registration between multiple coordinate systems, and interfacing with a tool tracking system. We have developed a novel image-guided surgery framework called Kit for Navigation by Image Focused Exploration (KNIFE). In this work we assess the efficacy of this image-guided navigation system for ASD repair using a series of mock clinical experiments designed to simulate ASD repair device deployment.

  5. Construction of occluded recombinant baculoviruses containing the full-length cry1Ab and cry1Ac genes from Bacillus thuringiensis

    OpenAIRE

    Ribeiro, B M; Crook, N. E.

    1998-01-01

    The administration of baculoviruses to insects for bioassay purposes is carried out, in most cases, by contamination of food surfaces with a known amount of occlusion bodies (OBs). Since per os infection is the natural route of infection, occluded recombinant viruses containing crystal protein genes (cry1Ab and cry1Ac) from Bacillus thuringiensis were constructed for comparison with the baculovirus prototype Autographa californica nucleopolyhedrovirus (AcNPV). The transfer vector pAcUW2B was ...

  6. Bleeding Duodenal Varices Successfully Treated with Balloon-Occluded Retrograde Transvenous Obliteration (B-RTO) Assisted by CT During Arterial Portography

    International Nuclear Information System (INIS)

    A 60-year-old woman with massive hemorrhage from duodenal varices was transferred to our hospital for the purpose of transcatheter intervention. Although digital subtraction arterial portography could not depict the entire pathway of collateral circulation, the efferent route of the duodenal varices was clearly demonstrated on subsequent CT during arterial portography. Balloon-occluded retrograde transvenous obliteration (B-RTO) of the varices was performed via the efferent vein and achieved complete thrombosis of the varices

  7. IR-SNOM analysis of occluding substances in lumina of xylem elements in sapwood of Quercus serrata attacked by Platypus quercivorus.

    Science.gov (United States)

    Yamagishi, Takayuki; Aizawa, Kento; Yamada, Toshihiro; Matsumoto, Yuji

    2013-01-01

    A new microspectroscopic technique was applied to the analysis of occluding deposits in xylem elements of Quercus serrata. The production of this substance is believed to be a defense response of the sapwood against fungal infection. An occluding substance about 10 μm across was analyzed by Infrared-Scanning Near-field Optical Microscopy (IR-SNOM), which allows for the measurement of IR spectrum with high spatial resolution. The near-field IR spectrum of an occluding substance was different from those of xylem elements and featured a lack of the clear C-H absorption band that should appear at 3000-2850 cm(-1). On the other hand, the absorption band of ester bond exhibited a very strong peak. Among the near-field IR spectra of related compounds, a similar ester absorption peak was observed in the spectrum of pectin and tannic acid. The presence of a C-H absorption band as a very week peak was similar to (+)-catechin and tannic acid. PMID:23574667

  8. Pupil-occluding organized hyphema anterior to the intraocular lens treated by neodymium: yttrium-aluminum-garnet laser: a case report

    Science.gov (United States)

    Kim, Moosang; Lee, Seung-Jun; Han, Sang Beom; Yang, Hee Kyung; Hyon, Joon Young

    2016-01-01

    We report, to our best knowledge, the first case of treatment of pupil-occluding postoperative organized hyphema anterior to the intraocular lens (IOL) using neodymium: yttrium-aluminum-garnet (Nd:YAG) laser. A 78-year-old Asian female underwent uneventful cataract operation. She had been taking aspirin, which she discontinued 1 week before surgery. Iris prolapse occurred at the end of the surgery, which led to intracameral bleeding. Two weeks later, her best-corrected visual acuity was hand motion. Although hyphema had decreased, pupil-occluding organized hematoma had formed anterior to the IOL. The blood clot anterior to the IOL was removed using Nd:YAG laser. One week later, although the hematoma anterior to the IOL resolved, endocapsular hematoma was observed, which was dispersed with Nd:YAG laser posterior capsulotomy. Two weeks later, her best-corrected visual acuity improved to 20/60. There was no complication associated with Nd:YAG laser. In conclusion, pupil-occluding organized hyphema anterior to the IOL can occur as a complication of cataract surgery, in which Nd:YAG laser can be a useful treatment option. PMID:27462181

  9. Studies on the Construction Parameter of an Artificial Occluded Cell for In-situ Inspection of the Propagation Rate of Localized Corrosion

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    An artificial localized corrosion system is assembled and some parameters related to the localized corrosion in active dissolution state(i.e.,non-passive state)have been studied.The results showed that the developed electrochemical system can satisfactorily imitate a naturally formed localized corrosion and the coupling current can indicate the maximum localized propagating rate.In this artificial system, the anodic dissolution reaction followed the auto-catalytic mechanism.The localized corrosion current density was dependent on the area ratio R of the cathode tothe occluded anode. While R was equal to or more than 6, the coupling current reached at a maximum value and did not alter with the increase in R-value. Therefore, R=7 is chosen as one of these optimum parameters used in constructing the system, with which the biggest galvanic current might be obtained. In contrast, the thickness of the polymer filler separating the occluded anode area from the bulk electrolyte solution and the volume of the occluded anode area did not affect the corrosion current obviously. They might affect the response time to approach a steady state.

  10. Differential modulation of lateral septal vasopressin receptor blockade in spatial learning, social recognition, and anxiety-related behaviors in rats

    OpenAIRE

    Everts, HGJ; Koolhaas, JM

    1999-01-01

    The role of lateral septal vasopressin (VP) in the modulation of spatial memory, social memory, and anxiety-related behavior was studied in adult, male Wistar rats. Animals were equipped with osmotic minipumps delivering the VP-antagonist d(CH2)5-D-Tyr(Et)VAVP (1 ng/0.5 mu l per h) bilaterally into the lateral septum (LS). Subsequently, all rats were subjected to four behavioral tests. First, animals were tested in a spatial learning paradigm (Morris water maze; 12 trials), followed by the so...

  11. Visualization of a Small Ventricular Septal Defect at First-pass Contrast-enhanced Cardiac Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Francesco Secchi

    2013-01-01

    Full Text Available Ventricular septal defect (VSD is a congenital heart disease that accounts for up to 40% of all congenital cardiac malformations. VSD is a connection between right and left ventricle, through the ventricular septum. Echocardiography and magnetic resonance imaging (MRI help identify this entity. This case presents a 12-year-old male diagnosed with a small muscular apical VSD of 3 mm in diameter, at echocardiography. Cardiac MRI using first-pass perfusion sequence, combining the right plane of acquisition with a short bolus of contrast material, clearly confirmed the presence of VSD.

  12. Unusual Case of Left Bronchial Compression by Aneurysmal Pulmonary Arteries in a Child With Atrial Septal Defect.

    Science.gov (United States)

    Pawar, Ranjit; Kumar, Gaurav; Sharma, Vipul; Dalal, S S

    2016-07-01

    We report an uncommon case of large ostium secundum atrial septal defect (ASD) with severe pulmonary arterial hypertension, with associated aneurysmal dilatation of the pulmonary arteries (PAs) leading to compression of the left main bronchus and collapse of the entire left lung in a 15-month-old female child. The patient was managed by surgical closure of the ASD, translocation of the right PA anterior to the aorta with PA aneurysmorrhaphy. Left bronchial compression was relieved with complete lung expansion on the third postoperative day. PMID:26865068

  13. Three-dimensional image analysis of plugging at the septal pore by Woronin body during hypotonic shock inducing hyphal tip bursting in the filamentous fungus Aspergillus oryzae

    International Nuclear Information System (INIS)

    We observed that the filamentous fungus, Aspergillus oryzae, grown on agar media burst out cytoplasmic constituents from the hyphal tip soon after flooding with water. Woronin body is a specialized organelle known to plug the septal pore adjacent to the lysed compartment to prevent extensive loss of cytoplasm. A. oryzae Aohex1 gene homologous to Neurospora crassa HEX1 gene encoding a major protein in Woronin body was expressed as a fusion with DsRed2, resulting in visualization of Woronin body. Confocal microscopy and three-dimensional reconstruction of images visualized the septal pore as a dark region surrounded by green fluorescence of EGFP-fused secretory protein, RNase T1, on the septum. Dual fluorescent labeling revealed the plugging of the septal pores adjacent to the lysed apical compartments by Woronin bodies during hypotonic shock. Disruption of Aohex1 gene caused disappearance of Woronin bodies and the defect to prevent extensive loss of cytoplasm during hypotonic shock

  14. Development of Thrombus in a Systemic Vein after Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimatsu, Rika; Yamagami, Takuji; Tanaka, Osamu; Miura, Hiroshi; Nishimura, Tsunehiko [Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto (Japan); Okuda, Kotaro; Hashiba, Mitsuoki [Fukuchiyama City Hospital, Kyoto (Japan)

    2012-06-15

    To retrospectively evaluate the frequency and risk factors for developing thrombus in a systemic vein such as the infrarenal inferior vena cava or the iliac vein, in which a balloon-occluded retrograde transvenous obliteration (B-RTO) catheter was indwelled. Forty-nine patients who underwent B-RTO for gastric varices were included in this study. The B-RTO procedure was performed from the right femoral vein, and the B-RTO catheter was retained overnight in all patients. Pre- and post-procedural CT scans were retrospectively compared in order to evaluate the development of thrombus in the systemic vein in which the catheter was indwelled. Additionally, several variables were analyzed to assess risk factors for thrombus in a systemic vein. In all 49 patients (100%), B-RTO was technically successful, and in 46 patients (94%), complete thrombosis of the gastric varices was achieved. In 6 patients (12%), thrombus developed in the infrarenal inferior vena cava or the right common-external iliac vein. All thrombi lay longitudinally on the right side of the inferior vena cava or the right iliac vein. One of the aforementioned 6 patients required anticoagulation therapy. No symptoms suggestive of pulmonary embolism were observed. Prothrombin time-international normalized ratio and the addition of 5% ethanolamine oleate iopamidol, on the second day, were related to the development of thrombus. Development of a thrombus in a systemic vein such as the inferior vena cava or iliac vein, caused by indwelling of the B-RTO catheter, is relatively frequent. Physicians should be aware of the possibility of pulmonary embolism due to iliocaval thrombosis.

  15. Effect of naringin on hemodynamic changes and left ventricular function in renal artery occluded renovascular hypertension in rats

    Directory of Open Access Journals (Sweden)

    Asjad Visnagri

    2015-01-01

    Full Text Available Background: Renal artery occlusion (RAO induced hypertension is a major health problem associated with structural and functional variations of the renal and cardiac vasculature. Naringin a flavanone glycoside derived possesses metal-chelating, antioxidant and free radical scavenging properties. Objective: The objective of this study was to investigate the antihypertensive activity of naringin in RAO induced hypertension in rats.Material and Methods: Male Wistar rats (180-200 g were divided into five groups Sham, RAO, naringin (20, 40 and 80 mg/kg. Animals were pretreated with naringin (20, 40 and 80 mg/kg p.o for 4 weeks. On the last day of the experiment, left renal artery was occluded with renal bulldog clamp for 4 h. After assessment of hemodynamic and left ventricular function various biochemical (superoxide dismutase [SOD], glutathione [GSH] and malondialdehyde [MDA] and histological parameters were determined in the kidney. Results: RAO group significantly (P < 0.001 increased hemodynamic parameters at 15, 30 and 45 min of clamp removal. Naringin (40 and 80 mg/kg treated groups showed a significant decrease in hemodynamic parameters at 15 min. after clamp removal that remained sustained for 60 min. Naringin (40 and 80 mg/kg treated groups showed significant improvement in left ventricular function at 15, 30 and 45 min after clamp removal. Alteration in level of SOD, GSH and MDA was significantly restored by naringin (40 and 80 mg/kg treatment. It also reduced histological aberration induced in kidney by RAO. Conclusion: It is concluded that the antihypertensive activity of naringin may result through inhibition of oxidative stress.

  16. Presentation of congestive cardiac failure in children with ventricular septal defect

    International Nuclear Information System (INIS)

    Background: While there is much data on cardiac problems of adults, there is a limited statistical data available to evaluate the magnitude of the cardiac problems in children in Pakistan. Many of these children present with recurrent chest infections and congestive cardiac failure (CCF), and are managed by general practitioners. A careful search for underlying cardiac problems and awareness about the presentation of CCF and its magnitude will definitely decrease the morbidity and mortality of these children. The objective of this study was to see the frequency and clinical presentation of CCF in children with Ventricular Septal Defect (VSD). Methods: Forty-nine patients met the preset criteria during the study period of 6 months. A detailed history and physical examination with special emphasis on symptoms and signs was sought and the findings were noted in a questionnaire. Data was analysed using SPSS-11. Frequencies and percentages were calculated for all categorical variables. Results: CCF in VSD was found more in males, with a male to female ratio of 1.45:1. Majority (63.1%) of the patients presented in infancy. The common symptoms at presentation were dyspnoea (98%), cough (83.7%), and feeding difficulty (9.6%). Other important symptoms were fever, fatigue, failure to thrive, sweating and wheezing. The common physical signs in order of frequency were murmur 98%, tachypnoea 91.8%, tachycardia 89.8%, hepatomegaly 89.9% and crackles in chest 85.7%. Other presenting signs were displaced apex beat 57%, oedema 28.6% and chest deformity 20.4%. Regarding the type of VSD, peri membranous was the commonest 61.2% as confirmed by echocardiography. Conclusion: This study was done on a smaller scale in hospitalised children. The exact studies regarding CCF in paediatric patients are scarce. There is a need to design more studies in children with CCF. Early recognition of signs and symptoms of CCF on paediatric patients with VSD and awareness at primary health care level

  17. Resultados da correção simplificada com enxerto único no defeito septal atrioventricular completo

    Directory of Open Access Journals (Sweden)

    Ana Paula Tagliari

    2013-03-01

    Full Text Available FUNDAMENTO: Desde que Wilcox, em 1997, descreveu uma forma simplificada de correção do Defeito Septal Atrioventricular (DSAV com enxerto único, diversos estudos têm sido realizados comparando-a à técnica com duplo enxerto. OBJETIVO: Relatar os resultados em médio e longo prazos da correção de DSAV completo pela técnica simplificada de enxerto único. MÉTODOS: Estudo retrospectivo de 16 casos consecutivos arrolados entre janeiro de 2001 e dezembro de 2011. A idade média foi 18,31 ± 34,19 meses (2 meses - 11 anos e o peso 7,80 ± 6,12 Kg (3,77 - 25,0 Kg; 6 pacientes eram do sexo masculino e 14 eram portadores de Síndrome de Down. O tempo de seguimento médio foi de 54,97 ± 47,79 meses. RESULTADOS: O tempo médio de circulação extracorpórea foi 74,63 ± 18,48 min (49 - 112 min e o de pinçamento aórtico, de 46,44 ± 11,89 min (34 - 67 min. Foram observados dois óbitos hospitalares (12,5%, ambos por causa cardiovascular. Três pacientes foram reoperados por regurgitação da valva atrioventricular (VA esquerda e dois apresentaram bloqueio atrioventricular (BAV completo com necessidade de implante de marca-passo definitivo. Não houve nenhum caso de obstrução da via de saída do ventrículo esquerdo. Os 14 pacientes sobreviventes permanecem assintomáticos, 10 deles com insuficiência da valva VA esquerda leve (71,42%. CONCLUSÃO: A técnica simplificada com enxerto único para correção de DSAV completo mostrou-se factível, associada à correção adequada dos defeitos e à favorável evolução clínica e ecocardiográfica nos 57,97 meses de seguimento médio avaliados.

  18. Interatrial shunt. Diagnosis of patent foramen ovale and atrial septal defect with 64-row coronary computed tomography angiography

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the frequency with which interatrial shunts are found during routine coronary computed tomography (CT) angiography and to describe imaging characterizations of patent foramen ovale (PFO), atrial septal defect (ASD), and atrial septal aneurysm (ASA). A total of 1081 adult patients were evaluated retrospectively for interatrial shunting; 77 were excluded from the study. CT diagnosis of PFO was defined as (1) a channel-like appearance of the interatrial septum (IAS) and (2) a contrast agent jet flow from the left atrium (LA) to the right atrium (RA). ASD was defined as (1) the IAS resembling a membrane with a hole and (2) a contrast jet flow between the two atria. ASA was identified by detecting a minimum 10-mm protrusion of the LA beyond the IAS into the RA. Among 1004 patients, 86 patients (8.6%) were diagnosed to have PFO. Another 23 patients (2.3%) had a hole in the IAS and were diagnosed as having ASD: 21 with an ostium secundum-type ASD and 2 with the sinus venosus type. ASA accompanied ASD in three patients. Electrocardiography-gated CT using the saline-chaser contrast injection technique that is routinely used for coronary arterial imaging can be used to detect interatrial shunts. The technique can also serve as a method for differentiating PFO, ASD, and ASA. (author)

  19. Transcatheter closure of secundum atrial septal defect in adults: report of our first experience in a developing country

    Directory of Open Access Journals (Sweden)

    Animasahun BA

    2014-04-01

    Full Text Available B Adeola Animasahun,1 Yele Aluko,2 Adeyemi Johnson,3 Kofo Ogunyankin,3 Sunita Maheshwari41Department of Paediatrics and Child Health, Lagos State University College of Medicine, Lagos, Nigeria; 2Mid Carolina Cardiology, Charlotte, NC, USA; 3First Cardiology Consultants, Lagos, Nigeria; 4Narayana Hrudayalaya Institute of Cardiac Sciences, Bangalore, IndiaBackground: Since the first report on device closure of atrial septal defect (ASD in 1976, the procedure has gained wide acceptance and has been used worldwide, including parts of Africa. The advantages when compared to surgical closure include a shorter procedure time and hospital stay and no scarring. This mode of treatment was not available in Nigeria prior to the cases reported here, requiring patients to travel abroad for the procedure.Methods: A cardiac catheterization laboratory became available in Lagos, Nigeria in 2009, and in December 2010 the laboratory collaborated with Lagos State University College of Medicine and Lagos State University Teaching Hospital to perform the device closure on two women (aged 34 and 62 years with secundum ASD. To the best of our knowledge, these are the first times the procedure has been performed in Nigeria.Results: Both patients made successful recovery and are stable.Conclusion: Transcatheter closure of ASD is now safe and available in Nigeria.Keywords: atrial septal defect, transcatheter closure, Nigeria

  20. ANAESTHETIC MANAGEMENT OF AN ADULT PATIENT WITH UNCORRECTED VENTRICULAR SEPTAL DEFECT POSTED FOR OBSTRUCTED INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Shivaramu

    2015-08-01

    Full Text Available Adults with unrepaired acyanotic heart disease scheduled for a non - cardiac surgery present serious concerns for the anaesthesiologists. Ventricular septal defect (VSD, is an acyanotic congenital heart disease, characterized by a left to right shunt. The incidence varies between 2 to 6 per 1000 live births. It is found in 30% to 60% of all the newborns with congenital heart disease, thus making it one of the most common congenital heart diseases VSD is the commonest form of CHD. Unlike ASD, the majority will undergo spontaneous closure : 40% by the age of 2yr and 90% by the age of 10 yr . 1 The goal of anesthetic management should be to maintain intravascular volume. Systemic and pulmonary vascular resistance changes, such as might occur due to acidosis, hypothermia, hypercarbia or excessive airway pressures, should be avoided. Maintenance of preload, contractility and sinus rhythm is of major importance. The c omplex pathophysiologies of such heart disease, in addition to the circumstances of emergency operation, exacerbate the total anesthetic risk. We present here a rare case of obstructed right sided inguinal hernia repair with successful outcome in an adult with ventricular septal defect.

  1. Widespread blunting of hypothalamic and amygdala-septal activity and behavior in rats with long-term hyperglycemia.

    Science.gov (United States)

    Moreno-Cortés, M L; Gutiérrez-García, A G; Guillén-Ruiz, G; Romo-González, T; Contreras, C M

    2016-09-01

    Anxiety and depression in diabetic patients contributes to a poor prognosis, but possible causal relationships have been controversial. Anxiety, fear, and anhedonia are mediated by interactions between different deep structures of the temporal lobe (e.g., amygdala complex and hippocampus) and other forebrain-related structures (e.g., lateral septal nucleus). Connections between these structures and the hypothalamic orexinergic system are necessary for the maintenance of energy and wakefulness. However, few studies have explored the impact of long-term hyperglycemia in these structures on anxiety. We induced long-term hyperglycemia (glucose levels of ∼500mg/dl) in Wistar rats by injecting them with alloxan and simultaneously protecting them from hyperglycemia by injecting them daily with a low dose of insulin (i.e., just enough insulin to avoid death), thus maintaining hyperglycemia and ketonuria for as long as 6 weeks. Compared with controls, long-term hyperglycemic rats exhibited a significant reduction of Fos expression in the lateral septal nucleus and basolateral amygdala, but no differences were found in cerebellar regions. Orexin-A cells appeared to be inactive in the lateral hypothalamus. No differences were found in sucrose consumption or behavior in the elevated plus maze compared with the control group, but a decrease in general locomotion was observed. These data indicate a generalized blunting of the metabolic brain response, accompanied by a decrease in locomotion but no changes in hedonic- or anxiety-like behavior. PMID:27173433

  2. Diffusion of hyperpolarized 129Xe in the lung: a simplified model of 129Xe septal uptake and experimental results

    Science.gov (United States)

    Patz, Samuel; Muradyan, Iga; Hrovat, Mirko I.; Dabaghyan, Mikayel; Washko, George R.; Hatabu, Hiroto; Butler, James P.

    2011-01-01

    We used hyperpolarized 129Xe NMR to measure pulmonary alveolar surface area per unit gas volume SA/Vgas, alveolar septal thickness h and capillary transit time τ, three critical determinants of the lung's primary role as a gas exchange organ. An analytical solution for a simplified diffusion model is described, together with a modification of the xenon transfer contrast imaging technique utilizing 90° radio-frequency pulses applied to the dissolved phase, rather than traditional 180° pulses. With this approach, three-dimensional (3D) maps of SA/Vgas were obtained. We measured global SA/Vgas, h and τ in four normal subjects, two subjects with mild interstitial lung disease (ILD) and two subjects with mild chronic obstructive pulmonary disease (COPD). In normals, SA/Vgas decreased with increasing lung volume from ~320 to 80 cm-1 both h~13 μm and τ~1.5 s were relatively constant. For the two ILD subjects, h was, respectively, 36 and 97% larger than normal, quantifying an increased gas/blood tissue barrier; SA/Vgas and τ were normal. The two COPD subjects had SA/Vgas values ~25% that of normals, quantifying septal surface loss in emphysema; h and τ were normal. These are the first noninvasive, non-radiation-based, quantitative measurements of h and τ in patients with pulmonary disease.

  3. Diffusion of hyperpolarized 129Xe in the lung: a simplified model of 129Xe septal uptake and experimental results

    International Nuclear Information System (INIS)

    We used hyperpolarized 129Xe NMR to measure pulmonary alveolar surface area per unit gas volume SA/Vgas, alveolar septal thickness h and capillary transit time τ, three critical determinants of the lung's primary role as a gas exchange organ. An analytical solution for a simplified diffusion model is described, together with a modification of the xenon transfer contrast imaging technique utilizing 900 radio-frequency pulses applied to the dissolved phase, rather than traditional 1800 pulses. With this approach, three-dimensional (3D) maps of SA/Vgas were obtained. We measured global SA/Vgas, h and τ in four normal subjects, two subjects with mild interstitial lung disease (ILD) and two subjects with mild chronic obstructive pulmonary disease (COPD). In normals, SA/Vgas decreased with increasing lung volume from ∼320 to 80 cm-1; both h∼13 μm and τ∼1.5 s were relatively constant. For the two ILD subjects, h was, respectively, 36 and 97% larger than normal, quantifying an increased gas/blood tissue barrier; SA/Vgas and τ were normal. The two COPD subjects had SA/Vgas values ∼25% that of normals, quantifying septal surface loss in emphysema; h and τ were normal. These are the first noninvasive, non-radiation-based, quantitative measurements of h and τ in patients with pulmonary disease.

  4. Thallium-201 evidence that anterior ST segment depression during early acute inferior myocardial infarction reflects septal or posterolateral ischemic injury

    International Nuclear Information System (INIS)

    The pathogenesis of anterior (ANT) ST segment depression (ST decreasing) during acute inferior myocardial infarction (IMI) remains controversial. To evaluate the role of septal (S) or posterolateral (PL) ischemic injury (IS), resting thallium-201 (T1-201) scintigrams closely timed to ECG findings (mean 21+-21 minutes) were evaluated in 49 consecutive pts during the first 5 hrs of a first acute IMI. ANT ST decreasing (any lead V1-V4) of ≥ 1.0 mm was considered significant. All 49 pts had inferior T1-201 defects. In all 38 pts with ANT ST decreasing, there was T1-201 evidence of PL and/or S IS. In 9 of 11 pts without ANT ST decreasing, IS was confined to the inferior wall. The magnitude of inferior lead ST segment elevation correlated well with ST decreasing in leads 1 and AVL (r=0.88) and poorly with ST decreasing in anterior leads (r=0.32, supporting the concept that in acute IMI, ST decreasing in 1 and AVL is a reciprocal electrical phenomenon, but that ANT ST decreasing has a different pathogenesis. Thus the authors conclude that anterior ST depression in acute inferior myocardial infarction is associated with additional septal and/or posterolateral ischemic injury and does not reflect a benign reciprocal electrical phenomenon

  5. Coronary to pulmonary fistula as the primary source of pulmonary blood supply in pulmonary atresia with ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Isman Firdaus

    2004-12-01

    Full Text Available A communication between the coronary and pulmonary arteries, so called coronary to pulmonary fistula, is a rare source of pulmonary supply in pulmonary atresia (PA with ventricular septal defect (VSD. A 4 year old girl referred to National Cardiovascular Center Harapan Kita, Jakarta with symptoms and signs of increased pulmonary blood flow since infancy and was confirmed by the chest x-rays. Heart examination revealed normal first heart sound with single loud second heart sound and an ejection systolic murmur at the pulmonary area. ECG demonstrated sinus rhythm with normal axis and biventricular hypertrophy. Echocardiography was performed and truncus arteriosus (TA type I was suspected with perimembranus VSD, overriding of the aorta, and dilated main pulmonary artery. But on cardiac catheterization studies, a non obstructive fistula was found between the left coronary and main pulmonary artery coexisted with PA and VSD. A successful surgery was performed subsequently and confirmed the above diagnosis. Although there were episodes of pulmonary hypertension crisis during early post operative course, she was then discharge from the hospital in a good condition. Since irreversible pulmonary vascular disease may develop in a non restrictive coronary to pulmonary fistula, early recognition of this anomaly is very important for better surgical result. (Med J Indones 2004; 13: 237-40Keywords: coronary to pulmonary fistula, pulmonary atresia, ventricular septal defect

  6. Anaesthetic management of a child with "cor-triatriatum" and multiple ventricular septal defects - A rare congenital anomaly

    Directory of Open Access Journals (Sweden)

    Sriram Sabade

    2010-01-01

    Full Text Available Cor-triatriatum is a rare congenital cardiac anomaly. It accounts for 0.1% of congenital heart diseases. Its association with multiple ventricular septal defects (VSD is even rarer. A five-month-old baby was admitted with respiratory distress and failure to thrive. Clinical examination revealed diastolic murmur over mitral area. Chest X-ray showed cardiomegaly. Haematological and biochemical investigations were within normal limits. Electrocardiogram showed left atrial enlargement. 2D echo showed double-chambered left atrium (cor-triatriatum, atrial septal defect (ASD and muscular VSD with moderate pulmonary arterial hypertension. The child was treated with 100% oxygen, diuretics and digoxin and was stabilized medically. We used balanced anaesthetic technique using oxygen, air, isoflurane, fentanyl, midazolam and vecuronium. Patient was operated under cardiopulmonary bypass (CPB with moderate hypothermia. Through right atriotomy abnormal membrane in the left atrium was excised to make one chamber. VSD were closed with Dacron patches and ASD was closed with autologous pericardial patch. Patient tolerated the whole procedure well and was ventilated electively for 12h in the intensive care unit. He was discharged on the 10 th postoperative day.

  7. Warden repair for superior sinus venosus atrial septal defect and anomalous pulmonary venous drainage in children: Anesthesia and transesophageal echocardiography perspectives

    OpenAIRE

    Neelam Aggarwal; Shrinivas Gadhinglajkar; Rupa Sreedhar; Baiju S Dharan; Keerthi Chigurupati; Saravana Babu

    2016-01-01

    Objective: Review of intraoperative anesthetic challenges and the role of transesophageal echocardiography in children with sinus venosus atrial septal defect and partial anomalous pulmonary venous drainage undergoing Warden repair. Design: A retrospective observational case series. Methodolgy: Pediatric patients who underwent Warden repair between October 2011-September 2015 were recruited. Their preoperative clinical details, anesthetic techniques, intraoperative TEE findings and postoperat...

  8. Switching from Contextual to Tone Fear Conditioning and Vice Versa: The Key Role of the Glutamatergic Hippocampal-Lateral Septal Neurotransmission

    Science.gov (United States)

    Calandreau, Ludovic; Desgranges, Bertrand; Jaffard, Robert; Desmedt, Aline

    2010-01-01

    The aim of the present experiment was to directly assess the role of the glutamatergic hippocampal-lateral septal (HPC-LS) neurotransmission in tone and contextual fear conditioning. We found that pretraining infusion of glutamatergic acid into the lateral septum promotes tone conditioning and concomitantly disrupts contextual conditioning.…

  9. Maternal alcohol drinking pattern during pregnancy and the risk for an offspring with an isolated congenital heart defect and in particular a ventricular septal defect or an atrial septal defect

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Katrine; Skov-Ettrup, Lise Skrubbeltrang; Grønbaek, Morten; Andersen, Anne-Marie Nybo; Olsen, Jørn; Tolstrup, Janne Schurmann

    2011-01-01

    alcohol. Few (if any) women with an excessive/abusive intake of alcohol were enrolled into the Danish National Birth Cohort. RESULTS: Through linkage with the National Hospital Discharge Registry, we identified 477 infants with a diagnosis of isolated congenital heart defect registered at any time during...... their first 3½-years of life; they included 198 infants with a VSD and 145 with an ASD. Neither the number of episodes of binge drinking nor binge drinking during three different developmental periods was associated with VSD or ASD. Women drinking ½-1½, 2, and 3+ drinks of alcohol per week had adjusted......BACKGROUND: This cohort study examines the possible association between maternal alcohol intake, including binge drinking, during pregnancy, and the subsequent risk of having a child with an isolated congenital heart defect and, more specifically, with the isolated form of ventricular septal defect...

  10. Impact of percutaneous coronary intervention on biomarker levels in patients in the subacute phase following myocardial infarction: the Occluded Artery Trial (OAT) biomarker ancillary study

    OpenAIRE

    Kruk, Mariusz; Menon, Venu; Kądziela, Jacek; Sadowski, Zygmunt; Rużyłło, Witold; Janas, Jadwiga; Roik, Marek; Opolski, Grzegorz; Zmudka, Krzysztof; Czunko, Piotr; Kurowski, Michal; Busz-Papież, Benita; Zinka, Elzbieta; Jablonski, Wojciech; Jaworska, Krystyna

    2013-01-01

    Background The purpose of the Occluded Artery Trial (OAT) Biomarker substudy was to evaluate the impact of infarct related artery (IRA) revascularization on serial levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and dynamics of other biomarkers related to left ventricular remodeling, fibrosis and angiogenesis. Methods Patients were eligible for OAT-Biomarker based on the main OAT criteria. Of 70 patients (age 60.8 ± 8.8, 25% women) enrolled in the substudy, 37 were ra...

  11. Defecto septal atrioventricular: Estudio anatomopatológico y correlación embriológica

    OpenAIRE

    Kuri Nivon,Magdalena; Martínez Martínez,Edith; Muñoz Castellanos,Luis; Espínola Zavaleta,Nilda

    2008-01-01

    El defecto septal atrioventricular es una cardiopatía congénita compleja en la que no sólo están deficientes los tabiques cardíacos, sino que muestra otras alteraciones anatómicas en el corazón expresadas en un amplio espectro a nivel de la unión atrioventricular común. En este trabajo se muestra la experiencia anatomopatológica de esta cardiopatía en el Instituto Nacional de Cardiología "Ignacio Chávez" y se elabora una correlación anatomoembriológica para inferir su patogenia. Se analizaron...

  12. Study on ventilation-perfusion lung scintigraphy before and after closed surgery for atrial septal defect with persistent ostium secundum

    International Nuclear Information System (INIS)

    To examine changes of ventilation and perfusion distribution before and after closed surgery in atrial septal defect (ASD), a total of 25 ventrilation-perfusion lung scintigraphies were performed in a supine position in 15 ASD patients. Their ages ranged from one year and 11 months to 23 years (an average age of 7 years and one month). Ventilation and perfusion distribution was almost uniform before surgery. Preoperative time constant obtained from Xe-133 washout curve had a positive correlation with pulmonary blood flow per pulmonary volume. Although preoperative higher perfusion was seen in the upper lobe, perfusion tended to be uniform after surgery. Non-uniform distribution of ventilation/perfusion ratio became uniform within a few weeks after surgery. (N.K.)

  13. Mineral associated and aggregate-occluded soil carbon decreased with increasing nitrogen and residue input for three decades

    Science.gov (United States)

    Shahbaz, Muhammad; Kuzyakov, Yakov; Heitkamp, Felix

    2016-04-01

    Cropland soils may be a source or sink for atmospheric CO2. Therefore, effects of cropland management and fertilization on soil organic carbon (SOC) can be assessed best in long-term experiments. Generally, it is assumed that change in SOC is linearly related to C-input into the soil. However, recently it has been shown that residue incorporation resulted to only small extents in the increase of SOC levels. This gives rise to environmental concerns regarding the efficient use of crop residue. Such concerns are also applicable for the well designed and documented long-term experiment of Puch, Germany, in a silt-loam soil. The crop rotation is winter barley - winter wheat - silage maize. Five organic amendments were combined with N-fertiliser rates. The levels of organic amendments are unamended control (CON), straw was removed; farmyard manure (FYM), straw was removed; straw incorporation (STR); slurry application (SLU), straw was removed; and straw incorporation combined with slurry application (STSL). Three levels of mineral fertilizer application were selected: no nitrogen (N0); medium, 100 kg N ha-1year-1 (N2); and high, 200 kg N ha-1 year-1 (N4). These treatments resulted in a wide range of mean annual carbon input (1 - 5 t C ha-1 year-1). We hypothesize that the amount of soil carbon stored in different fractions will increase with C-input, but the effect will decrease in the order free light fraction (f-LF), occluded light fraction (o-LF) and heavy mineral-associated fraction (HF). Soil samples were fractionated by density using sodium polytungstate (1.6 g cm-3). Compared to the starting value SOC was lost in STR and CON and increased in SLU and STSL, whereas FYM showed no differences to initial carbon stocks. However, N additions resulted in only slightly increase in SOC contents with reference to C-input. The lower amount of o-LF carbon in CON and STR demonstrated the low ability of crop residue in comparison to animal manures to build up SOC contents

  14. Adrenoceptors of the medial septal area modulate water intake and renal excretory function induced by central administration of angiotensin II

    Directory of Open Access Journals (Sweden)

    Saad W.A.

    2002-01-01

    Full Text Available We investigated the role of alpha-adrenergic antagonists and clonidine injected into the medial septal area (MSA on water intake and the decrease in Na+, K+ and urine elicited by ANGII injection into the third ventricle (3rdV. Male Holtzman rats with stainless steel cannulas implanted into the 3rdV and MSA were used. ANGII (12 nmol/µl increased water intake (12.5 ± 1.7 ml/120 min. Clonidine (20 nmol/µl injected into the MSA reduced the ANGII-induced water intake (2.9 ± 0.5 ml/120 min. Pretreatment with 80 nmol/µl yohimbine or prazosin into the MSA also reduced the ANGII-induced water intake (3.0 ± 0.4 and 3.1 ± 0.2 ml/120 min, respectively. Yohimbine + prazosin + clonidine injected into the MSA abolished the ANGII-induced water intake (0.2 ± 0.1 and 0.2 ± 0.1 ml/120 min, respectively. ANGII reduced Na+ (23 ± 7 µEq/120 min, K+ (27 ± 3 µEq/120 min and urine volume (4.3 ± 0.9 ml/120 min. Clonidine increased the parameters above. Clonidine injected into the MSA abolished the inhibitory effect of ANGII on urinary sodium. Yohimbine injected into the MSA also abolished the inhibitory effects of ANGII. Yohimbine + clonidine attenuated the inhibitory effects of ANGII. Prazosin injected into the MSA did not cause changes in ANGII responses. Prazosin + clonidine attenuated the inhibitory effects of ANGII. The results showed that MSA injections of alpha1- and alpha2-antagonists decreased ANGII-induced water intake, and abolished the Na+, K+ and urine decrease induced by ANGII into the 3rdV. These findings suggest the involvement of septal alpha1- and alpha2-adrenergic receptors in water intake and electrolyte and urine excretion induced by central ANGII.

  15. A hazardous finding of a rare anomalous left main coronary artery in a patient with a secundum atrial septal defect

    Directory of Open Access Journals (Sweden)

    Michael Emery

    2008-02-01

    Full Text Available Michael Emery1, Waqas Ghumman1, Shawn Teague2, Jo Mahenthiran11Krannert Institute of Cardiology, 2Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana, USAAbstract: A 23-year-old male referred for evaluation of a “choking” sensation with exertion and a murmur. A transthoracic echocardiogram demonstrated right atrial and ventricular dilatation, right ventricular volume overload, and a large secundum atrial septal defect (ASD with left to right shunt and a calculated pulmonary-to-systemic blood flow ratio (Qp/Qs estimated at 2.3 to 1. Cardiac catheterization also demonstrated evidence of the ASD with Qp/Qs of 4.6 to 1 with a significant step-up in oxygen saturation at the right atrial level. Additionally, an anomalous left main coronary artery (ALMCA origin from the anterior right coronary cusp was suspected. Using 64-slice multidetector computed tomography coronary angiography (CCTA the left main coronary artery was seen to arise from the right coronary cusp then traverse between the pulmonary trunk and the proximal ascending aorta before bifurcating into the left anterior descending and circumflex arteries that followed their normal courses distally. Based on the high risk nature of associated sudden death from an anomalous left main coronary artery (ALMCA coursing between the aorta and the pulmonary trunk, the patient underwent surgical re-implantation of the ALMCA to the left coronary cusp and repair of the ASD. This case highlights a rare finding of a hazardous ALMCA in a patient with a secundum ASD and the utility of CCTA in evaluating the course of coronary anomalies along with other cardiac pathology.Keywords: atrial septal defect, anomalous coronary artery, congenital heart disease

  16. Measurement of Atrial Septal Defect Size: A Comparative Study between Transesophageal Echocardiography and Balloon Occlusive Diameter Method

    Directory of Open Access Journals (Sweden)

    Bahareh Eslami

    2010-05-01

    Full Text Available Background: Transcatheter closure of atrial septal defect secundum (ASD-II has become an alternative method for surgery. We sought to compare the two-dimensional transesophageal echocardiography (TEE method for measuring atrial septal defect with balloon occlusive diameter (BOD in transcatheter ASD-II closure.Methods: A total of 39 patients (71.1% female, mean age: 35.31 ± 15.37 years who underwent successful transcatheter closure of ASD-II between November 2005 and July 2008 were enrolled in this study. Transthoracic echocardiography (TTE and TEE were performed to select suitable cases for device closure and measure the defect size before the procedure, and BOD measurement was performed during catheterization via TEE. The final size of the selected device was usually either equal to or 1 – 2 mm larger than the BOD of the defect.Results: The mean defect size obtained by TEE and BOD was 18.50 ± 5.08 mm and 22.86 ± 4.76 mm, respectively. The mean difference between the values of ASD size obtained by TEE and BOD was 4.36 ± 2.93 mm. In comparison with BOD, TEE underestimated the defect size in 94.9%, but TEE value being equal to BOD was observed in 5.1%. There was a good linear correlation between the two measurements: BOD = 0.773 × ASD size by TEE+8.562; r2 = 67.9.1%. A negative correlation was found between TEE sizing and the difference between BOD and TEE values (r = -0.394, p value = 0.013.Conclusion: In this study, BOD was larger than ASD size obtained by two-dimensional TEE. However, TEE maximal defect sizing correlates with BOD and may provide credible information in device size selection for transcatheter ASD closure.

  17. MORPHOLOGICAL STUDIES OF OCCLUDED PROCESSES IN THALASSIOSIRA SPECIES FROM CHINA%我国沿海闭合突海链藻的形态学研究

    Institute of Scientific and Technical Information of China (English)

    李扬; 赵秋兰; 吕颂辉

    2012-01-01

    Thalassiosira along Chinese coastal waters, water samples were collected from different locations. Thalassiosira specimens within these samples as well as several clonal strains isolated from natural samples were studied using scanning electron microscopy. All samples were fixed with Lugo's solution and were concentrated to a final volume about 2?0 mL by settling overnight for several times. For observation under scanning electron microscope, sub-samples were taken and treated in several steps. Firstly, after the same volume of concentrated H2SO4 was added, these samples were boiled in the water bath for about 10?5 minutes to remove organic materials. Secondly, these samples were rinsed with distilled water several times to rid the acid. Then, these samples were coated by gold and thus could be observed, identified, and photographed under scanning electron microscope. The morphology and pattern of processes, including three types, fultoportula, rimoportula and occluded process, are key taxonomic characteristics for Thalassiosira species, even for some pennatae diatoms. Fultoportula and rimoportula are very common structures in all Thalassiosira taxa, while occluded process is just found in no more than 20 taxa from presently known 150 reported Thalassiosira species. The different features between occluded process and other two types of process is that occluded process does not penetrate the valve, so there is no structure of occluded process on the internal valve face. Previous reports about Thalassiosira species with occluded processes from China coast were rare, and almost no EM photos of occluded processes have been provided. In present study, five Thalassiosira species with occluded processes were observed and they were T. ce-darkeyensis Prasad, T. eccentrica (Ehrenberg) Cleve, T. lundiana Fryxell, T. punctigera (Castracane) Hasle and T. tubif-era Fryxell. Three of them are newly recorded species for China, T. cedarkeyensis, T punctigera and T. tubifera. The detailed

  18. Análise dos fatores de risco na correção cirúrgica do defeito septal atrioventricular de forma total Risk factors analysis in the surgical repair of complete atrioventricular septal defect

    Directory of Open Access Journals (Sweden)

    Eduardo Keller Saadi

    1993-06-01

    Full Text Available Pacientes com defeito septal atrioventricular de forma total (DSAVT freqüentemente apresentam insuficiência cardíaca intratável e hipertensão arterial pulmonar nos primeiros meses de vida, e apenas uma minoria sobrevive sem tratamento cirúrgico precoce. Por essa razão, indica-se a correção definitiva para alterar favoravelmente a história natural da doença. Entretanto, vários fatores são responsáveis pela alta mortalidade cirúrgica. O presente trabalho estuda a experiência na correção cirúrgica do DSAVT com o objetivo de identificar alguns fatores de risco estatisticamente significativos para a ocorrência de morte operatória. Analisaram-se, retrospectivamente, 52 pacientes submetidos, entre janeiro de 1974 e dezembro de 1990, a cirurgia definitiva para correção de DSAVT no Royal Brompton and National Heart and Lung Institute, sendo estudadas as seguintes variáveis: idade, peso, sexo, ano da operação, presença de síndrome de Down, grau de regurgitação da valva AV, bandagem prévia do tronco pulmonar, presença de anomalias associadas, pressão sistólica pulmonar, duplo orifício mitral, classificação do defeito segundo Rastelli, emprego de parada circulatória e técnica de correção (1 x 2 retalhos. Todos os fatores foram avaliados isoladamente, mediante a análise univariada. Para determinar quais os fatores que, independentemente da ação de outros, contribuíram significativamente para maior mortalidade cirúrgica, foi utilizada a análise multivariada com regressão logística. A análise multivariada demonstrou que o baixo peso na época da operação e a técnica de correção com um retalho aumentam significativamente a mortalidade cirúrgica.Patients with complete atrioventricular septal defects (CAVSD frequently present with severe heart failure which cannot be controllable medically and pulmonary hypertension in infancy. Just a small number survives without early surgical treatment. For this reason

  19. [Tetralogy of Fallow with Total Anomalous Pulmonary Vein Return and Atrial Septal Defect;Successful Two-staged Surgical Management;Report of a Case].

    Science.gov (United States)

    Maekawa, Yoshiyuki; Miyahara, Yoshinori; Yoshizumi, Ko; Kawada, Masaaki; Minami, Takaomi; Sato, Tomoyuki; Yokomizo, Akiko; Oka, Kensuke; Furui, Sadahiro; Kataoka, Koichi

    2016-09-01

    A combination of tetralogy of Fallot( TOF) and total anomalous pulmonary venous return(TAPVR) is rare and results in chronic volume and pressure load of the right side of the heart and underfilling of the left heart. We report a successful 2-staged surgical correction of TOF associated with TAPVR and atrial septal defect. The patient was unsuitable for total primary intracardiac correction because the volume of the left ventricle was considered to be small. First, repair of anomalous pulmonary venous return and palliative right ventricle outflow tract reconstruction were simultaneously performed in 2 months of birth. One year after 1st operation, cardiac catheterization revealed that normalization of left ventricle volume, so 2nd operation was planned. Total correction of ventricular septal defect and right ventricle outflow reconstruction was performed and the patient was discharged on the 21st postoperative day with good hemodynamic status. PMID:27586317

  20. Post-traumatic fulminant paradoxical fat embolism syndrome in conjunction with asymptomatic atrial septal defect: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Nerlich Michael

    2011-04-01

    Full Text Available Abstract Introduction Fat embolism syndrome with respiratory failure after intramedullary nailing of a femur fracture is a rare but serious complication in trauma patients. Case presentation We present the case of a 20-year-old Caucasian man who experienced paradoxical cerebral fat embolism syndrome with fulminant progression after intramedullary nailing of a femur fracture, in conjunction with a clinically asymptomatic atrial septal defect in a high position resulting in a right-to-left shunt. Conclusion Fat embolism syndrome may occur as a fulminant complication following femoral fracture repair in the presence of a concomitant atrial septal defect with right-to-left shunt. Thus, in patients with cardiac right-to-left shunts, femurs should not be nailed intramedullary, not even in cases of isolated injuries.

  1. Axotomy-induced neurotrophic withdrawal causes the loss of phenotypic differentiation and downregulation of NGF signalling, but not death of septal cholinergic neurons

    Directory of Open Access Journals (Sweden)

    Inestrosa Nibaldo C

    2010-01-01

    Full Text Available Abstract Background Septal cholinergic neurons account for most of the cholinergic innervations of the hippocampus, playing a key role in the regulation of hippocampal synaptic activity. Disruption of the septo-hippocampal pathway by an experimental transection of the fimbria-fornix drastically reduces the target-derived trophic support received by cholinergic septal neurons, mainly nerve growth factor (NGF from the hippocampus. Axotomy of cholinergic neurons induces a reduction in the number of neurons positive for cholinergic markers in the medial septum. In several studies, the reduction of cholinergic markers has been interpreted as analogous to the neurodegeneration of cholinergic cells, ruling out the possibility that neurons lose their cholinergic phenotype without dying. Understanding the mechanism of cholinergic neurodegeneration after axotomy is relevant, since this paradigm has been extensively explored as an animal model of the cholinergic impairment observed in neuropathologies such as Alzheimer's disease. The principal aim of this study was to evaluate, using modern quantitative confocal microscopy, neurodegenerative changes in septal cholinergic neurons after axotomy and to assess their response to delayed infusion of NGF in rats. Results We found that there is a slow reduction of cholinergic cells labeled by ChAT and p75 after axotomy. However, this phenomenon is not accompanied by neurodegenerative changes or by a decrease in total neuronal number in the medial septum. Although the remaining axotomized-neurons appear healthy, they are unable to respond to delayed NGF infusion. Conclusions Our results demonstrate that at 3 weeks, axotomized cholinergic neurons lose their cholinergic phenotype without dying and down-regulate their NGF-receptors, precluding the possibility of a response to NGF. Therefore, the physiological role of NGF in the adult septal cholinergic system is to support phenotypic differentiation and not survival

  2. The Role of Nasopharyngeal Temperature Monitoring in Detection of a Malpositioned Superior Vena Cava Cannula in an Emergency Coronary Artery Bypass in a Patient With Ventricular Septal Defect

    OpenAIRE

    Dabbagh, A; M Shahzamani; M Foroughi; K Ghods; M Ghomeisi; Rahimian, H.

    2010-01-01

    A 55 year-old woman was admitted to the CCU ward of our university hospital due to typical chest pain. The patient received supportive care and was transferred to the operating room for an emergency repair of the ventricular septal defect (VSD) and myocardial revascularization. The surgical team was notified regarding the tolerance to cooling detected by the temperature monitoring and also, the congestion of eye and blanching of forehead. After a few maneuvers, the cannula was repositioned. I...

  3. Impact of incidental amyloidosis on the prognosis of patients with hypertrophic cardiomyopathy undergoing septal myectomy for left ventricular outflow tract obstruction.

    Science.gov (United States)

    Helder, Meghana R K; Schaff, Hartzell V; Nishimura, Rick A; Gersh, Bernard J; Dearani, Joseph A; Ommen, Steve R; Mereuta, Oana M; Theis, Jason D; Dogan, Ahmet; Edwards, William D

    2014-11-01

    To determine the impact of amyloid on the prognosis of patients with hypertrophic cardiomyopathy (HC), we reviewed outcomes of patients who underwent septal myectomy for HC from March 7, 1996, to October 9, 2012, with amyloid deposits identified in operative specimens. Amyloid subtypes were differentiated by mass spectrometry-based proteomics. The survival rate was compared with that of an age-matched population (2:1) without amyloid who underwent septal myectomy for HC. Sixteen patients (mean age ± SD 71 ± 8 years; 12 men) met study criteria. All 16 had intraventricular peak systolic gradients reduced intraoperatively from 105 ± 53 mm Hg to 3 ± 7 mm Hg (p Amyloid deposits in specimens ranged from minimal to mild. Nine patients had senile (transthyretin-type) amyloidosis, 4 had immunoglobulin-associated amyloidosis, 2 had apolipoprotein A4 amyloidosis type, and 1 had serum amyloid A type. There were no deaths before 30 days. Twelve patients had New York Heart Association class III or IV function preoperatively, and at last follow-up (median 3 years), class I or II. Only 1 patient received postoperative amyloidosis treatment. The postoperative survival rate at 2 and 4 years was 100% (n = 11 at risk) and 91% (n = 6 at risk), respectively, similar to that of the age-matched population with HC without amyloid who underwent myectomy (p = 0.13). Patients undergoing septal myectomy for HC who have histologic evidence of mild amyloidosis have early outcomes and midterm survival similar to those of patients with HC without amyloidosis who undergo myectomy. In conclusion, although longer follow-up is necessary, small amounts of amyloid, regardless of subtype, do not confer a poor prognosis on patients with HC who undergo septal myectomy. PMID:25217455

  4. Right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle and ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Chirantan Mangukia

    2014-01-01

    Full Text Available Herein, we report an unusual case of right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle with ventricular septal defect. The blood supply to the innominate artery was by a collateral arising from the descending aorta. The embryological development of this anomaly can be explained by the hypothetical double aortic arch model proposed by Edwards with interruption of the arch at two levels.

  5. Right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle and ventricular septal defect.

    Science.gov (United States)

    Mangukia, Chirantan; Sethi, Sonali; Agarwal, Saket; Mishra, Smita; Satsangi, Deepak Kumar

    2014-05-01

    Herein, we report an unusual case of right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle with ventricular septal defect. The blood supply to the innominate artery was by a collateral arising from the descending aorta. The embryological development of this anomaly can be explained by the hypothetical double aortic arch model proposed by Edwards with interruption of the arch at two levels. PMID:24987265

  6. Visualization of transcoronary ablation of septal hypertrophy in patients with hypertrophic obstructive cardiomyopathy: a comparison between cardiac MRI, invasive measurements and echocardiography

    OpenAIRE

    Sohns, Christian; Sossalla, Samuel; Schmitto, Jan D; Jacobshagen, Claudius; Raab, Björn; Obenauer, Silvia; Maier, Lars S.

    2010-01-01

    Objective Hypertrophic obstructive cardiomyopathy (HOCM) is treated by surgical myectomy or transcoronary ablation of septal hypertrophy (TASH). The aim of this study was to visualize the feasibility, success and short-term results of TASH on the basis of cardiac MRI (CMR) in comparison with cardiac catheterization and echocardiography. Methods In this in vivo study, nine patients with HOCM were treated with TASH. Patients were evaluated by transthoracic echocardiography, invasive cardiac ang...

  7. Pulmonary atresia and ventricular septal defect with collaterals to right lung associated with anomalous left pulmonary artery from the ascending aorta

    Energy Technology Data Exchange (ETDEWEB)

    Khositseth, Anant [Mahidol University, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Bangkok (Thailand); Siripornpitak, Suvipaporn; Pornkul, Ratanaporn [Mahidol University, Department of Radiology, Ramathibodi Hospital, Bangkok (Thailand)

    2010-12-15

    We present a 10-month-old boy with cyanosis. This is a rare case of pulmonary atresia, ventricular septal defect (VSD), major aorto-pulmonary collateral arteries (MAPCAs) to the right lung with absent native right pulmonary artery (RPA) in association with anomalous left pulmonary artery (LPA) from the ascending aorta (AAo). Echocardiography was unable to identify all of the cardiovascular abnormalities. Multidetector CT demonstrated all of these abnormalities and is the investigation of choice instead of cardiac catheterization. (orig.)

  8. Septal co-infusions of glucose with the benzodiazepine agonist chlordiazepoxide impair memory, but co-infusions of glucose with the opiate morphine do not

    OpenAIRE

    Krebs-Kraft, Desiree L.; Parent, Marise B.

    2009-01-01

    We have found repeatedly that medial septal (MS) infusions of glucose impair memory when co-infused with the γ-amino butyric acid (GABA) agonist muscimol. The present experiment sought to determine whether the memory-impairing effects of this concentration of glucose would generalize to another GABAA receptor agonist and to an agonist from another neurotransmitter system that is known to impair memory. Specifically, we determined whether the dose of glucose that produces memory deficits when ...

  9. Post-traumatic fulminant paradoxical fat embolism syndrome in conjunction with asymptomatic atrial septal defect: a case report and review of the literature

    OpenAIRE

    Nerlich Michael; Englert Carsten; Kinner Bernd; Pfeifer Christian; Mueller Franz; Neumann Carsten

    2011-01-01

    Abstract Introduction Fat embolism syndrome with respiratory failure after intramedullary nailing of a femur fracture is a rare but serious complication in trauma patients. Case presentation We present the case of a 20-year-old Caucasian man who experienced paradoxical cerebral fat embolism syndrome with fulminant progression after intramedullary nailing of a femur fracture, in conjunction with a clinically asymptomatic atrial septal defect in a high position resulting in a right-to-left shun...

  10. Right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle and ventricular septal defect

    International Nuclear Information System (INIS)

    Herein, we report an unusual case of right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle with ventricular septal defect. The blood supply to the innominate artery was by a collateral arising from the descending aorta. The embryological development of this anomaly can be explained by the hypothetical double aortic arch model proposed by Edwards with interruption of the arch at two levels

  11. Virtual reality 3D echocardiography in the assessment of tricuspid valve function after surgical closure of ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Kappetein A Pieter

    2007-02-01

    Full Text Available Abstract Background This study was done to investigate the potential additional role of virtual reality, using three-dimensional (3D echocardiographic holograms, in the postoperative assessment of tricuspid valve function after surgical closure of ventricular septal defect (VSD. Methods 12 data sets from intraoperative epicardial echocardiographic studies in 5 operations (patient age at operation 3 weeks to 4 years and bodyweight at operation 3.8 to 17.2 kg after surgical closure of VSD were included in the study. The data sets were analysed as two-dimensional (2D images on the screen of the ultrasound system as well as holograms in an I-space virtual reality (VR system. The 2D images were assessed for tricuspid valve function. In the I-Space, a 6 degrees-of-freedom controller was used to create the necessary projectory positions and cutting planes in the hologram. The holograms were used for additional assessment of tricuspid valve leaflet mobility. Results All data sets could be used for 2D as well as holographic analysis. In all data sets the area of interest could be identified. The 2D analysis showed no tricuspid valve stenosis or regurgitation. Leaflet mobility was considered normal. In the virtual reality of the I-Space, all data sets allowed to assess the tricuspid leaflet level in a single holographic representation. In 3 holograms the septal leaflet showed restricted mobility that was not appreciated in the 2D echocardiogram. In 4 data sets the posterior leaflet and the tricuspid papillary apparatus were not completely included. Conclusion This report shows that dynamic holographic imaging of intraoperative postoperative echocardiographic data regarding tricuspid valve function after VSD closure is feasible. Holographic analysis allows for additional tricuspid valve leaflet mobility analysis. The large size of the probe, in relation to small size of the patient, may preclude a complete data set. At the moment the requirement of an I

  12. Avaliação geoquímica de biomarcadores ocluídos em estruturas asfaltênicas Geochemical evaluation of occluded biomarkers in asphaltenic structures

    Directory of Open Access Journals (Sweden)

    Débora de Almeida Azevedo

    2009-01-01

    Full Text Available Asphaltenes from two Brazilian crude oils were submitted to mild oxidation to disrupt their structure, releasing the occluded oil. The released hydrocarbons were compared with those from the original crude oil, and used to evaluate the alteration of the oils, especially as a result of biodegradation, but also thermal maturity. The crude oils used are depleted in n-alkanes, which are usually related to biodegradation. However, the released products from the corresponding asphaltenes have n-alkane distributions from nC10 to nC40, suggesting a protection effect from biodegradation. The m/z 191 mass chromatograms showed higher relative intensities for tricyclic terpanes than the hopanes in the crude in comparison with the released ones.

  13. Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

    International Nuclear Information System (INIS)

    Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization

  14. Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Yasuyuki, E-mail: onoyasy@hirakata.kmu.ac.jp; Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp; Kono, Yumiko, E-mail: kohnoy@hirakata.kmu.ac.jp; Kan, Naoki, E-mail: kanna@takii.kmu.ac.jp; Ueno, Yutaka, E-mail: uenoyut@hirakata.kmu.ac.jp; Komemushi, Atsushi, E-mail: komemush@takii.kmu.ac.jp; Tanigawa, Noboru, E-mail: tanigano@hirakata.kmu.ac.jp [Kansai Medical University, Department of Radiology (Japan)

    2015-10-15

    Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.

  15. Hippocampal rhythmical slow activity following ibotenic acid lesions of the septal region. I. Relations to behavior and effects of atropine and urethane.

    Science.gov (United States)

    Stewart, D J; Vanderwolf, C H

    1987-10-13

    The effects of intraseptal injections of various concentrations of ibotenic acid on hippocampal electrical activity were studied in freely moving and urethane-anesthetized rats. Ibotenic acid selectively abolished the atropine-sensitive form of hippocampal rhythmical slow activity (RSA) normally seen during urethane anesthesia. Large amplitude irregular activity (LIA) and RSA in the waking state were somewhat depressed as well. Despite this, clear RSA persisted in the waking state in association with locomotion or struggling (Type 1 behavior). As in normal rats, such RSA was resistant to systemic administration of atropine. Analysis of brain sections stained with gallocyanin or for acetylcholinesterase showed that ibotenic acid produced cell loss in the dorsal lateral septal nucleus and the septohippocampal nucleus. Cells in the medial septal and diagonal band nuclei were resistant to ibotenic acid. The results suggest that intrinsic septal circuitry is critically involved in the generation of the atropine-sensitive (presumably cholinergic) form of RSA. The mechanisms by which LIA and the two forms of RSA are generated in the hippocampus is discussed. PMID:3676823

  16. Pacman in the sky with shadows: the effect of cast shadows on the perceptual completion of occluded figures by chimpanzees and humans

    Directory of Open Access Journals (Sweden)

    Imura Tomoko

    2010-07-01

    Full Text Available Abstract Background Humans readily perceive whole shapes as intact when some portions of these shapes are occluded by another object. This type of amodal completion has also been widely reported among nonhuman animals and is related to pictorial depth perception. However, the effect of a cast shadow, a critical pictorial-depth cue for amodal completion has been investigated only rarely from the comparative-cognitive perspective. In the present study, we examined this effect in chimpanzees and humans. Results Chimpanzees were slower in responding to a Pacman target with an occluding square than to the control condition, suggesting that participants perceptually completed the whole circle. When a cast shadow was added to the square, amodal completion occurred in both species. On the other hand, however, critical differences between the species emerged when the cast shadow was added to the Pacman figure, implying that Pacman was in the sky casting a shadow on the square. The cast shadow prevented, to a significant extent, compulsory amodal completion in humans, but had no effect on chimpanzees. Conclusion These results suggest that cast shadows played a critical role in enabling humans to infer the spatial relationship between Pacman and the square. For chimpanzees, however, a cast shadow may be perceived as another "object". A limited role for cast shadows in the perception of pictorial depth has also been reported with respect to human cognitive development. Further studies on nonhuman primates using a comparative-developmental perspective will clarify the evolutionary origin of the role of cast shadows in visual perception.

  17. Occluded Vehicle Segmentation Method Based on Corner Feature%基于角点特征的粘连车辆分割方法

    Institute of Scientific and Technical Information of China (English)

    陈舒; 刘秉瀚

    2013-01-01

    在智能交通系统粘连车辆的分割中,已有方法不能很好地保留车辆目标的轮廓细节.为此,提出一种基于角点特征的粘连车辆分割方法.采用帧差法提取运动车辆,借助数学形态学方法进行修复,引入长宽比、面积比等形态参数,判定粘连类别,结合Harris角点和K-means算法,检测并还原粘连区的角点,以实现粘连车辆的分割.实验结果表明,该方法能较好地保留车辆的轮廓细节信息,达到预期的实验效果.%How to segment the occluded vehicle is a key problem in Intelligent Transportation System(ITS).But the available algorithms can not preserve the edge characteristics of vehicle.This paper presents a new occluded vehicle segmentation method based on comer feature.It chooses the frame difference method to extract object and uses the mathematical morphology to repair,introduces two geometric parameters to judge the overlapping type,combines Harris comer detection with the K-means algorithm to identify the comer points which is in the overlapping area,realizes the segmentation for overlapping vehicle according to the axial symmetry.Experimental results show that this method can keep the vehicle's profile details information,and realizes the desired results.

  18. 小儿先天性心脏病介入治疗手术73例临床分析%Clinical analysis of intercurrent treatment on congenital heart disease in 73 patients

    Institute of Scientific and Technical Information of China (English)

    钱炜; 沙红

    2009-01-01

    Objective: To evaluate the therapeutic effect of intercurrent treatment of congenital heart disease. Mehods: The clinal effects of intercurrent treatment in consecutive 73 patients with congenital heart disease at Wuxi children hospital this years were retrospectively analyzed, and the patient distribution included patent ductus arteriosus (PDA) 35, atrial septal defect (ASD) 30, ventricular septal defect (VSD) 5, pulmonary stenosis (PS) 3, using AGA Amplatzer occluder homemade occluder and percutaneous ballon catheter, results: The technical successful rate was 100%, No complications were found in later 3 months to 2 years followup. Conclusions : intercurrent treatment of congenital heart disease is characterized with a high successful rate, less invasive, low complication and as well as shorter hospital day, and it has become promising alternative therapy.%目的 评价介入治疗手术在小儿先天性心脏病治疗中的价值.方法 总结我院近五年来73例经导管介入治疗的先天性心脏病患儿.其中动脉导管未闭(PDA)35例,继发孔房间隔缺损(ASD)30例,室间隔缺损(VSD)5例,肺动脉瓣狭窄(PS)3例.应用AGA Amplatzer封堵器、国产封堵器及球囊扩张导管.结果 成功率为100%,术后随访3月-2年,无不良并发症.结论 经导管介入治疗小儿先天性心脏病安全,有效,创伤小,操作简单,住院时间短,是一项有发展前景的治疗方法.

  19. Preventive echocardiographic examination in athletes and workers – Quadricuspid aortic valve and atrial septal aneurysm in a young basketball player

    Directory of Open Access Journals (Sweden)

    Karina Wierzbowska-Drabik

    2015-02-01

    Full Text Available Ensuring safety of young athletes and employees who perform hard physical work within the scope of their professional duties, with a special focus on prevention of a sudden cardiac death at sports fields or during hard physical work is one of the most important tasks, which demands joint effort of cardiologists and sport physicians or occupational physicians, who qualify patients for a job or a sport discipline. Apart from hypertrophic and arhythmogenic right ventricular cardiomyopathy, coronary anomalies and aortic dissection belong to the most frequent causes of dramatic complications during competitive exercise or work with an increased energy expenditure. Although a detailed medical history and a physical examination combined with 12-lead ECG assessment may significantly improve the safety in competitive sports, adding echocardiography examination gives a detailed and noninvasive insight into the heart morphology and function. Therefore, in our opinion, it should constitute a standard part of the evaluation of candidates for competitive sports. The practice indicates that beyond subjects with severe heart diseases and those classified as normal, there is a group of individuals with abnormalities which should be more closely monitored, but are not contraindications against professional sports or work with an increased energy expenditure. We describe the case of a young female with a diagnosis of rare congenital aortic valve disease, quadricuspid valve, with mild regurgitation and atrial septal aneurysm which was established during transthoracic echocardiography and confirmed and expanded during TEE examination.

  20. The reducing agent dithiothreitol (DTT) does not abolish the inhibitory nicotinic response recorded from rat dorsolateral septal neurons

    Science.gov (United States)

    Sorenson, E. M.; Gallagher, J. P.

    1993-01-01

    Previous intracellular recordings have demonstrated that dorsolateral septal nucleus (DLSN) neurons express a novel nicotinic receptor which produces a direct membrane hyperpolarization when activated by nicotinic agonists. Activation of the classical excitatory nicotinic receptors has been shown to require a disulfide bond involving the cysteines at positions 192 and 193 of the alpha subunits of the receptor. Reduction of this cystine bond with dithiothreitol (DTT) abolishes agonist activation of excitatory nicotinic receptors. We have now examined whether DTT treatment of the inhibitory nicotinic receptor on DLSN neurons also abolishes the inhibitory nicotinic response. We find that the inhibitory response persists after treatment of the neurons with 1 mM DTT, even if the reduction is followed by alkylation of the receptor with bromoacetylcholine to prevent possible reformation of disulfide bonds. This result suggests that the agonist binding site on the inhibitory nicotinic receptor does not require an intact disulfide bond, similar to the bond on the alpha subunit of the excitatory nicotinic receptor, for agonist activation of the receptor. Some of these results have been previously reported in abstract form.

  1. Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect

    Directory of Open Access Journals (Sweden)

    Juan Lacalzada

    2010-01-01

    Full Text Available A hypertensive 76-year-old man with severe pulmonary valve stenosis (PVS and recent initiation of haemodialysis was referred with fever, chills, and asthenia. One month prior, he had been admitted with similar symptoms. Transthoracic echocardiography (TTE had shown a PVS and no valve vegetations were observed. Following discharge, he was readmitted with fever and blood cultures positive for Staphylococcus haemolyticus. A new TTE revealed two pulmonary valve vegetations and a previously undetected ostium secundum-type atrial septal defect (ASD, confirmed by transesophageal echocardiography. The clinical course was uneventful with intravenous antibiotic treatment and the patient was safely discharged. This is a case of pulmonary valve infective endocarditis (IE. The incidence of right-sided IE is on the rise due to the increased number of patients using central venous lines, pacing, haemodialysis and other intravascular devices. Pulmonary valve IE is extremely rare, especially in structurally normal hearts. The case reported here, presents a combination of predisposing factors, such as severe congenital PVS, the presence of a central venous catheter, and haemodialysis. The fact that it was an older patient with severe congenital PVS and associated with a previously undiagnosed ASD, is also an unusual feature of this case, making it even more interesting.

  2. Effect of interferon-alpha on experimental septal fibrosis of the liver - study with a new model

    Directory of Open Access Journals (Sweden)

    Marcia Maria de Souza

    2001-04-01

    Full Text Available Interferon-alpha is used in antiviral therapy in humans, mainly for viral hepatitis B and C. An anti-fibrotic effect of interferon has been postulated even in the absence of anti-viral response, which suggests that interferon directly inhibits fibrogenesis. Rats infected with the helminth Capillaria hepatica regularly develop diffuse septal fibrosis of the liver, which terminates in cirrhosis 40 days after inoculation. The aim of this study was to test the anti-fibrotic effect of interferon in this experimental model. Evaluation of fibrosis was made by three separate methods: semi-quantitative histology, computerized morphometry and hydroxyproline measurements. Treatment with interferon-alpha proved to inhibit the development of fibrosis in this model, especially when doses of 500,000 and 800,000 IU were used for 60 days. Besides confirming the anti-fibrotic potential of interferon-alpha on a non-viral new experimental model of hepatic fibrosis, a clear-cut dose-dependent effect was observed.

  3. Evaluation of left-to-right shunts in adults with atrial septal defect using first-pass radionuclide cardiography

    DEFF Research Database (Denmark)

    Kelbaek, H; Aldershvile, J; Svendsen, Jesper Hastrup; Nielsen, S L; Munck, O; Wennevold, A

    1992-01-01

    Non-invasive determination of left-to-right shunts at the atrial level was performed by a new procedure using first-pass radionuclide measurement of cardiac output of the right and left ventricle. In 23 patients with coronary artery disease without shunt the mean difference between the cardiac...... outputs of the right and left ventricle was 0.04 l.min-1, the limits of agreement -0.80 to 0.88 l.min-1 and the 95% confidence interval for the bias -0.14 to 0.22 l.min-1. Right-sided cardiac catheterization was performed to assess the severity of the arterio-venous shunt by oximetry in 18 adult patients...... by two independent observers -0.75 to 0.77. The present findings suggest that first-pass radionuclide determination of left-to-right shunts through atrial septal defects is both reproducible and accurate when compared to the oximetric technique....

  4. Lessons learnt from a series of hemodynamic and interventional complications during pulmonary valvotomy and device closure of ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Anil Kumar Singhi

    2015-01-01

    Full Text Available In an adolescent girl with coexistent valvar pulmonary stenosis (PS and muscular ventricular septal defect (VSD causing right to left shunt and severe cyanosis, a series of complications were encountered during transcatheter intervention. After balloon pulmonary valvotomy (BPV and device closure of the VSD, dynamic infundibular hypercontractility elevated the right ventricular (RV systolic pressures leading to embolization of the device into the left ventricle. During retrieval of the device from the left ventricular outflow tract (LVOT, there was injury to the atrioventricular nodal tissue resulting in transient complete heart block. Even though the device was successfully retrieved out from the right femoral arterial access, there was a retroperitoneal hematoma causing severe anemia. A combination of dynamic infundibular obstruction, intravascular volume depletion caused by hemorrhage, low oxygen carrying capacity due to anemia, and inotropes resulted in a life-threatening hypercyanotic spell. Once this combination of suicidal hypercontractile right ventricle, anemia, and dehydration was recognized; management of the pathophysiology resulted in recovery of the patient. On a subsequent day, device closure of the VSD was complicated by unstable device position, but was finally achieved by an innovative device stabilization technique. We propose to explain the basis of hemodynamic and procedural complications, their recognition, and management. During preparatory stage before interventions in patients with multiple defects, which are linked by strong hemodynamic interdependence, meticulous planning should be done and multiple untoward events should be foreseen. While a few complications were completely unanticipated, some others could have been predicted.

  5. Pre-operative evaluation with MR in tetralogy of Fallot and pulmonary atresia with ventricular septal defect

    International Nuclear Information System (INIS)

    To assess whether MR imaging could replace angiography in pre-operative evaluation of patients with tetralogy of Fallot and pulmonary atresia with ventricular septal defect (VSD), especially since the surgical correction was done earlier than was previously the rule. Fourteen patients with tetralogy of Fallot (n=10) or pulmonary atresia with VSD (n=4), mean age 7.5±4.4 months, were evaluated with angiocardiography and MR before definitive surgical correction. There was good diagnostic agreement between the two modalities when evaluating right ventricular outflow obstruction; 86% for valvular and 93% for supra valvular stenosis, but the agreement was somewhat lower for the sub valvular obstruction (57%). Surgery findings, however, were in favour of MR in 5 patients concerning the sub valvular right ventricular outflow tract obstruction. MR images identified all stenoses in the right and left pulmonary arteries, but overlooked one stenosis in the main pulmonary artery. MR could evaluate patency in all palliative shunts. Even in this young age group, MR imaging offers a good alternative to angiocardiography for the pre-operative evaluation of the right ventricular outflow tract, the main pulmonary artery and the proximal right and left pulmonary arteries, before definitive surgical correction of tetralogy of Fallot and pulmonary atresia with VSD

  6. Pre-operative evaluation with MR in tetralogy of Fallot and pulmonary atresia with ventricular septal defect

    Energy Technology Data Exchange (ETDEWEB)

    Holmqvist, C.; Hochbergs, P. [Univ. Hospital, Lund (Sweden). Dept of Diagnostic Radiology; Bjoerkhem, G. [Univ. Hospital, Lund (Sweden). Dept of Paediatrics; Brockstedt, S.; Laurin, S. [Univ. Hospital, Lund (Sweden). Dept of Diagnostic Radiology

    2000-01-01

    To assess whether MR imaging could replace angiography in pre-operative evaluation of patients with tetralogy of Fallot and pulmonary atresia with ventricular septal defect (VSD), especially since the surgical correction was done earlier than was previously the rule. Fourteen patients with tetralogy of Fallot (n=10) or pulmonary atresia with VSD (n=4), mean age 7.5{+-}4.4 months, were evaluated with angiocardiography and MR before definitive surgical correction. There was good diagnostic agreement between the two modalities when evaluating right ventricular outflow obstruction; 86% for valvular and 93% for supra valvular stenosis, but the agreement was somewhat lower for the sub valvular obstruction (57%). Surgery findings, however, were in favour of MR in 5 patients concerning the sub valvular right ventricular outflow tract obstruction. MR images identified all stenoses in the right and left pulmonary arteries, but overlooked one stenosis in the main pulmonary artery. MR could evaluate patency in all palliative shunts. Even in this young age group, MR imaging offers a good alternative to angiocardiography for the pre-operative evaluation of the right ventricular outflow tract, the main pulmonary artery and the proximal right and left pulmonary arteries, before definitive surgical correction of tetralogy of Fallot and pulmonary atresia with VSD.

  7. Application of caudal septal advancement technique in nasal tip plasty%鼻中隔尾段前徙术在鼻尖成形中的应用

    Institute of Scientific and Technical Information of China (English)

    徐航

    2012-01-01

    Objective To build the steady framework of the nasal tip by using caudal septal advancement technique to obtain the permanent nasorostral configuration.Methods From Oct 2009 to Apr 2011,the caudal septal advancement technique was used to reconstruct the septum to make the septal anterior angel and the caudal septal margin reach the anticipated height and length of the tip,then medial crus and the vault of the lower lateral cartilage were sutured to the caudal septum to form the steady supporting structure of the nasal tip.Results 3-16 months follow-up in 26 cases showed that 2 cases appeared the staircase deformity in the junction of the bone and the cartilage in the dorsum,but the nasorostral configuration was good.3 cases whose tip and columella were deviated before the operation appeared the deviation again after 3 months but the nasorostral configuration was better than before.The other 21 cases were good.Conclusions It is a available method of using caudal septal advancement technique to form the steady nasorostral configuration.%目的 通过鼻中隔尾段前徙术,建立稳定的鼻尖支撑结构,以获得持久的鼻尖形态.方法 应用鼻中隔尾段前徙术重构鼻中隔,使鼻中隔前角及尾侧缘达到鼻尖预计的高度和长度;再将下外侧软骨穹窿、鼻翼内侧脚与鼻中隔尾侧缝合,从而形成稳定的鼻尖支撑结构.结果 26例受术者随访3~16个月,其中2例出现鼻背骨与软骨衔接处阶梯状改变,但鼻尖形态良好;3例原有鼻尖鼻小柱偏斜的患者,在3个月后出现再次偏斜,但较原先有一定改善;其余21例均鼻尖形态良好.结论 利用鼻中隔尾段前徙术可形成稳定的鼻尖形态,是一种有效的方法.

  8. The application of transcatheter closure procedure in congenital heart diseases

    International Nuclear Information System (INIS)

    Objective: To explore and evaluate the value of transcatheter closure procedure in congenital heart diseases. Methods: Transcatheter closure was performed in 12 patients with congenital heart diseases including 6 ventricular septal defect (VSD), 4 atrial septal defect (ASD), 2 patent ductus arteriosus (PDA), by the Amplatzer occlusion device under local or general anesthesia. Results: The procedure was successful in all patients outcoming with the disappearance of cardiac murmur. All of them could get out of the bed within 6 to 12 hours postoperatively, and were discharged from hospital after 4 to 6 days. Conclusions: Transcatheter treatment of congenital cardiac defects by Amplatzer occlusion device is less traumatic, with good effect, simultaneously

  9. Ventricular Septal Defect: a Literature Review Comunicación interventricular: revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Luis Ángel Osorio Góngora

    2011-12-01

    Full Text Available Congenital heart defects occur in approximately eight of every 1000 live births. Ventricular septal defect occupies a large percentage of them and is the most commonly associated with chromosomal syndromes presenting multifactorial etiology. In 1879, Roger was the first to define the underlying clinical signs. New milestones in its history are marked by Einsenmenger, Dalrymple, Heath and Edwards. In 1979, the use of two-dimensional echocardiography in real time, dramatically improved non-invasive anatomical diagnosis. The main pathophysiologic alteration is part of the injuries that produce volume overload and left to right short-circuit. It is a model for the study of anatomical and physiological relationship in the different injuries that allow communication between the pulmonary and systemic circuits. The imperfections of the sites of origin of the interventricular septum result in different types of ventricular septal defects. The most commonly used classification is the anatomical, from Soto. Homodynamic effects after birth depend on the physiological changes of systemic and pulmonary circulation, as well as on the diameter of the hole. The clinical case depends on the defect and the pulmonary and vascular resistance. The diagnosis is clinical and echocardiographic. Treatment is medical, palliative, surgical and with rehabilitation. Currently, rehabilitation is approached as an essential part of care and therapy.Las cardiopatías congénitas se presentan aproximadamente en 8 de cada 1000 recién nacidos vivos. La comunicación interventricular ocupa un gran porcentaje entre todas, y es la que más se asocia a los síndromes cromosómicos con etiología multifactorial. En 1879 Roger fue el primero en definir los signos clínicos subyacentes. Nuevos hitos en su historia marcan: Einsenmenger, Dalrymple, Heath y Edwards, hasta 1979 en que, con el uso de la ecocardiografía bidimensional en tiempo real, se mejora dramáticamente el diagn

  10. Repair of complete atrioventricular septal defect in infants with down syndrome: outcomes and long-term results.

    Science.gov (United States)

    Tumanyan, Margarita R; Filaretova, Olga V; Chechneva, Vera V; Gulasaryan, Ruben S; Butrim, Iuliia V; Bockeria, Leo A

    2015-01-01

    In clinical practice, the combination of congenital heart disease (CHD) with malformations of other organs occurs in about 10 % of cases, including chromosomal disease with heart defects, which are observed mainly with certain syndromes. In the Bakoulev SCCS (Moscow, Russian Federation), from 01.2005 to 01.2011, complete atrioventricular septal defect (CAVSD) repair was performed on 163 patients (5.6 ± 3.0 months) with Down Syndrome (DS) using the single-patch (n = 40) and the two-patch (n = 123) methods. The control group consisted of 214 infants aged 6.49 ± 3.03 months with CAVSD and normal karyotype. A retrospective cohort study was made, as well as a comparative analysis of the immediate (up to 30 days) and long-term (12-75 months, at the average of 56 ± 15) results of the repair of CAVSD in infants with DSand normal karyotype/chromosome set (NK). During the hospital treatment period, we registered the following complications: pulmonary hypertensive crises in 6 % (n = 9) of patients with DS and in 10 % (n = 21) of infants with NK, infectious complications in 21% (n = 34) of patients with DS and in 8% (n = 17) of infants with NK. Squeal structures in groups were differentiated. The doses and duration of cardiotonic support in the NK patients were significantly higher in comparison with the DS patients (7.5 ± 2.1 days vs 3.4 ± 1.15 days, p Down syndrome. Concerning the long-term results, there was no significant difference (Gehan-Wilcoxon test) in actuarial freedom from reoperation after repair of CAVSD between DS and NK groups (p Down Syndrome in patients significantly increases the risk of severe co-morbidities that have a significant impact on the recovery period, as well as on life expectancy even after successful CHD correction. PMID:25099029

  11. Ventricular septal rupture complicating acute myocardial infarction in the modern era with mechanical circulatory support: a single center observational study.

    Science.gov (United States)

    Liebelt, Jared J; Yang, Yuanquan; DeRose, Joseph J; Taub, Cynthia C

    2016-01-01

    Ventricular septal rupture (VSR) is a rare but devastating complication after acute myocardial infarction (AMI). While the incidence has decreased, the mortality rate from VSR has remained extremely high. The use of mechanical circulatory support with intra-aortic balloon pump (IABP) and extracorporal membrane oxygenation (ECMO) may be useful in providing hemodynamic stability and time for myocardial scarring. However, the optimal timing for surgical repair remains an enigma. Retrospective analysis of 14 consecutive patients diagnosed with VSR after AMI at Montefiore Medical Center between January 2009 and June 2015. A chart review was performed with analysis of baseline characteristics, hemodynamics, imaging, percutaneous interventions, surgical timing, and outcomes. The survival group had a higher systolic BP (145 vs 98, p<0.01), higher MAP (96 vs 76, p=0.03), and lower HR (75 vs 104, p=0.05). Overall surgical timing was 6.5 ± 3.7 days after indexed myocardial infarction with a significant difference between survivors and non-survivors (9.8 vs 4.3, p=0.01). The number of pre-operative days using IABP was longer in survivors (6.5 vs 3.2, p=0.36) as was post-operative ECMO use (4.5 vs 2 days, p=0.35). The overall 30-day mortality was 71.4% with a 60% surgical mortality rate. Hemodynamics at the time of presentation and a delayed surgical approach of at least 9 days showed significant association with improved survival. Percutaneous coronary intervention (PCI) was more common in non-survivors. The use of IABP in the pre-operative period and post-operative ECMO use likely provide a survival benefit. PMID:27073732

  12. Trans-catheter closure of atrial septal defect: Balloon sizing or no balloon sizing - single centre experience

    Directory of Open Access Journals (Sweden)

    Gupta Saurabh

    2011-01-01

    Full Text Available Background : Selecting the device size using a sizing balloon could oversize the ostium secundum atrial septal defect (OSASD with floppy margins and at times may lead to complications. Identifying the firm margins using trans-esophageal echocardiography (TEE and selecting appropriate-sized device optimizes ASD device closure. This retrospective study was undertaken to document the safety and feasibility of device closure without balloon sizing the defect. Methods : Sixty-one consecutive patients who underwent trans-catheter closure of OSASD guided by balloon sizing of the defect and intra procedural fluoroscopy (group I and 67 consecutive patients in whom TEE was used for defect sizing and as intraprocedural imaging during device deployment (group II were compared. The procedural success rate, device characteristics, and complications were compared between the two groups. Results : The procedure was successful in 79.7 % patients. The success rate in group II (60 of 67, 89.6% was significantly higher than in group I (41 of 61, 67.2 % (P = 0.002. Mean upsizing of ASD device was significantly lower in group II (P < 0.001. TEE also provided better success rate with smaller device in subjects with large ASD (>25 mm and in those who were younger than 14 years of age. There were four cases of device embolization (two in each group; of which one died in group II despite successful surgical retrieval. Conclusion : Balloon sizing may not be essential for successful ASD device closure. TEE-guided sizing of ASD and device deployment provides better success rate with relatively smaller sized device.

  13. Supramammillary serotonin reduction alters place learning and concomitant hippocampal, septal, and supramammillar theta activity in a Morris water maze

    Science.gov (United States)

    Hernández-Pérez, J. Jesús; Gutiérrez-Guzmán, Blanca E.; López-Vázquez, Miguel Á.; Olvera-Cortés, María E.

    2015-01-01

    Hippocampal theta activity is related to spatial information processing, and high-frequency theta activity, in particular, has been linked to efficient spatial memory performance. Theta activity is regulated by the synchronizing ascending system (SAS), which includes mesencephalic and diencephalic relays. The supramamillary nucleus (SUMn) is located between the reticularis pontis oralis and the medial septum (MS), in close relation with the posterior hypothalamic nucleus (PHn), all of which are part of this ascending system. It has been proposed that the SUMn plays a role in the modulation of hippocampal theta-frequency; this could occur through direct connections between the SUMn and the hippocampus or through the influence of the SUMn on the MS. Serotonergic raphe neurons prominently innervate the hippocampus and several components of the SAS, including the SUMn. Serotonin desynchronizes hippocampal theta activity, and it has been proposed that serotonin may regulate learning through the modulation of hippocampal synchrony. In agreement with this hypothesis, serotonin depletion in the SUMn/PHn results in deficient spatial learning and alterations in CA1 theta activity-related learning in a Morris water maze. Because it has been reported that SUMn inactivation with lidocaine impairs the consolidation of reference memory, we asked whether changes in hippocampal theta activity related to learning would occur through serotonin depletion in the SUMn, together with deficiencies in memory. We infused 5,7-DHT bilaterally into the SUMn in rats and evaluated place learning in the standard Morris water maze task. Hippocampal (CA1 and dentate gyrus), septal and SUMn EEG were recorded during training of the test. The EEG power in each region and the coherence between the different regions were evaluated. Serotonin depletion in the SUMn induced deficient spatial learning and altered the expression of hippocampal high-frequency theta activity. These results provide evidence in

  14. Discussion of Operation Coding of Atrial Septal Defect Neoplasty%房间隔缺损修补术的手术编码探讨

    Institute of Scientific and Technical Information of China (English)

    刘晶; 林海丽; 郑琳

    2015-01-01

    With the innovation and development of cardiac surgery technology, atrial septal defect neoplasty methods are varied. Coders have difficulty in coding this operation because of clinicians General writing atrial septal defect neoplasty in the front page of medical record and the records. Through an introduction to the atrial septal defect neoplasty, encode the operations according to the 2011 edition of the ICD-9-CM-3. In the process of coding, coding workers should carefully read operation records, and familiar with coding principle, to ensure the code accurately.%随着心脏外科技术的创新发展,房间隔缺损修补术的手术方式多种多样,由于临床医师在病案首页填写和病历记录中只笼统的书写“房间隔缺损修补术”,从而在手术编码的过程中常常给编码工作者带来困扰。通过对房间隔缺损修补术的手术方式介绍,依据2011版ICD-9-CM-3手术与操作对不同术式的房间隔缺损修补术进行编码。在编码的过程中,编码工作者应仔细阅读手术记录,熟练掌握编码原则,确保房间隔缺损修补术的手术编码准确。

  15. Preoperative and postoperative pulmonary function tests in patients with atrial septal defect and their relation to pulmonary artery pressure and pulmonary:systemic flow ratio.

    OpenAIRE

    Schofield, P. M.; Barber, P V; Kingston, T

    1985-01-01

    Pulmonary diffusing properties and lung volumes were investigated in 44 patients with atrial septal defect, and in 30 of them preoperative and postoperative data were obtained. The patients were divided into three groups according to mean pulmonary artery pressure: less than or equal to 15 mm Hg (group 1), 16-29 mm Hg (group 2), and greater than or equal to 30 mm Hg (group 3). Patients in groups 1 and 2 had a high carbon monoxide transfer test which became normal after surgical correction of ...

  16. En bloc aortic and mitral valve replacement and left ventricular outflow tract enlargement using a combined transaortic and trans-septal atrial approach.

    Science.gov (United States)

    Hassan, Mohammed; Windsor, Jimmy; Ricci, Marco

    2015-12-01

    Aortic and mitral valve replacement with division and reconstruction of the inter-valvular fibrous body has been described in clinical situations involving infective endocarditis, extensive annular calcifications and diminutive valve annuli. Herein, we describe a combined transaortic and trans-septal approach with division of the inter-valvular fibrosa for combined aortic and mitral valve replacement. The reconstruction of the inter-valvular fibrous body, atrial walls and aortic root was carried out using a 'three-patch' technique with bovine pericardium. PMID:26409564

  17. Combined Rastelli and Bentall Procedures for Pulmonary Atresia With Ventricular Septal Defect and a Large Aortopulmonary Collateral Artery and Ascending Aorta Aneurysm.

    Science.gov (United States)

    Chiostri, Benjamin; Piccinini, Fernando; Vrancic, Mariano; Klinger, Daniel; Navia, Daniel; Lalor, Nicolas; Longo, Francisco; Kreutzer, Christián

    2014-06-23

    We report a challenging case of a 32-year-old patient in New York Heart Association (NYHA) class IV with pulmonary atresia, ventricular septal defect, a left aortopulmonary collateral artery, a right modified Blalock-Taussing shunt, and a gigantic aneurysm of the ascending aorta with severe aortic valve insufficiency. A combined Rastelli and Bentall procedure was performed by a joint adult and pediatric cardiovascular surgery team. One year after the operation, the patient is in NYHA class I, working full time. PMID:24958054

  18. Alcohol septal ablation and hypertrophic cardiomyopathy%酒精室间隔消融术与肥厚型心肌病

    Institute of Scientific and Technical Information of China (English)

    Carey Kimmelstiel; Barath Krishnamurthy; Andrew Weintraub; Navin Kapur; 王新国

    2009-01-01

    Patients with hypertrophic cardiomyopathy who experience refractory symptoms due to left ventricular outflow tract obstruction are often referred for definitive therapy consisting of either surgical myectomy or alcohol septal ablation ( ASA). There currently exists clinical equipoise regarding which therapy is the most efficacious in this challenging patient population. ASA utilizes common interventional techniques usually employed to treat atherosclerotic coronary artery disease to inject small aliquots of ethanol into a branch of the appropriate septal vessel to cause necrosis of the obstructing basal septal tissue. Myocardial contrast echocardiography is used to facilitate location of the most appropriate septal branch with success determined by an acute reduction in the resting and/or provoked gradient. Recent comparative data have suggested similar rates of long and short-term mortality in when comparing patients undergoing ASA and surgical myectomy, with ASA patients experiencing a higher rate of requirement for permanent pacemakers. In addition, patients treated by both techniques appear to have similar gradient reductions and improvement in symptomatic status. Comparisons of these two methods of treatment are limited by the non-randomized nature of the studies, retrospective data collection and the allocation of higher-risk patients to ASA treatment. Concern for the wide-spread adoption of ASA to drug-resistant HCM patients is warranted due to the potential for arrhythmogenesis is a patient population already at risk for life-threatening arrhythmias. There have been case reports of such arrhythmias, however, clinical series to date have not suggested an enhanced risk of sudden cardiac death in patients treated with ASA. Definitive answers concerning which patient subsets with drug-refractory hypertrophic cardiomyopathy would benefit from the two competing therapies can only be answered by a randomized clinical trial. However, for a variety of clinical and

  19. Complete Repair of Coarctation of the Aorta and a Ventricular Septal Defect in a 1,480 g Low Birth Weight Neonate

    OpenAIRE

    Lee, Hongkyu; Cho, Joon-Yong; Kim, Gun-Jik

    2011-01-01

    Although outcomes of neonatal cardiac surgery have dramatically improved in the last two decades, low body weight still constitutes an important risk factor for morbidity and mortality. In particular, cardiac surgery in neonates with very low birth weight (≤1.5 kg) is carried out with greater risk because most organ systems are immature. We report here on a successful case of early one-stage total repair of coarctation of the aorta and a ventricular septal defect in a 1,480 gram neonate.

  20. Using extracorporeal membrane oxygenation support preoperatively and postoperatively as a successful bridge to recovery in a patient with a large infarct-induced ventricular septal defect

    Science.gov (United States)

    Jacob, Samuel; Patel, Mitesh J.; Lima, Brian; Felius, Joost; Malyala, Rajasekhar S.; Chamogeorgakis, Themistokles; MacHannaford, Juan C.; Gonzalez-Stawinski, Gonzalo V.

    2016-01-01

    Rupture of the ventricular septum during acute myocardial infarction usually occurs within the first week. The event is usually followed by low cardiac output, heart failure, and multiorgan failure. Despite the many advances in the nonoperative treatment of heart failure and cardiogenic shock, including the intra-aortic balloon pump and a multitude of new inotropic agents and vasodilators, these do not supplant the need for operative intervention in these critically ill patients. This article describes the successful use of extracorporeal membrane oxygenation support as a bridge to recovery postoperatively in a patient with a large infarct-produced ventricular septal defect. PMID:27365878

  1. Intraductal Radiofrequency Ablation Followed by Locoregional Tumor Treatments for Treating Occluded Biliary Stents in Non-Resectable Malignant Biliary Obstruction: A Single-Institution Experience.

    Directory of Open Access Journals (Sweden)

    Xu-Hua Duan

    Full Text Available To determine the safety and feasibility of intraductal radiofrequency ablation (RFA followed by locoregional tumor treatments in patients with non-resectable malignant biliary obstruction and stent re-occlusion.Fourteen patients with malignant biliary obstruction and blocked metal stents were studied retrospectively. All had intraductal RFA followed by locoregional tumor treatments and were monitored clinically and radiologically. The practicality, safety, postoperative complications, jaundice remission, stent patency and survival time were analyzed.Combination treatment was successful for all patients. There were no severe complications during RFA or local treatments. All patients had stent patency restored, with a decline in serum bilirubin. Three patients had recurrent jaundice by 195, 237 and 357 days; two patients underwent repeat intraductal RFA; and one required an internal-external biliary drain. The average stent patency time was 234 days (range 187-544 days. With a median follow-up of 384 days (range 187-544 days, six patients were alive, while eight had died. There was no mortality at 30 days. The 3, 6, 12 and 18 month survival rates were 100%, 100%, 64.3% and 42.9%, respectively.Intraductal RFA followed by locoregional tumor treatments for occluded metal stents is safe and practically feasible and potential increase stent patency and survival times.

  2. Energy landscape of the reactions governing the Na+ deeply occluded state of the Na+/K+-ATPase in the giant axon of the Humboldt squid.

    Science.gov (United States)

    Castillo, Juan P; De Giorgis, Daniela; Basilio, Daniel; Gadsby, David C; Rosenthal, Joshua J C; Latorre, Ramon; Holmgren, Miguel; Bezanilla, Francisco

    2011-12-20

    The Na(+)/K(+) pump is a nearly ubiquitous membrane protein in animal cells that uses the free energy of ATP hydrolysis to alternatively export 3Na(+) from the cell and import 2K(+) per cycle. This exchange of ions produces a steady-state outwardly directed current, which is proportional in magnitude to the turnover rate. Under certain ionic conditions, a sudden voltage jump generates temporally distinct transient currents mediated by the Na(+)/K(+) pump that represent the kinetics of extracellular Na(+) binding/release and Na(+) occlusion/deocclusion transitions. For many years, these events have escaped a proper thermodynamic treatment due to the relatively small electrical signal. Here, taking the advantages offered by the large diameter of the axons from the squid Dosidicus gigas, we have been able to separate the kinetic components of the transient currents in an extended temperature range and thus characterize the energetic landscape of the pump cycle and those transitions associated with the extracellular release of the first Na(+) from the deeply occluded state. Occlusion/deocclusion transition involves large changes in enthalpy and entropy as the ion is exposed to the external milieu for release. Binding/unbinding is substantially less costly, yet larger than predicted for the energetic cost of an ion diffusing through a permeation pathway, which suggests that ion binding/unbinding must involve amino acid side-chain rearrangements at the site. PMID:22143771

  3. Comparison of Coil Embolization and Sclerotherapy of Collateral Veins during Balloon Occluded Retrograde Transvenous Obliteration: Its Long Term Effect for Gastric Varix Treatment

    Energy Technology Data Exchange (ETDEWEB)

    An, Eun Jung; Kim, Young Hwan; Kim, Seee Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-10-15

    We compared the long term effect gastric varix treatment between coil embolization and sclerotherapy of collateral veins during balloon occluded retrograde transvenous obliteration (BRTO). Between February 2004 and November 2008 48 patients with gastric varix bleeding successfully treated with BRTO 23 underwent embolization of collateral veins during BRTO were enrolled in this study. In patients, collateral veins were embolized with the use of microcoil (group 1). Agent (5% ethanolamine oleate + lipiodol) was used in the remaining 7 patients (Group 2). Recurrence and rebleeding of gastric varix were evaluated by endoscopy or CT. Gastric varix recurred in 4 patients (17.4%) and rebleeding occurred in 2 (8.7%). Recurrence (57.1%, p 0.001) and rebleeding (28.6%, p = 0.029) of gastric occurred in group 2. CT finding within 6 months in partial or complete thrombosis without lipiodol uptake in gastric varix, gastric varix recurred on follow up CT. Coil embolization of collateral veins during BRTO may promote complete obliteration of gastric varix, provide lower recurrence and rebleeding rates of gastric sclerosing agent on long term follow-up.

  4. Measurement of void volume of a fuel rod and the exchange of occluded gases from mixed carbide fuel with filling gas helium

    Energy Technology Data Exchange (ETDEWEB)

    Rama Rao, G.A. [Bhabha Atomic Res. Centre, Bombay (India). Fuel Chem. Div.; Kulkarni, S.G. [Bhabha Atomic Res. Centre, Bombay (India). Fuel Chem. Div.; Venugopal, V. [Bhabha Atomic Res. Centre, Bombay (India). Fuel Chem. Div.; Manchanda, V.K. [Radiochemistry Division, Bhabha Atomic Research Centre, Bombay 400 085 (India); Goswami, G.L. [Atomic Fuels Division, Bhabha Atomic Research Centre, Bombay 400 085 (India)

    1995-02-01

    The presence of gaseous impurities in the filling gas of a fuel pin is detrimental to the thermal performance of a nuclear reactor fuel. The composition of the filling gas does not remain constant throughout the life of the fuel pin. The gas exchange phenomena that occur between the cover gas and impurity gases affect the fuel performance more severely in (U, Pu)O{sub 2} fuel pin due to its inherently poor thermal conductivity than in advanced fuels such as mixed carbides and nitrides. In the present study the exchange phenomenon of the occluded gases present in our Fast Breeder Test Reactor (FBTR) fuel pellets [(U{sub 0.30}, Pu{sub 0.70})C with 6500 ppm O] with the cover gas helium was observed as a function of time and temperature. Quantitative analysis of the released gases namely H{sub 2}, O{sub 2}+Ar, N{sub 2}, CH{sub 4} and CO was carried out at subambient pressure by gas chromatography. The void volume of the fuel element is determined experimentally by gas equilibration with known volume. ((orig.))

  5. Measurement of void volume of a fuel rod and the exchange of occluded gases from mixed carbide fuel with filling gas helium

    Science.gov (United States)

    Rao, G. A. Rama; Kukarni, S. G.; Venugoopal, V.; Manchanda, V. K.; Goswami, G. L.

    1995-02-01

    The presence of gaseous impurities in the filling gas of a fuel pin is detriental to the thermal performance of a nuclear reactor fuel. The composition of the filling gas does not remain constant throughout the life of the fuel pin. The gas exchange phenomena that occur between the cover gas and impurity gases affect the fuel performance more severely in (U, Pu)O 2 fuel pin due to its inherently poor thermal conductivity than in advanced fuels such as mixed carbides and nitrides. In the present study the exchange phenomenon of the occluded gases present in our Fast Breeder Test Reactor (FBTR) fuel pellets [(U 0.30, Pu 0.70)C with 6500 ppm o] with the cover gas helium was observed as a function of time and temperature. Quantitative analysis of the released gases namely H 2, O 2 + Ar, N 2, CH 4 and CO was carried out at subambient pressure by gas chromatography. The void volume of the fuel element is determined experimentally by gas equilibration with known volume.

  6. The Escherichia coli cell division protein and model Tat substrate SufI (FtsP) localizes to the septal ring and has a multicopper oxidase-like structure.

    Science.gov (United States)

    Tarry, Michael; Arends, S J Ryan; Roversi, Pietro; Piette, Evan; Sargent, Frank; Berks, Ben C; Weiss, David S; Lea, Susan M

    2009-02-20

    The Escherichia coli protein SufI (FtsP) has recently been proposed to be a component of the cell division apparatus. The SufI protein is also in widespread experimental use as a model substrate in studies of the Tat (twin arginine translocation) protein transport system. We have used SufI-GFP (green fluorescent protein) fusions to show that SufI localizes to the septal ring in the dividing cell. We have also determined the structure of SufI by X-ray crystallography to a resolution of 1.9 A. SufI is structurally related to the multicopper oxidase superfamily but lacks metal cofactors. The structure of SufI suggests it serves a scaffolding rather than an enzymatic role in the septal ring and reveals regions of the protein likely to be involved in the protein-protein interactions required to assemble SufI at the septal ring. PMID:19135451

  7. Remodelamento do ventrículo esquerdo pela técnica da endoventriculoplastia com exclusão septal: experiência inicial Endoventricular circular patch plasty with septal exclusion: initial experience

    Directory of Open Access Journals (Sweden)

    Rui Manuel Sequeira de ALMEIDA

    2000-12-01

    Full Text Available OBJETIVO: Neste trabalho apresentam-se os resultados iniciais do tratamento cirúrgico de aneurismas anteriores do ventrículo esquerdo (Aneu VE, pela técnica de Dor, endoventriculoplastia circular, com exclusão septal, baseada nos conceitos de Hutchins & Bulkley, da geometria do VE e da sua reconstrução geométrica, e nos da operação da redução circular de Jatene. CASUÍSTICA E MÉTODO: No período de abril a outubro de 1999, foram realizados 6 procedimentos para a correção de Aneu VE, com a técnica de Dor. O tempo entre o infarto de parede anterior e a operação variou de 8 dias a 10 meses, sendo que 3 pacientes se encontravam na classe III, 2 na classe IV e 1 na classe I da NYHA. Quatro pacientes eram do sexo masculino e a idade média do grupo era de 58,3 anos. No estudo hemodinâmico pré-operatório, a fração de ejeção global variou de 27 a 46% (média de 37,2%, o volume sistólico final de VE de 64,4 a 135,3 ml (média de 107,9 ml e o volume diastólico final de VE de 132,9 a 236,4 ml (média de 183,8 ml. A operação foi associada à retirada de trombos do VE em 3 casos, a revascularização coronária concomitante em 5 casos, com o uso de 10 enxertos venosos e 3 arteriais (2,2 enxertos/paciente e uma endarterectomia. A parede anterior foi revascularizada em 9 casos e as paredes, lateral e inferior, em 2 cada. Os tempos médios de pinçamento aórtico e circulação extracorpórea foram, respectivamente, 44 e 110 minutos. RESULTADOS: O tempo médio de permanência hospitalar pós-operatória foi de 7,7 dias. Os pacientes foram seguidos de 5 a 31 semanas, sendo que todos se encontram na classe funcional I; em 3 casos o cateterismo cardíaco foi realizado e nos outros 3, um ecocardiograma bidimensional, para avaliação da fração de ejeção global, que variou de 42,5 a 60% (média de 49,4%, com melhora de 32,8% em relação à inicial. CONCLUSÃO: Diante destes resultados, pode-se considerar que esta seja mais uma t

  8. Prediction of early-onset atrial tachyarrhythmia after successful trans-catheter device closure of atrial septal defect.

    Science.gov (United States)

    Park, Kyoung-Min; Hwang, Jin Kyung; Chun, Kwang Jin; Park, Seung-Jung; On, Young Keun; Kim, June Soo; Park, Seung Woo; Kang, I-Seok; Song, Jinyoung; Huh, June

    2016-08-01

    Atrial tachyarrhythmia is a well-known long-term complication of atrial septal defect (ASD) in adults, even after successful trans-catheter closure. However, the risk factors for early-onset atrial tachyarrhythmia after trans-catheter closure remain unclear. This retrospective study enrolled adults with secundum ASD undergoing trans-catheter closure from January 2000 to March 2014. We analyzed the clinical characteristics of patients and assessed risk factors for new-onset atrial tachyarrhythmia defined as a composite of atrial fibrillation or flutter (AF/AFL) after ASD closure. We enrolled a total of 427 patients; 123 were male (28.8%) and the median age was 37.0 (interquartile range [IQR]: 18.3-49.0). Nineteen (4.4%) patients had documented atrial tachyarrhythmia during the follow-up period (median: 11.4 months [IQR: 5.4-24]). Patients with transient AF/AFL during closure showed a greater incidence of new-onset atrial tachyarrhythmia during the follow-up period than patients with consistent sinus rhythm during closure (27.3% vs 3.8%; P = 0.01). Most new-onset atrial tachyarrhythmias were documented within 6 months (median: 2.6 [IQR: 1.2-4.1] months) of closure. In the multivariate analysis, the risk for new-onset atrial tachyarrhythmia was significant in patients with AF/AFL during closure (hazard ratio [HR]: 9.90, 95% confidence interval [CI]: 2.86-34.20; P < 0.001), deficient posteroinferior rim (HR: 5.48, 95% CI: 1.15-25.72; P = 0.04), and age of closure over 48 years (HR: 3.30, 95% CI: 1.30-8.38; P = 0.01). In conclusion, transient AF/AFL during trans-catheter closure of ASD as well as deficient posteroinferior rim and age of closure over 48 years may be useful for predicting early new-onset atrial tachyarrhythmia after device closure. PMID:27583905

  9. Inaccuracy of doppler echocardiographic estimates of pulmonary artery pressures in adult atrial septal defect patients with pulmonary arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    Zhang Caojin; Huang Tao; Huang Xinsheng; Huang Yigao; Chen Jimei; Chen Jiyan; Wu Shulin

    2014-01-01

    Background While echocardiography has been a pivotal screening test in pulmonary arterial hypertension (PAH),the presence of structural cardiac defects may affect the ability to reliably predict pulmonary artery pressures (PAPs).This study sought to evaluate the accuracy of Doppler echocardiography (DE) for estimating PAPs in adult atrial septal defect (ASD) patients with PAH.Methods A prospective study was carried out to compare the echocardiographic assessment of PAP with the same pressures obtained by right heart catheterization (RHC) in adult ASD patients with PAH who underwent simultaneous DE and RHC.Bland-Altman analyses were performed to evaluate the agreement between DE and RHC measurements of PAPs.Results Two hundred and fifty-seven patients were included in the study.A significant overestimation of the systolic pulmonary arterial pressure (sPAP) and mean pulmonary artery pressure (mPAP) was reported by echocardiography compared with those by catheterization ((81.8±26.9) mmHg vs.(72.9±26.9) mmHg,P <0.01; (51.9±16.4) mmHg vs.(41.4±17.2) mmHg,P <0.01,respectively).Twenty-one percent (55/257) of the patients had PAH when estimated by echocardiography whereas showed normal results in the subsequent catheterization test.Using Bland-Altman analytic methods,the bias for the echocardiographic assessment of the sPAP was 9.1 mmHg with 95% limits of agreement ranging from-24.4 to 42.6 mmHg.For mPAP measurement,the bias was 10.5 mmHg with 95% limits of agreement ranging from-12.4 to 33.4 mmHg.On multiple linear regression analysis,age,gender,body surface area,ASDs' diameter,PVR,diastolic blood pressure,and echocardiographic assessment of right atrial pressure (RAP) explained 68.8% of the total variability in the model (r2=0.688,P <0.01).Conclusion Inaccuracy was frequently reported in Doppler echocardiographic assessment of the PAP in adult ASD patients with PAH and was often associated with age,gender,body surface area,ASDs' diameter

  10. The Role of Nasopharyngeal Temperature Monitoring in Detection of a Malpositioned Superior Vena Cava Cannula in an Emergency Coronary Artery Bypass in a Patient With Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    A Dabbagh

    2010-03-01

    Full Text Available A 55 year-old woman was admitted to the CCU ward of our university hospital due to typical chest pain. The patient received supportive care and was transferred to the operating room for an emergency repair of the ventricular septal defect (VSD and myocardial revascularization. The surgical team was notified regarding the tolerance to cooling detected by the temperature monitoring and also, the congestion of eye and blanching of forehead. After a few maneuvers, the cannula was repositioned. In a few seconds, the forehead was cooled, while the airlocking episodes were lifted completely and the blanching and chemosis in the face and eyes all resolved. The septal defect was approached through the left ventricle; a 15 in 20 mm foramen, due to the ischemic rupture of the superior portion of the anteroseptal wall, was repaired with a patch of hemoshield. The incision over the LV was then repaired with 2 parallel bands of felt. The patient was operated on and transferred to the intensive care unit.

  11. Identification of the occluded artery in patients with myocardial ischemia induced by prolonged percutaneous transluminal coronary angioplasty using traditional vs transformed ECG-based indexes.

    Science.gov (United States)

    García, J; Wagner, G; Sömmo, L; Lander, P; Laguna, P

    1999-10-01

    We have studied the spatial properties of ischemic changes as induced by prolonged angioplasty and how the changes are related to different ECG indexes. Indexes based on measurements at specific points in time (ST level at J + 60 ms point, maximal T wave amplitude and position, QT interval, and QRS duration) and global indexes (based on the Karhunen-Loève transform and applied to the QRS complex, ST-T complex, ST segment, and T wave), considering both repolarization and depolarization information, were analyzed. The changes during the occlusion period of the different indexes were used as variables in a multivariate discriminant analysis to determine which indexes showed the best discrimination of the three major occlusion sites (corresponding to LAD, RCA, and LCX coronary arteries). Occlusions in LCX artery were the most difficult to classify. With three local indexes (ST60 level measured in lead V3, T wave amplitude in I, and ST60 in III) it was possible to correctly classify 76% of patients by the occlusion site, and with three KLT-derived indexes (first-order KLT index for ST-T complex in I and for QRS in leads V3 and I) 83% of correct classification was obtained. Using six indexes for local and KLT-derived indexes the correct classification was increased to 85 and 90% of patients, respectively. The use of different ECG indexes (from different intervals) on quasiorthogonal leads permitted the identification of the occluded artery in patients undergoing PTCA and may be extended to more general use. PMID:10529303

  12. Atrial septal defect (ASD)

    Science.gov (United States)

    ... ncbi.nlm.nih.gov/pubmed/17015547 . Marelli AJ. Congenital heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ... Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Mann DL, Zipes DP, Libby P, Bonow ...

  13. Ventricular Septal Defect

    Science.gov (United States)

    ... restricted in any way. Recovery Recovery A typical stay in the hospital after surgical closure is 4 to 5 days, if there are no problems. After repair, most children go on to live healthy, productive lives. Reviewed ...

  14. 隔瓣后室间隔缺损并假性室隔瘤的手术治疗%Surgical Treatment of Ventricular Septal Defect With False Aneurysm of Membrane Septum

    Institute of Scientific and Technical Information of China (English)

    毛志福; 高尚志; 陈俊堂; 姚震; 涂仲凡

    1996-01-01

    Objective:To introduce the procedure for better exposure of the ventricular septal defect(VSD)from fused septal leaflet pouch.Method:Among the 28 cases,the septal leaflet of tricuspid valve in 22 cases was incised and the papillary muscle in 6 cases was dissected to expose the rim of the hidden VSD for proper anatomic repair.Results:There was no death,no significant intraoperative or postoperative complications and tricuspid valve dysfunction.Conclusion: Opening the fused septal leaflet pouch is safe and beneficial to a better exposure and repair of the hidden defect.%采用隔瓣切开或圆锥乳头肌切断术治疗假性室隔瘤型VSD并予以评价.全组共28例,其中22例采用隔瓣切开,6例采用圆锥乳头肌切断片显露缺损,再以涤纶片或自体心包片修补VSD.全组无手术死亡,无重大并发症及三尖瓣功能不全.此法安全,有利于VSD的显露和对VSD准确可靠的修补,值得推荐使用.

  15. Interaction between paraventricular nucleus and septal area in the control of physiological responses induced by angiotensin II

    Directory of Open Access Journals (Sweden)

    L.A.A. Camargo

    2002-09-01

    Full Text Available We determined the effects of losartan (40 nmol and PD 123319 (40 nmol (both non-peptides and selective antagonists of the AT1 and AT2 angiotensin receptors, respectively, and [Sar¹, Ala8] angiotensin II (ANG II (40 nmol (a non-selective peptide antagonist of angiotensin receptors injected into the paraventricular nucleus (PVN on the water and salt appetite, diuresis and natriuresis and mean arterial pressure (MAP induced by administration of 10 nmol of ANG II into the medial septal area (MSA of male Holtzman rats weighing 250-300 g. The volume of drug solution injected was 0.5 µl over a period of 10-15 s. The responses were measured over a period of 120 min. ANG II alone injected into the MSA induced an increase in all the above parameters (8.1 ± 1.2, 1.8 ± 0.3, and 17.1 ± 1.0 ml, 217 ± 25 µEq/120 min, and 24 ± 4 mmHg, respectively, N = 10-12 compared with vehicle-treated rats (1.4 ± 0.2, 0.6 ± 0.1, and 9.3 ± 0.5 ml, 47 ± 5 µEq/120 min, and 4.1 ± 0.8 mmHg, respectively, N = 10-14. Pretreatment with losartan and [Sar¹, Ala8] ANG II completely abolished the water and sodium intake, and the pressor increase (0.5 ± 0.2, 1.1 ± 0.2, 0.5 ± 0.2, and 0.8 ± 0.2 ml, and 1.2 ± 3.9, 31 ± 4.6 mmHg, respectively, N = 9-12, whereas losartan blunted the urinary and sodium excretion induced by ANG II (13.9 ± 1.0 ml and 187 ± 10 µEq/120 min, respectively, N = 9. Pretreatment with PD 123319 and [Sar¹, Ala8] ANG II blocked the urinary and sodium excretion (10.7 ± 0.8, 9.8 ± 0.7 ml, and 67 ± 13 and 57 ± 17 µEq/120 min, respectively, N = 9, whereas pretreatment with PD 123319 partially blocked the water and sodium intake, and the MAP induced by ANG II administration (2.3 ± 0.3, 1.1 ± 0.1 ml, and 12 ± 3 mmHg, respectively, N = 9-10. These results suggest the angiotensinergic effect of the MSA on the AT1 and AT2 receptors of the PVN in terms of water and sodium homeostasis and MAP modulation.

  16. O acometimento isquêmico obstrutivo na cardiomiopatia hipertrófica do tipo septal assimétrico com envolvimento da artéria descendente anterior

    Directory of Open Access Journals (Sweden)

    Albanesi Fº Francisco Manes

    1997-01-01

    Full Text Available OBJETIVO: Avaliar o papel da doença arterial coronária (DAC com comprometimento da artéria descendente anterior (ADA na cardiomiopatia hipertrófica (CMH e sua repercussão na evolução, visto ser controverso o significado da necrose e fibrose do septo interventricular (SIV nesta cardiomiopatia. MÉTODOS: Entre 158 pacientes com CMH, selecionamos 6 (3,79% com CMH e DAC com lesão obrigatória de ADA, sendo 4 homens, entre 52 e 70 (x= 65,16 nos, 4 com a forma obstrutiva da CMH. O tempo de diagnóstico da CMH foi de 78 a 182 (x=141 meses e da DAC de 1 dia a 106 (x= 42 meses. Os pacientes foram acompanhados com avaliações clínicas e exames complementares periódicos. RESULTADOS: A forma de apresentação da DAC foi em 5 com angina instável e um com infarto do miocárdio. A ADA estava comprometida entre 60 a 100%, sendo em um lesão única e nos 5 restantes com lesão em 2 ou mais vasos. Na evolução, 3 foram submetidos a revascularização miocárdica (RM, um associada a miomectomia septal, um a angioplastia e 2 somente a tratamento clínico. No período de observação de 76 a 124 meses após o diagnóstico da DAC, ocorreu um óbito. No fim do estudo observamos redução nos valores médios do SIV de 1,53 para 1,40cm, gradiente de pressão entre o corpo e a via de saída do ventrículo esquerdo (VE de 56 para 15,75mmHg, com discreto aumento no diâmetro diastólico do VE de 4,55 para 4,85cm e do diâmetro sistólico de 2,83 para 3,13cm, sem alterar a dimensão do átrio esquerdo (4,13cm. CONCLUSÃO: A DAC da ADA é bem tolerada na CMH septal assimétrica, participando do processo fibrótico septal e melhorando o desempenho cardíaco, não representando problema adverso na evolução da CMH.

  17. Postoperative Residual Shunt After Repair of Ventricular Septal Defect Among Children%小儿室间隔缺损术后残余漏

    Institute of Scientific and Technical Information of China (English)

    蒋雄刚

    1995-01-01

    8例小儿室间隔缺损修补术后残余漏再次手术病例分析:残余漏表现为5例术后残留心前区Ⅲ级以上收缩期杂音,7例血红蛋白尿,2例右心衰,8例超声心动图(UCG)证实心室水平残余左向右分流.均于术后2~112天行残余漏修补.术中见残余漏原因为不同部位缝针处组织撕裂6例,修补不全2例.8例均经带垫片褥式缝合加固,7例痊愈,1例再次发生残余漏.本文对残余漏特点、诊断、手术适应证及时机进行了讨论.%Eight cases of postoperative residual shunt after repair of venticular septal defect (VSD) were analysed in this paper.Their clinical features disclosed:hemofiubinuria in 7 cases,cardiac murmur in 5 and residual shunt signs on echocardiograph in 8.In the operation for residual shunt,it was found:the tear in septal leaflet in aneurysm-like VSD in 2 cases,the tear in septal leaflet of tricuspid in 4,infundibular muscular 2 and residual triangle defect under the patch repair in VSD 2.Residual shunt in all the 8 cases were repaired with mattress suture under cardiopulmonary bypass,seven patients recovered without hemogiobinuria or cardiac murmur,but one had residual shunt again and cerebral insufficiency,which was improved by medical therapy.The harmfulness,the diagnosis and prevention of postoperative residual shunt,the operative indication,optimal time and surgical procedures were discussed.

  18. Results of beating heart mitral valve surgery via the trans-septal approach Resultados da abordagem transeptal para a valva mitral com coração batendo

    Directory of Open Access Journals (Sweden)

    Tomas A Salerno

    2009-03-01

    Full Text Available OBJECTIVE: Mitral valve surgery can be performed through the trans-atrial or the trans-septal approach. Although the trans-atrial is the preferred method, the trans-septal approach has also been used recently and has a particular value in beating-heart mitral valve surgery. Herein we report our experience with beating-heart mitral valve surgery via trans-septal approach, and discuss its advantages and pitfalls. METHODS: Between 2000 and 2007, 214 consecutive patients were operated upon utilizing beating heart technique for mitral valve surgery. The operation was performed via transseptal approach with the aorta unclamped, the heart beating, with normal electrocardiogram and in sinus rhythm. RESULTS: Mean age was 56.03 ± 13.93 years (range: 19-86 years; median: 56 years. There were 131 (61.2% males and 83 (38.8% females. Of the prostheses used, 108 (50.5% were biological, and 39 (18.2% were mechanical. Mitral repairs were performed in 67 (31.3% patients. Mean hospital stay was 17.4 ± 20.0 days (range: 3-135 days; median: 11 days. Intra-aortic balloon pump (IABP utilization was required in 12 (5.6% of 214 patients. One-month mortality was 7.4%, and re-operation for bleeding was needed in 15 (7% patients. CONCLUSIONS: Beating-heart mitral valve surgery is an option for myocardial protection in patients undergoing mitral valve surgery. This technique is facilitated by the trans-septal approach due to reduced aortic insufficiency and improved visualization of the mitral apparatus.OBJETIVO: A cirurgia da valva mitral pode ser feita via transatrial ou transeptal. Embora a transatrial seja a preferida, a via transeptal tem sido utilizada mais recentemente e tido um grande valor nas operações com o coração batendo. Mostramos a nossa experiência na cirurgia da valva mitral via transeptal com coração batendo e discutimos seus benefícios e problemas. MÉTODOS: Entre 2000 e 2007, 214 pacientes consecutivos foram operados com o coração batendo. A

  19. [Mitral Valve Replacement with a Low-Profile Bioprosthesis in Combination with Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy;Report of a Case].

    Science.gov (United States)

    Furukawa, Koji; Sakaguchi, Shuhei; Nakamura, Eisaku; Yano, Mitsuhiro

    2015-06-01

    An 83-year-old woman diagnosed with hypertrophic obstructive cardiomyopathy was referred to our hospital. Her echocardiogram revealed diffuse left ventricular hypertrophy, severe mitral valve regurgitation with systolic anterior motion of the mitral valve, and left ventricular obstruction with a peak outflow gradient of 142 mmHg. Cardiac catheterization revealed a peak pressure gradient of 60 mmHg across the left ventricular outflow tract. Because of the patient's advanced age, as well as uncertainty regarding our ability to resolve her mitral regurgitation, we performed mitral valve replacement with a St. Jude Medical Epic porcine low-profile bioprosthesis in combination with septal myectomy. The patient's postoperative course was uneventful. At 1 year after the operation, her functional status was New York Heart Association class I. The echocardiogram showed the peak outflow gradient markedly decreased to 9 mmHg. PMID:26066877

  20. Importance of Close Follow-Up in the Fetus with Premature Atrial Contractions Accompanied by Atrial Septal Aneurysm: A Case Report

    Directory of Open Access Journals (Sweden)

    Yilmaz Yozgat

    2013-01-01

    Full Text Available Rhythms that derive from parts of atria other than the sinus node are called premature atrial contractions (PACs. Vast majority of fetal PACs are idiopathic. Fetal PACs usually have a good prognosis and disappear spontaneously during pregnancy or after delivery. Development of fetal tachycardia or fetal bradycardia is rarely reported during follow-up of fetuses diagnosed with PACs. To the best of our knowledge, coexistence of tachycardia and bradycardia leading to hemodynamic impairment has not yet been reported. We present a fetus diagnosed with PACs and atrial septal aneurysm (ASA on the 23rd week of gestation proceeding to fetal bradycardia and fetal tachycardia and consequently hemodynamic impairment. We suggest closer follow-up of fetuses with PACs accompanied by ASA.

  1. Importance of close follow-up in the fetus with premature atrial contractions accompanied by atrial septal aneurysm: a case report.

    Science.gov (United States)

    Yozgat, Yilmaz; Kilic, Ayhan; Karadeniz, Cem; Ozdemir, Rahmi; Doksoz, Onder; Mese, Timur; Unal, Nurettin

    2013-01-01

    Rhythms that derive from parts of atria other than the sinus node are called premature atrial contractions (PACs). Vast majority of fetal PACs are idiopathic. Fetal PACs usually have a good prognosis and disappear spontaneously during pregnancy or after delivery. Development of fetal tachycardia or fetal bradycardia is rarely reported during follow-up of fetuses diagnosed with PACs. To the best of our knowledge, coexistence of tachycardia and bradycardia leading to hemodynamic impairment has not yet been reported. We present a fetus diagnosed with PACs and atrial septal aneurysm (ASA) on the 23rd week of gestation proceeding to fetal bradycardia and fetal tachycardia and consequently hemodynamic impairment. We suggest closer follow-up of fetuses with PACs accompanied by ASA. PMID:24455349

  2. Hypothermia During Cardiopulmonary Bypass Increases Need for Inotropic Support but Does Not Impact Inflammation in Children Undergoing Surgical Ventricular Septal Defect Closure.

    Science.gov (United States)

    Schmitt, Katharina Rose Luise; Fedarava, Katsiaryna; Justus, Georgia; Redlin, Mathias; Böttcher, Wolfgang; Delmo Walter, Eva Maria; Hetzer, Roland; Berger, Felix; Miera, Oliver

    2016-05-01

    Minimizing the systemic inflammatory response caused by cardiopulmonary bypass is a major concern. It has been suggested that the perfusion temperature affects the inflammatory response. The aim of this prospective study was to compare the effects of moderate hypothermia (32°C) and normothermia (36°C) during cardiopulmonary bypass on markers of the inflammatory response and clinical outcomes (time on ventilator) after surgical closure of ventricular septal defects. During surgical closure of ventricular septal defects under cardiopulmonary bypass, 20 children (median age 4.9 months, range 2.3-38 months; median weight 7.2 kg, range 5.2-11.7 kg) were randomized to a perfusion temperature of either 32°C (Group 1, n = 10) or 36°C (Group 2, n = 10). The clinical data and blood samples were collected before cardiopulmonary bypass, directly after aortic cross-clamp release, and 4 and 24 h after weaning from cardiopulmonary bypass. Time on ventilation as primary outcome did not differ between the two groups. Other clinical outcome parameters like fluid balance or length of stay in the intensive care were also similar in the two groups. Compared with Group 2, Group 1 needed significantly higher and longer inotropic support (P Perfusion temperature did not influence cytokine release, organ injury, or coagulation. Cardiopulmonary bypass temperature does not influence time on ventilation or inflammatory marker release. However, in the present study, with a small patient cohort, patients operated under hypothermic bypass needed higher and longer inotropic support. The use of hypothermic cardiopulmonary bypass in infants and children should be approached with care. PMID:26581834

  3. Diffusion of hyperpolarized {sup 129}Xe in the lung: a simplified model of {sup 129}Xe septal uptake and experimental results

    Energy Technology Data Exchange (ETDEWEB)

    Patz, Samuel; Muradyan, Iga; Dabaghyan, Mikayel; Washko, George R; Hatabu, Hiroto; Butler, James P [Center for Pulmonary Functional Imaging, Departments of Radiology and Pulmonary Medicine, Brigham and Women' s Hospital and Harvard Medical School, Boston, MA 02115 (United States); Hrovat, Mirko I, E-mail: patz@bwh.harvard.edu [Mirtech, Inc., Brockton, MA 02301 (United States)

    2011-01-15

    We used hyperpolarized {sup 129}Xe NMR to measure pulmonary alveolar surface area per unit gas volume S{sub A}/V{sub gas}, alveolar septal thickness h and capillary transit time {tau}, three critical determinants of the lung's primary role as a gas exchange organ. An analytical solution for a simplified diffusion model is described, together with a modification of the xenon transfer contrast imaging technique utilizing 90{sup 0} radio-frequency pulses applied to the dissolved phase, rather than traditional 180{sup 0} pulses. With this approach, three-dimensional (3D) maps of S{sub A}/V{sub gas} were obtained. We measured global S{sub A}/V{sub gas}, h and {tau} in four normal subjects, two subjects with mild interstitial lung disease (ILD) and two subjects with mild chronic obstructive pulmonary disease (COPD). In normals, S{sub A}/V{sub gas} decreased with increasing lung volume from {approx}320 to 80 cm{sup -1}; both h{approx}13 {mu}m and {tau}{approx}1.5 s were relatively constant. For the two ILD subjects, h was, respectively, 36 and 97% larger than normal, quantifying an increased gas/blood tissue barrier; S{sub A}/V{sub gas} and {tau} were normal. The two COPD subjects had S{sub A}/V{sub gas} values {approx}25% that of normals, quantifying septal surface loss in emphysema; h and {tau} were normal. These are the first noninvasive, non-radiation-based, quantitative measurements of h and {tau} in patients with pulmonary disease.

  4. Current knowledge of occluder device-associated endocarditis%封堵器植入后感染性心内膜炎的初步认识及诊治进展

    Institute of Scientific and Technical Information of China (English)

    杨呈伟; 李炯佾; 徐仲英; 赵世华; 吴文辉

    2014-01-01

    The percutaneous approach remains an increasingly utilization and valuable method of treating congenital heart disease (CHD) and perivalvular leak. Although reportedly rare, infective endocarditis (IE) as a complication may become more widely recognized as the use of percutaneous occluder devices increases and the population of patients with indwelling prostheses grows. Eighteen previous cases of IE after occluder device implantation have been reported. The increasing use of intracardiac devices may require a reevaluation of the possible need for administration of prophylactic antibiotics before, during, or after the procedure and the type of antibiotics to be given. The current knowledge of occluder device-associated IE was reviewed in this article.%经导管封堵术主要用于治疗先天性心脏病间隔缺损,也用于其他心内或心外异常分流,如瓣膜置换术后瓣周漏。封堵器植入后感染性心内膜炎(IE)非常罕见,资料较完整者仅有18例报道,但是一旦发生则非常严重,随着经皮封堵装置临床应用的日益广泛,该类并发症须引起足够重视,甚至对封堵术前、术中及术后预防性应用抗生素方案也可能需要重新评价。本文对封堵器植入后IE的初步认识及诊治进展进行综述。

  5. Surgical experience for the treatment of aortopulmonary septal defect%主肺间隔缺损的外科治疗

    Institute of Scientific and Technical Information of China (English)

    李进华; 来永强; 李景伟; 赖以恒; 崔永超; 郝兴海; 章良; 周其文

    2009-01-01

    目的 探讨主肺间隔缺损的外科治疗经验.方法 1987年12月至2007年3月,16例主肺间隔缺损病儿(人),其中男11例,女5例,年龄5个月~22岁,平均(8.2±7.1)岁;体重5.8~50.0 kg,平均(22.2±13.9)kg.Mori分型Ⅰ型7例,Ⅱ型7例,Ⅲ型2例.主肺间隔缺损大小10~35mm,平均(22.6±7.3)mm.其中合并室间隔缺损、房间隔缺损和肺主动脉弓离断畸形(B型)各2例,动脉导管未闭1例.术前10例行心导管检查,肺动脉收缩压50~120 mm Hg(1 mm Hg=0.133 kPa),平均(75.4±25.2)mm Hg,肺动脉平均压21~100 mm Hg,平均(60.3±24.8)m Hg.14例在中低温体外循环下完成手术,2例在深低温停循环完成手术.结果 主动脉阻断(70.6±48.1)min,体外循环(110.5±62.9)min.术后10例肺动脉收缩压(50.2±18.5)mm Hg,平均肺动脉压(40.0±15.2)mm Hg,术后呼吸机使用(22.6±14.5)h,滞留蕈症监护室1~70 d,总住院14~127 d.2例合并主动脉弓离断者围术期分别死于急性肾衰和术后低心排出量综合征.14例痊愈,平均随访(8.8±7.5)年,1例主肺动脉间隔小残余漏,余心功能明显改善.结论 主肺间隔缺损者肺血管病理改变早,早期诊断、及时手术,能降低病死率.%Objective Aortopulmonary septal defect is rare and accounted for abont 0.15% to0.60% of infants and children with congenital heart malformation. Aortopulmonary septal defect has similar pathophysiologic findings with patent ductus. Early pul-monary hypertension and congestive heart failure may develop as a result of large left to right shunt from the ascending aorta to the pul-monary artery, with a relatively rapid progression of pathological changes in the pulmonary vessels associated with pulmonary hyperten-sion. This article will describe our surgical experience in the treatment of this disease. Methods From December 1987 to March 2000,16 cases with aortopulmonary septal defect underwent surgical treatment, 11 were males and 5 were females. The mean age and weight were (8

  6. Percutaneous transfemoral closure of a pseudoaneurysm at the left ventricular apical access site for transcatheter aortic valve implantation.

    Science.gov (United States)

    Karimi, Ashkan; Beaver, Thomas M; Fudge, James C

    2015-02-01

    This case report illustrates a left ventricular pseudoaneurysm that developed at the transapical access site for transcatheter aortic valve implantation and was successfully excluded percutaneously through a femoral approach using an Amplatzer muscular VSD occluder (St. Jude Medical). We also discuss various currently available devices and technical pearls for percutaneous closure of left ventricular pseudoaneurysms. PMID:25661768

  7. Estudo clínico de celulite orbitária e pré-septal na infância Orbital and preseptal cellulitis in childhood: a clinical study

    OpenAIRE

    César Moreira Sampaio; Lívia Maria Bittencourt Nossa; Ana Paula Ramos; Renata Abreu Paim; Roberto Lorens Marback

    2001-01-01

    Objetivo: Estudar retrospectivamente aspectos clínicos e terapêuticos em crianças portadoras de celulite orbitária e pré-septal. Métodos: Foram analisados 52 prontuários de pacientes com idades variando de um mês a doze anos, internados no período compreendido entre 1990 e 1998, com quadro de celulite orbitária ou pré-septal. Resultados: Trauma foi o fator predisponente mais freqüente das celulites orbitárias e pré-septais na infância, seguido pela sinusite e causas não-definidas. As infecçõe...

  8. 婴幼儿完全性房室隔缺损的外科治疗%Surgical correction of complete atrioventricular septal defect in infants

    Institute of Scientific and Technical Information of China (English)

    胡型锑; 赵琦峰; 吴国伟; 杜杰; 费建斌; 夏杰

    2014-01-01

    目的 总结婴幼儿完全性房室隔缺损外科治疗的临床经验.方法 本院2004年6月至2013年12月共手术治疗婴幼儿完全性房室间隔缺损56例,年龄53 d至12个月.全部患者术前经心脏超声检查确诊,其中18例患儿同时行心脏血管CTA检查.Rastelli A型44例,B型3例,C型9例.手术采用单片法修补37例,双片法修补3例,改良单片法修补16例.术后机械通气时间26 ~ 172 h,住ICU时间3~19d.结果 术后早期院内死亡5例,死亡原因分别为严重低心排2例,肾功能衰竭2例,严重肺部感染1例;晚期死亡1例,术后2个月因二尖瓣中、重度返流,死于心肺功能衰竭.手术死亡率10.7% (6/56).47例患儿术后随访3个月至5年,心功能恢复良好.结论 完全性房室间隔缺损一旦诊断明确应在生后6个月至1周岁及时手术,早期手术临床效果满意.手术效果关键取决于对心内结构的仔细探查以及彻底纠正心内畸形.%Objective To summarize the clinical experience of surgical treatment for complete atrioventricular septal defect in infants.Methods From December 2013 to June 2004,56 patients aged from 53 days to 12 months with complete atrioventricular septal defect were undergone operations.All patients were diagnosed by 2D-echocardiography,and 18 patients underwent cardiovascular computed angiography (CTA).Rastelli type A had 44 cases,type B 3 cases,and type C 9 cases.The single pericardium patch repair was used for 37 cases,the two-patch repair for 3 cases,and the modified single-patch repair for 16 cases.The time of mechanical ventilation was 26 to 172 hours,and the time of staying at Intensive Care Unit (ICU) was 3 to 19 days.Results There were 5 early deaths caused by severe low cardiac output in 2 cases,renal failure in 2 cases,and severe pulmonary inflammation in 1 case.One late death was due to severe mitral regurgitation with pneumonia and heart failure.The operative mortality was 10.7%.A total of 47 patients was

  9. Significant reduction of left atrial volume concomitant with clinical improvement after percutaneous transluminal septal myocardial ablation for drug-refractory hypertrophic obstructive cardiomyopathy, and its precise detection with multidetector CT

    OpenAIRE

    Maekawa, Yuichiro; Akita, Keitaro; Tsuruta, Hikaru; Yamada, Yoshitake; Hayashida, Kentaro; Yuasa, Shinsuke; Murata, Mitsushige; Jinzaki, Masahiro; Fukuda, Keiichi

    2016-01-01

    Objective In patients with hypertrophic obstructive cardiomyopathy (HOCM), left atrial (LA) volume measurement is very important to provide prognostic information. Recent studies demonstrated that multidetector CT (MDCT) is useful to assess the changes in LA volume. Our aim was to examine the utility of a follow-up cardiac MDCT for long-term evaluation of the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on LA volume. Methods We studied a consecutive cohort of 20 pati...

  10. Association between the European GWAS-Identified Susceptibility Locus at Chromosome 4p16 and the Risk of Atrial Septal Defect: A Case-Control Study in Southwest China and a Meta-Analysis

    OpenAIRE

    Zhao, Li; Li, Bei; Dian, Ke; Ying, Binwu; Lu, Xiaojun; Hu, Xuejiao; An, Qi; CHEN, CHUNXIA; Huang, Chunyan; Tan, Bin; Qin, Li

    2015-01-01

    Atrial septal defect (ASD) is the third most frequent type of congenital heart anomaly, featuring shunting of blood between the two atria. Gene-environment interaction remains to be an acknowledged cause for ASD occurrence. A recent European genome-wide association study (GWAS) of congenital heart disease (CHD) identified 3 susceptibility SNPs at chromosome 4p16 associated with ASD: rs870142, rs16835979 and rs6824295. A Chinese-GWAS of CHD conducted in the corresponding period did not reveal ...

  11. Simultaneous transfemoral transcatheter mitral and tricuspid valve edge-to-edge repair (using MitraClip system) completed by atrial septal defect occlusion in a surgically inoperable patient. First-in-human report

    OpenAIRE

    Kowalski, Marek; Franz, Norbert; Ritter, Frank; Hofmann, Steffen; Stabel-Mahassine, Chourok; Warnecke, Henning; Thale, Joachim

    2015-01-01

    Transcatheter transfemoral mitral valve repair using the MitraClip system (Abbott Vascular, USA) is used in high-risk or inoperable patients with severe mitral regurgitation. We report the first-in-human simultaneous transfemoral clipping of the mitral and tricuspid valve completed by occlusion of an atrial septal defect (ASD). The procedure was performed in an 84-year-old patient in October 2015. After effective reduction of mitral and tricuspid regurgitations using the MitraClip system a PF...

  12. Site-specific enhancement of gamma-aminobutyric acid-mediated inhibition of neural activity by ethanol in the rat medial septal area.

    Science.gov (United States)

    Givens, B S; Breese, G R

    1990-08-01

    Because of uncertainty concerning the interaction of ethanol with gamma-aminobutyric acid (GABA) receptor-mediated events, the present work was designed to investigate the effect of ethanol on GABA transmission in the rat septal area using behavioral and electrophysiological techniques. Microinjection of the GABAA agonist muscimol into the medial septal area (MSA) enhanced, and bicuculline administration antagonized, ethanol-induced impairment of the aerial righting reflex. Microinjection of these drugs into the lateral septum (LSi) did not influence this measure of ethanol-induced sedation. Furthermore, intraseptal injections of muscimol or bicuculline in saline-treated rats had no effect on the aerial righting reflex. These data suggest that the MSA plays a critical modulatory role in the sedative actions of ethanol. To assess the effect of ethanol on muscimol responses in the MSA and LSi at the cellular level, GABA was applied by iontophoresis to rhythmically bursting neurons of the MSA and to cells in the LSi. The magnitude of the resultant inhibition by GABA on these cells was assessed before and after systemic administration of ethanol. Ethanol enhanced GABA-mediated inhibition of MSA neural activity, but did not alter GABA-mediated inhibition of cellular activity in the LSi. In contrast, the inhibition of cellular activity in the MSA, caused by a maximally effective concentration of the benzodiazepine flurazepam, was not altered by ethanol. Other work in the MSA demonstrated that electrical stimulation of the fimbria caused an inhibition of ongoing single unit activity that was reduced by concurrent application of bicuculline. The duration of this electrically elicited inhibition in the MSA was enhanced after ethanol injection and then recovered to base-line levels. In addition, ethanol (1.5 mg/kg) caused an enhancement of the inhibition induced by nipecotic acid, a GABA uptake inhibitor. These findings demonstrate that GABA-mediated neural inhibition is

  13. 室间隔切除术:治疗梗阻性肥厚型心肌病的金标准%Septal myectomy for obstructive hypertrophic cardiomyopathy:the gold standard

    Institute of Scientific and Technical Information of China (English)

    Joseph A Dearani; Hartzell V Schaff; Steve R Ommen

    2009-01-01

    Septal myectomy effectively and definitively relieves LVOT obstruction and cardiac symptoms in adults and children with obstructive hypertrophic cardiomyopathy(HCM).Abnormalities of the mitral valve can be addressed without the need for mitral valve replacement in almost all circumstances.Concomitant mitral valve repair for myxomatous disease requires minor modifications when performed in conjunction with septal myectomy;mitral valve replacement is rarely necessary.In experienced centers,early mortality for isolated septai myectomy is low(~1%)and overall results are excellent and continue to improve in the current era.Symptomatic improvement with myectomy is expected for most;90% of patients improve by at least one functional class,and most remain improved on late follow-up.Late survivorship is improved compared to nonopereted patients with obstructive HCM,and myectomy may be associated with reduced risk of sudden cardiac death.These results should serve as the gold standard and a basis for comparison with newer nonsurgical medalities,i.e.,septal alcohol ablation.

  14. The combined occluding effect of fluor protector and Nd:YAG laser irradiation on human dentinal tubules%激光促进氟保护漆对牙本质小管的 封闭作用

    Institute of Scientific and Technical Information of China (English)

    张成飞; 林琼光; 赵宝红; 邱华

    2001-01-01

    Objective To evaluate the combined occluding effect of fluor protector and Nd:YAG Laser irradiation on human dentinal tubules. Methods Twenty-four dentin specimens with exposed dentinal tubule orifices treated by 37% H3PO4 were randomly divided into four groups. Group B, C and D were vanished by fluor protector, group A served as a control. Group D was lased by Nd:YAG laser. Group C and D were brushed with normal force. Results Under SEM, group A showed numerous exposed dentinal tubule orifices, the diameter of which is 2-3 μm. Group B showed closure of dentinal tubule orifices. Group C showed that most of the fluor protector were brushed away and group D showed over 80% of the dentinal tubule orifices were occluded. Conclusions Fluor protector combined with Nd:YAG laser can make most of the dentinal tubule orifices occluded even after brushed.%目的探讨Nd:YAG激光与氟保护漆联合应用对牙本质小管的封闭作用。方法将24个牙本质块随机分为A、B、C、D4组,均用37%H3PO4处理表面。A组作为对照。B、C、D组均涂以一薄层氟保护漆,然后D组标本经Nd:YAG激光照射。以正常刷牙力度同时刷C、D 2组牙本质块10 min。所有标本以扫描电镜(scanning electron microscope,SEM)观察并照相。结果 A组显示大量牙本质小管口开放,管口直径约2~3 μm。B组显示牙本质表面被氟保护漆均匀覆盖。C组显示氟保护漆大部分被刷去。D组显示仍有超过80%的牙本质小管口被氟保护漆所封闭。结论在同样的刷牙条件下,将Nd:YAG激光与氟保护漆联合应用,仍有大部分牙本质小管口被封闭。

  15. Warden repair for superior sinus venosus atrial septal defect and anomalous pulmonary venous drainage in children: Anesthesia and transesophageal echocardiography perspectives

    Science.gov (United States)

    Aggarwal, Neelam; Gadhinglajkar, Shrinivas; Sreedhar, Rupa; Dharan, Baiju S.; Chigurupati, Keerthi; Babu, Saravana

    2016-01-01

    Objective: Review of intraoperative anesthetic challenges and the role of transesophageal echocardiography in children with sinus venosus atrial septal defect and partial anomalous pulmonary venous drainage undergoing Warden repair. Design: A retrospective observational case series. Methodolgy: Pediatric patients who underwent Warden repair between October 2011-September 2015 were recruited. Their preoperative clinical details, anesthetic techniques, intraoperative TEE findings and postoperative events were recorded from the medical records. The categorical variables and the continuous variables were expressed as number (percentages) and mean ± SD respectively. Results: A total of 35 patients were operated for Warden repair during the study period. Anesthesia was induced with the aim to prevent any fall in pulmonary vascular resistance. The right internal jugular vein was cannulated under ultrasound guidance using a short length cannula to monitor right superior vena cava pressure. Intraoperative TEE revealed the drainage of PAPVC high into RSVC in 22 patients. Persistent LSVC was found in 9 patients. After repair, TEE imaging detected a high gradient at Warden anastomotic site in 5 patients and 3 of them required revision of surgery. Rerouted pulmonary veins required surgical correction in 2 patients in view of obstruction. None of them had pulmonary venous and SVC obstruction in the postoperative period. Conclusion: The primary aim of anesthesia is to avoid any fall in PVR. Right IJV cannulation can be beneficial. The intraoperative TEE can help in delineating the anatomy of lesion and detecting anastomotic site obstruction. PMID:27052072

  16. Warden repair for superior sinus venosus atrial septal defect and anomalous pulmonary venous drainage in children: Anesthesia and transesophageal echocardiography perspective

    Directory of Open Access Journals (Sweden)

    Neelam Aggarwal

    2016-01-01

    Full Text Available Objective: Review of intraoperative anesthetic challenges and the role of transesophageal echocardiography in children with sinus venosus atrial septal defect and partial anomalous pulmonary venous drainage undergoing Warden repair. Design: A retrospective observational case series. Methodolgy: Pediatric patients who underwent Warden repair between October 2011-September 2015 were recruited. Their preoperative clinical details, anesthetic techniques, intraoperative TEE findings and postoperative events were recorded from the medical records. The categorical variables and the continuous variables were expressed as number (percentages and mean ΁ SD respectively. Results: A total of 35 patients were operated for Warden repair during the study period. Anesthesia was induced with the aim to prevent any fall in pulmonary vascular resistance. The right internal jugular vein was cannulated under ultrasound guidance using a short length cannula to monitor right superior vena cava pressure. Intraoperative TEE revealed the drainage of PAPVC high into RSVC in 22 patients. Persistent LSVC was found in 9 patients. After repair, TEE imaging detected a high gradient at Warden anastomotic site in 5 patients and 3 of them required revision of surgery. Rerouted pulmonary veins required surgical correction in 2 patients in view of obstruction. None of them had pulmonary venous and SVC obstruction in the postoperative period. Conclusion: The primary aim of anesthesia is to avoid any fall in PVR. Right IJV cannulation can be beneficial. The intraoperative TEE can help in delineating the anatomy of lesion and detecting anastomotic site obstruction.

  17. Social interaction and cocaine conditioning in mice increase spontaneous spike frequency in the nucleus accumbens or septal nuclei as revealed by multielectrode array recordings.

    Science.gov (United States)

    Kummer, Kai K; El Rawas, Rana; Kress, Michaela; Saria, Alois; Zernig, Gerald

    2015-01-01

    Both cocaine and social interaction place preference conditioning lead to increased neuronal expression of the immediate early gene EGR1 in the nucleus accumbens, a central region of the reward pathway, suggesting that both drug and natural rewards may be processed in similar brain regions. In order to gain novel insights into the intrinsic in vitro electrical activity of the nucleus accumbens and adjacent brain regions and to explore the effects of reward conditioning on network activity, we performed multielectrode array recordings of spontaneous firing in acute brain slices of mice conditioned to either cocaine or social interaction place preference. Cocaine conditioning increased the spike frequency of neurons in the septal nuclei, whereas social interaction conditioning increased the spike frequency in the nucleus accumbens compared to saline control animals. In addition, social interaction conditioning decreased the amount of active neuron clusters in the nucleus accumbens. Our findings suggest that place preference conditioning for both drug and natural rewards may induce persistent changes in neuronal network activity in the nucleus accumbens and the septum that are still preserved in acute slice preparations. PMID:25592253

  18. Isolation, characterization and genetic analysis of canine GATA4 gene in a family of Doberman Pinschers with an atrial septal defect

    Indian Academy of Sciences (India)

    Shin-Aeh Lee; Seung-Gon Lee; Hyeong-Sun Moon; Lopeti Lavulo; Kyoung-Oh Cho; Changbaig Hyun

    2007-12-01

    GATA4 is expressed early in the developing heart where it plays a key role in regulating the expression of genes encoding myocardial contractile proteins. Gene mutations in the human GATA4 have been implicated in various congenital heart defects (CHD), including atrial septal defect (ASD). Although ASD is the third most common CHD in humans, it is generally rare in dogs and cats. There is also no obvious predilection for ASD in dogs and cats, based on sex or breed. However, among dogs, the incidence rate of ASD is relatively high in Samoyeds and Doberman Pinschers, where its inheritance and genetic aetiology are not well understood. In this study, we identified and investigated the genetic aetiology of an ASD affected family in a pure breed dog population. Although the GATA4 gene was screened, we did not find any mutations that would result in the alteration of the coding sequence and hence, the predicted GATA4 structure and function. Although the aetiology of ASD is multifactorial, our findings indicate that GATA4 may not be responsible for the ASD in the dogs used in this study. However, this does not eliminate GATA4 as a candidate for ASD in other dog breeds.

  19. Timing in resolution of left heart dilation according to the degree of mitral regurgitation in children with ventricular septal defect after surgical closure

    Directory of Open Access Journals (Sweden)

    Hwa Jin Cho

    2014-01-01

    Full Text Available OBJECTIVE: Children with ventricular septal defects (VSD can have chronic volume overload, which can result in changes of left heart echocardiographic parameters. To evaluate the changes before and after surgical closure, the children were divided into three groups according to the degree of mitral regurgitation (MR, and their echocardiographic characteristics were reviewed at serial follow-up after surgical closure. METHODS: The preoperative, and one-, three-, and 12-month postoperative echocardiographic data of 40 children who underwent surgical closure of VSD were retrospectively reviewed. Left ventricular end-diastolic volume (LVEDV, left ventricular end-diastolic dimension (LVEDD, left ventricular end-systolic dimension (LVESD, mitral valvular characteristics, including degree of MR and mitral valve annulus, and left atrial (LA characteristics, including volume and dimensions, were observed. RESULTS: Preoperative LVEDV, LVEDD, LVESD, mitral valvular annulus, LA volume, and LA dimensions were significantly larger in children with MR. Additionally, there were significant decreases in LVEDV, LVEDD, LA volume, and LA dimensions at one, three, and 12 months postoperatively. The degree of MR also improved to a lower grade after surgical closure of the VSD without additional mitral valve repair. CONCLUSION: The echocardiographic parameters of left heart dilation and MR in children with VSD improved within the first year after surgical closure without additional mitral valve repair. Furthermore, in all of the patients with VSD, regardless of MR, LA dilation was reduced within three months after surgical closure of the VSD; however, LV and mitral valve annular dilatation decreased within 12 months.

  20. Cortex-, Hippocampus-, Thalamus-, Hypothalamus-, Lateral Septal Nucleus- and Striatum-specific In Utero Electroporation in the C57BL/6 Mouse.

    Science.gov (United States)

    Baumgart, Jan; Baumgart, Nadine

    2016-01-01

    In utero electroporation is a widely used technique for fast and efficient spatiotemporal manipulation of various genes in the rodent central nervous system. Overexpression of desired genes is just as possible as shRNA mediated loss-of-function studies. Therefore it offers a wide range of applications. The feasibility to target particular cells in a distinct area further increases the range of potential applications of this very useful method. For efficiently targeting specific regions knowledge about the subtleties, such as the embryonic stage, the voltage to apply and most importantly the position of the electrodes, is indispensable. Here, we provide a detailed protocol that allows for specific and efficient in utero electroporation of several regions of the C57BL/6 mouse central nervous system. In particular it is shown how to transfect regions the develop into the retrosplenial cortex, the motor cortex, the somatosensory cortex, the piriform cortex, the cornu ammonis 1-3, the dentate gyrus, the striatum, the lateral septal nucleus, the thalamus and the hypothalamus. For this information about the appropriate embryonic stage, the appropriate voltage for the corresponding embryonic stage is provided. Most importantly an angle-map, which indicates the appropriate position of the positive pole, is depicted. This standardized protocol helps to facilitate efficient in utero electroporation, which might also lead to a reduced number of animals. PMID:26862715

  1. Quantification of Shunt Volume Through Ventricular Septal Defect by Real-Time 3-D Color Doppler Echocardiography: An in Vitro Study.

    Science.gov (United States)

    Zhu, Meihua; Ashraf, Muhammad; Tam, Lydia; Streiff, Cole; Kimura, Sumito; Shimada, Eriko; Sahn, David J

    2016-05-01

    Quantification of shunt volume is important for ventricular septal defects (VSDs). The aim of the in vitro study described here was to test the feasibility of using real-time 3-D color Doppler echocardiography (RT3-D-CDE) to quantify shunt volume through a modeled VSD. Eight porcine heart phantoms with VSDs ranging in diameter from 3 to 25 mm were studied. Each phantom was passively driven at five different stroke volumes from 30 to 70 mL and two stroke rates, 60 and 120 strokes/min. RT3-D-CDE full volumes were obtained at color Doppler volume rates of 15, 20 and 27 volumes/s. Shunt flow derived from RT3-D-CDE was linearly correlated with pump-driven stroke volume (R = 0.982). RT3-D-CDE-derived shunt volumes from three color Doppler flow rate settings and two stroke rate acquisitions did not differ (p > 0.05). The use of RT3-D-CDE to determine shunt volume though VSDs is feasible. Different color volume rates/heart rates under clinically/physiologically relevant range have no effect on VSD 3-D shunt volume determination. PMID:26850842

  2. Management of Gastric Varices in the Pediatric Population with Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Utilizing Sodium Tetradecyl Sulfate Foam Sclerosis with or without Partial Splenic Artery Embolization

    International Nuclear Information System (INIS)

    It is unknown whether spontaneous gastrorenal shunts actually develop in the pediatric population. The minimum age documented in studies from Asia is 32 (range 32–44) years. This study describes three pediatric patients undergoing balloon-occluded retrograde transvenous obliteration (BRTO) for bleeding gastric varices with two of the three patients undergoing combined partial splenic embolization. The first BRTO is a selective-BRTO via a surgical splenorenal shunt (15 years old) and the other two patients underwent conventional-BRTO via a spontaneous gastrorenal shunt (8 and 14 years old). The recurrent significant bleeding that they exhibited before the combined endovascular therapy did not recur for an average of 7.1 (range 1.4–14) months. In the second patient, quantitative digitally subtracted angiography was utilized to evaluate the inline portal venous flow before and after BRTO

  3. Management of Gastric Varices in the Pediatric Population with Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Utilizing Sodium Tetradecyl Sulfate Foam Sclerosis with or without Partial Splenic Artery Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Saad, Wael E. A., E-mail: wspikes@yahoo.com; Anderson, Curtis L., E-mail: dranderson@southfloridavascular.com [University of Virginia Health System, Department of Radiology, Division of Vascular Interventional Radiology (United States); Patel, Rahul S., E-mail: patelr516@gmail.com [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States); Schwaner, Sandra, E-mail: sls5c@virginia.edu [University of Virginia Health System, Department of Radiology, Division of Vascular Interventional Radiology (United States); Caldwell, Stephen, E-mail: shc5c@virginia.edu [University of Virginia Health System, Department of Medicine, Division of Gastroenterology (United States); Pelletier, Shawn, E-mail: sjp7t@virginia.edu; Angle, John, E-mail: jfa2h@virginia.edu; Matsumoto, Alan H., E-mail: ahm4d@virginia.edu [University of Virginia Health System, Department of Radiology, Division of Vascular Interventional Radiology (United States); Fischman, Aaron M., E-mail: aaron.fischman@mountsinai.org [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States)

    2015-02-15

    It is unknown whether spontaneous gastrorenal shunts actually develop in the pediatric population. The minimum age documented in studies from Asia is 32 (range 32–44) years. This study describes three pediatric patients undergoing balloon-occluded retrograde transvenous obliteration (BRTO) for bleeding gastric varices with two of the three patients undergoing combined partial splenic embolization. The first BRTO is a selective-BRTO via a surgical splenorenal shunt (15 years old) and the other two patients underwent conventional-BRTO via a spontaneous gastrorenal shunt (8 and 14 years old). The recurrent significant bleeding that they exhibited before the combined endovascular therapy did not recur for an average of 7.1 (range 1.4–14) months. In the second patient, quantitative digitally subtracted angiography was utilized to evaluate the inline portal venous flow before and after BRTO.

  4. Down 综合征患儿室间隔缺损的手术治疗%Surgical Treatment of Ventricular Septal Defect in Children with Down Syndrome

    Institute of Scientific and Technical Information of China (English)

    吴士强

    2014-01-01

    目的:总结 Down 综合征患儿室间隔缺损的外科治疗经验。方法48例 Down 综合征患儿室间隔缺损在全身麻醉低温体外循环下行一期根治术。术前对于合并肺部感染、心功能不全、肺动脉高压者,给予有效的抗感染、强心及利尿剂、降肺动脉压等治疗;加强静脉营养,提高机体免疫力。术中提高手术技巧,操作轻柔,选择合适的手术切口及修补材料,避免发生传导阻滞等并发症。术后入 CICU,加强呼吸道管理,合理使用呼吸机;合理使用血管活性药物,维持循环系统的稳定;合理使用抗生素,减少肺部感染的发生。结果48例中无1例死亡,并发呼吸机相关性肺炎10例,心律失常2例,气胸1例,心包填塞1例,低心排1例。术后随访6个月至6年,生长发育好,无死亡。结论Down 综合征室间隔缺损患儿应尽早手术,选择适当的手术时机,合理有效的围术期处理,可提高手术成功率,延长患儿寿命。%Objective To summarize the experience with the surgical treatment of ventricular septal defect in children with Down syndrome.Methods Forty-eight children with Down syn-drome underwent one-stage radical operation under general anesthesia during hypothermic car-diopulmonary bypass.Patients with lung infection,heart failure,and pulmonary hypertension were given anti-infection,cardiotonics and diuretics,and anti-pulmonary hypertension,respectively.In addition,intravenous nutrition was strengthened and immunity was improved in all patients.Dur-ing operation,gentle operation technique was carried out and appropriate surgical incision and re-pair material were selected to avoid conduction block and other complications.After operation,pa-tients were admitted to CICU,and respiratory tract management and rational use of breathing ma-chine were strengthened.Moreover,vasoactive drugs and antibiotics were rationally used to main-tain the stability of

  5. Association of the GLI gene with ventricular septal defect after the susceptibility gene being narrowed to 3.56 cM in 12q13

    Institute of Scientific and Technical Information of China (English)

    QIU Guang-rong; GONG Li-guo; HE Guang; XU Xiao-yan; XIN Na; SUN Gui-feng; YUAN Yi-hua; SUN Kai-lai

    2006-01-01

    Background Our previous research has suggested that genes around D12S1056 in 12q13 may confer susceptibility to ventricular septal defect (VSD) in humans. The present study was to define the chromosome region assignment by transmission disequilibrium test (TDT), and to identify the important candidate gene by family-based association study and haplotype analysis. Methods Surrounding D12S1056, ten microsatellite markers including D12S329, D12S305, D12S1662, D12S1056, D12S1293, D12S334, D12S102, D12S83, D12S1655 and D12S1691 were chosen, and TDT was performed in 62 nuclear family trios each consisting of an affected child and two healty parents. Subsequently, the GLI gene, a positional candidate gene that maps to the target region, was selected for further analysis. Three single nucleotide polymorphisms (SNPs), G11888C, G11388A, and G11625T, were selected for family-based association study and haplotype analysis. Results VSD was significantly associated with all selected markers except D12S1691 [72.2 centi morgen (cM)] and D12S1700 (75.76 cM). VSD was also significantly associated with G11888C (χ2 = 5.918, P = 0.015), G11388A (χ2 = 8.067, P = 0.005), and G11625T (χ2 = 11.842, P = 0.001). Haplotype analysis showed a strong linkage disequilibrium between G11888C and G11388A (D'=0.999), but in significant (χ2 = 1.035, df = 2, P >0.05). Conclusions The susceptibility gene of VSD was mapped to 3.56 cM in 12q13 by TDT, and the GLI gene, an important candidate in the target region, was associated with VSD.

  6. Iron deposition and increased alveolar septal capillary density in nonfibrotic lung tissue are associated with pulmonary hypertension in idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Bartholmai Brian J

    2010-04-01

    Full Text Available Abstract Background Early diagnosis of pulmonary hypertension (PH in idiopathic pulmonary fibrosis (IPF has potential prognostic and therapeutic implications but can be difficult due to the lack of specific clinical manifestations or accurate non-invasive tests. Histopathologic parameters correlating with PH in IPF are also not known. Remodeling of postcapillary pulmonary vessels has been reported in the nonfibrotic areas of explanted lungs from IPF patients. We hypothesized that iron deposition and increased alveolar capillaries, the findings often seen in postcapillary PH, might predict the presence of clinical PH, independent of the severity of fibrosis or ventilatory dysfunction in IPF patients. To test this hypothesis, we examined the association between these histologic parameters and the degree of PH, with consideration of the severity of disease in IPF. Methods Iron deposition and alveolar septal capillary density (ASCD were evaluated on histologic sections with hematoxylin-eosin, iron, elastin and CD34 stainings. Percentage of predicted forced vital capacity (FVC% was used for grading pulmonary function status. Fibrosis score assessed on high resolution computed tomography (HRCT was used for evaluating overall degree of fibrosis in whole lungs. Right ventricular systolic pressure (RVSP by transthoracic echocardiography was used for the estimation of PH. Univariate and multivariate regression analyses were performed. Results A cohort of 154 patients was studied who had the clinicopathological diagnosis of IPF with surgical lung biopsies or explants during the period of 1997 to 2006 at Mayo Clinic Rochester. In univariate analysis, RVSP in our IPF cases was associated with both iron deposition and ASCD (p Conclusions Iron deposition and ASCD in non fibrotic lung tissue showed an association with RVSP, suggesting that these features are possible morphologic predictors of PH in IPF.

  7. Hippocampal formation is involved in movement selection: evidence from medial septal cholinergic modulation and concurrent slow-wave (theta rhythm) recording.

    Science.gov (United States)

    Oddie, S D; Kirk, I J; Whishaw, I Q; Bland, B H

    1997-11-01

    Hippocampal rhythmical slow-wave field activity which occurs in response to sensory stimulation is predominantly cholinergic (atropine-sensitive theta rhythm), can precede movement initiation, and co-occurs during non-cholinergic theta rhythm associated with ongoing movement (atropine-resistant). This relationship suggests that theta rhythm plays some role in movement control. The present naturalistic experiments tested the idea that atropine-sensitive theta rhythm plays a role in sensory integration and planning required for initiating appropriate movements. One of a pair of hungry rats, the victim, implanted with hippocampal field recording electrodes, a septal injection cannula, and a posterior hypothalamic stimulating electrode, was given food which the other, the robber, tries to steal. Since the victim dodges from the robber with a latency, distance, and velocity dependent upon the size of the food, elapsed eating time, and proximity of the robber, the movement requires sensory integration and planning. Although eating behavior seemed normal, atropine-sensitive theta rhythm and dodging were disrupted by an infusion of a cholinergic antagonist into the medial septum. When the victim in turn attempted to steal the food back, Type 1 theta rhythm was present and robbery attempts seemed normal. Prior to cholinergic blockade, posterior hypothalamic stimulation produced theta rhythm and dodges, even in the absence of the robber, but following injections, atropine-sensitive theta rhythm and dodging were absent as the animals dropped the food and ran. The results provide the first evidence to link atropine-sensitive theta rhythm and hippocampal structures to a role in sensory integration and planning for the initiation of movement. PMID:9404626

  8. 一个锢囚状中尺度对流系统的多尺度结构分析%An analysis of the multi-scale structure and evolution of a meso-scale occluding convective system

    Institute of Scientific and Technical Information of China (English)

    易笑园; 李泽椿; 姚学祥; 王红艳; 孙晓磊

    2011-01-01

    The composite Doppler radar data at the Beijing, Tianjin and Qinhuangdao stations, the satellite data, the automatic meteorological observing stations data and the NCEP 1° × 1° reanalysis data were used to analyze the multi-scale structure and evolution of a meso-scale occluding convective system in the east part of the Huabei plain, which caused severe heavy rainfall on 18 July 2007. The methods of the meso-scale filtering, the 4DVAR single Doppler radar retrieval, and the horizontal and vertical section analyses were employed in this paper. The results show that firstly, this MaCS experienced 3 phases including the intialization and developing, the maturation and the dissipation. The cold cloud top of the MαCS changed from an elongated top to a circle one with only single center again to a polygon top with several centers as shown in the satellite images. It is seen from the radar data that a meso-scale convective system under the cold top was a occluding squall-line mesoscale convective system, whose two cross meso-β-scale line-squall convective systems were composed of several MγCSs arranged in the form of a line with independent strong radar reflectivity center and life-cycle. In the occluding phase of the MaCS the active MγCSs caused local severe rainfall. In the occluded phase, those MγCSs were closely organized together so as to make their edges become obscured with the occluded point corresponding to the cold cloud top center of the MαCS. In the dissipation phase, with the pattern of crossing disappearing and cloud top dropping, the radar echo-top and the reflectivity both showed an eddy feature. Secondly, severe ascending motion existed in the MαCS whose center appears from 600 hPa to 500 hPa. At the height of 200 hPa, an anti-cyclonic circulation had an effect on the shape of cold cloud top. At the height of 700 hPa, the cold air flow brought by the cyclonic circulation weakened physically the intensity of MαCS. Thirdly, the structure and

  9. Morphological classification of patent ductus and its implications to the method of occlusion

    International Nuclear Information System (INIS)

    Objective: To classify the morphology of patent ductus arteriosis according of their sites of narrowing into 5 groups. Methods: From 1986-1997, totally 120 cases of angiogram were studied. The authors used Ivalon plug, Gianturco coil and Amplatzer method for occlusion. Results: Cases with Ivalon plug and Amplatzer device were all successful, no residual shunt or recanalization were found in the follow-up. Among 30 cases using coil, 3 had residual shunt, 2 had dislodgement of coil. Conclusions: In using coil to occluding PDA type A ductus was most successful, and in type B and C reopen may occur in follow-up

  10. The Escherichia coli Cell Division Protein and Model Tat Substrate SufI (FtsP) Localizes to the Septal Ring and Has a Multicopper Oxidase-Like Structure

    OpenAIRE

    Tarry, Michael; Arends, S. J. Ryan; Roversi, Pietro; Piette, Evan; Sargent, Frank; Berks, Ben C.; Weiss, David S.; Lea, Susan M.

    2009-01-01

    The Escherichia coli protein SufI (FtsP) has recently been proposed to be a component of the cell division apparatus. The SufI protein is also in widespread experimental use as a model substrate in studies of the Tat (twin arginine translocation) protein transport system. We have used SufI-GFP (green fluorescent protein) fusions to show that SufI localizes to the septal ring in the dividing cell. We have also determined the structure of SufI by X-ray crystallography to a resolution of 1.9 Å. ...

  11. Role of angiotensin II and vasopressin receptors within the supraoptic nucleus in water and sodium intake induced by the injection of angiotensin II into the medial septal area

    Directory of Open Access Journals (Sweden)

    Antunes V.R.

    1998-01-01

    Full Text Available In this study we investigated the effects of the injection into the supraoptic nucleus (SON of non-peptide AT1- and AT2-angiotensin II (ANG II receptor antagonists, DuP753 and PD123319, as well as of the arginine-vasopressin (AVP receptor antagonist d(CH25-Tyr(Me-AVP, on water and 3% NaCl intake induced by the injection of ANG II into the medial septal area (MSA. The effects on water or 3% NaCl intake were assessed in 30-h water-deprived or in 20-h water-deprived furosemide-treated adult male rats, respectively. The drugs were injected in 0.5 ml over 30-60 s. Controls were injected with a similar volume of 0.15 M NaCl. Antagonists were injected at doses of 20, 80 and 180 nmol. Water and sodium intake was measured over a 2-h period. Previous administration of the AT1 receptor antagonist DuP753 into the SON decreased water (65%, N = 10, P<0.01 and sodium intake (81%, N = 8, P<0.01 induced by the injection of ANG II (10 nmol into the MSA. Neither of these responses was significantly changed by injection of the AT2-receptor antagonist PD123319 into the SON. On the other hand, while there was a decrease in water intake (45%, N = 9, P<0.01, ANG II-induced sodium intake was significantly increased (70%, N = 8, P<0.01 following injection of the V1-type vasopressin antagonist d(CH25-Tyr(Me-AVP into the SON. These results suggest that both AT1 and V1 receptors within the SON may be involved in water and sodium intake induced by the activation of ANG II receptors within the MSA. Furthermore, they do not support the involvement of MSA AT2 receptors in the mediation of these responses.

  12. Ventricular Septal Defect (For Parents)

    Science.gov (United States)

    ... at greater risk in their lifetime of developing endocarditis , an infection of the inner surface of the heart. This occurs when bacteria in the bloodstream infect the lining of the heart. Bacteria are always ...

  13. Ventricular Septal Defect (For Teens)

    Science.gov (United States)

    ... VSD, are at more risk of having infective endocarditis in their lifetime. It's caused by bacteria in ... possibility that bacteria can get into the bloodstream, infect the heart, and damage heart valves. If you' ...

  14. Septal aneurysm with associated anomalies

    International Nuclear Information System (INIS)

    A 15-year-old boy had a history of a functional systolic murmur with systolic and diastolic murmurs and radiological evidence of left ventricular hypertrophy. The angiorcardiogram demonstrated an aneurysm of the membranous septum, bicuspid aortic valve, dilatation of the left subclavian artery and left common carotid artery. Echocardiography showed a holosystolic prolapse of the mitral valve with mitral insufficiency and a bicuspid aortic valve with insignificant incompetence of the aortic valve. Classical TM mode echocardiography did not show an aneurysm of the membranous septum. (orig.)

  15. Ablação por cateter do flutter atrial. Caracterização eletrofisiológica da interrupção da condução pelos istmos posterior e septal Catheter ablation of atrial flutter. Electrophysiological characterization of posterior and septal isthmus block

    Directory of Open Access Journals (Sweden)

    José Marcos Moreira

    1998-07-01

    Full Text Available OBJETIVO: Avaliar os tipos de bloqueio obtidos nos istmos posterior (entre o anel tricuspídeo e veia cava inferior e septal (entre o anel tricuspídeo e óstio do seio coronário, após ablação do flutter atrial (FLA. MÉTODOS: Foram submetidos à ablação por radiofreqüência (RF 14 pacientes com FLA tipo I (9 homens em 16 procedimentos. A ativação atrial ao redor do anel tricuspídeo foi avaliada em ritmo sinusal utilizando-se cateter "Halo" com 10 pares de eletrodos (H1-2 a H19-20, durante estimulação do seio coronário proximal (SCP e região póstero-lateral do átrio direito (H1-2, antes e após ablações lineares. De acordo com a frente de programação do impulso definiu-se: ausência de bloqueio (condução bidirecional, bloqueio incompleto (condução bidirecional com retardo num dos sentidos e bloqueio completo (ausência de condução pelo istmo. O intervalo desta ativação (deltaSCP/H1-2 foi analisado. RESULTADOS: Bloqueio completo foi obtido em 7 procedimentos (44% e incompleto em 4 (25%. O deltaSCP/H1-2 foi de 74 ± 26ms no primeiro grupo e de 30,5 ± 7,5ms no segundo (pPURPOSE: Evaluate the different types of conduction blocks obtained between inferior vena cava-tricuspid annulus (posterior isthmus and between tricuspid annulus-coronary sinus ostium (septal isthmus after radiofrequency (RF catheter ablation of atrial flutter (AFL METHODS: In 16 procedures, 14 patients (pts, 9 male, with type I AFL underwent RF ablation. Atrial activation around tricuspid annulus was performed with a 10-bipole "Halo" catheter (H1-2; H19-20. In sinus rhythm, isthmus conduction was evaluated during proximal coronary sinus (PCS and low lateral right atrium (H1-2 pacing, before and after linear ablation. According to the wave front of impulse propagation we assessed absence of block (bidirectional conduction; incomplete block (bidirectional conduction with delay in one front of impulse propagation and complete block (absence of conduction

  16. Acquired aortocameral fistula occurring late after infective endocarditis: An emblematic case and review of 38 reported cases

    Science.gov (United States)

    Said, Salah A M; Mariani, Massimo A

    2016-01-01

    AIM To delineate the features and current therapeutic option of congenital and acquired aortocameral fistulas (ACF) secondary to iatrogenic or infectious disorders. METHODS From a PubMed search using the term "aortocameral fistula", 30 suitable papers for the current review were retrieved. Reviews, case series and case reports published in English were considered. Abstracts and reports from scientific meetings were not included. A total of 38 reviewed subjects were collected and analyzed. In addition, another case - an adult male who presented with ACF between commissures of the right and non-coronary sinuses and right atrium as a late complication of Staphylococcus aureus infective endocarditis of the AV - is added, the world literature is briefly reviewed. RESULTS A total of thirty-eight subjects producing 39 fistulas were reviewed, analyzed and stratified into either congenital (47%) or acquired (53%) according to their etiology. Of all subjects, 11% were asymptomatic and 89% were symptomatic with dyspnea (21 ×) as the most common presentation. Diagnosis was established by a multidiagnostic approach in 23 (60%), single method in 14 (37%) (echocardiography in 12 and catheterization in 2), and at autopsy in 2 (3%) of the subjects. Treatment options included percutaneous transcatheter closure in 12 (30%) with the deployment of the Amplatzer duct or septal occluder and Gianturco coil and surgical correction in 24 (63%). CONCLUSION Acquired ACF is an infrequent entity which may occur late after an episode of endocarditis of the native AV. The management of ACF is generally by surgical correction but non-surgical device intervention has recently been introduced as a safe alternative.

  17. Surgical treatment of interrupted aortic arch associated with ventricular septal defect and patent ductus arteriosus in patients over one year of age

    Institute of Scientific and Technical Information of China (English)

    Li Zhiqiang; Li Bin; Fan Xiangming; Su Junwu; Zhang Jing; He Yan; Liu Yinglong

    2014-01-01

    Background Interrupted aortic arch (IAA) is a rare congenital anomaly affecting 1.5% of infants with congenital heart disease.Neonatal repair of IAA is required to avoid irreversible pulmonary vascular lesion.However,in China,patients with IAA associated with ventricular septal defect (VSD) and patent ductus arteriosus (PDA) over one year of age are common.So we investigated the outcome of surgical treatment of IAA with VSD and PDA in patients over one year of age.Methods From January 2009 to December 2012,19 patients with IAA have undergone complete single-stage repair.The patients' mean age was 4.4 years,ranging 1 to 15 years; and their mean weight was 12.8 kg,ranging 4.2 to 36.0 kg.Fifteen IAA were type A,four were type B.Preoperative cardiac catheterization data were available from all patients.Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) were measured.The measurements of postoperative pulmonary artery pressure were taken in the operating room at the end of the case.All patients underwent echocardiographic examinations before discharged from the hospital.In addition,cardiac catheterization and echocardiographic examinations were performed during follow-up.Selective brain perfusion through the innominate artery during aortic arch reconstruction was used in all patients.Mean follow-up was (1.6±0.8) years.Results There were two hospital deaths (2/19,11%).One patient died of pulmonary hypertension crisis,and another died of postoperative low cardiac output.Five cases had other main postoperative complications but no postoperative neurologic complications.Seventeen survivors were followed up,and there were no late deaths or reoperation.Mean cross-clamp duration was (85±22) minutes and selective brain perfusion duration was (34±11) minutes.Two patients required delayed sternal closure at two days postoperatively.Intensive care unit and hospital stays were (9±8) days and (47±24) days,respectively.Pressure gradients across

  18. 鼻中隔偏曲矫正术治疗鼾症的前瞻性研究%The Prospective Study of Nasal Septal Reconstruction in the Treatment of Apnea

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To study the clinical efficacy of nasal septal reconstruction in the treatment of apnea. Methods 56 cases of apnea with nasal septum deviation from January 2008 to December 2011 were treated with nasal septal reconstruction, UPPP was performed after operation in 20 cases with pharyngeal stricture. Results Only nasal septal reconstruction: the effective rates to the sound of a snore and apnea index in group without pharyngeal stricture was 94.4% and 71.43% respectively, which in group with pharyngeal stricture was 80% and 50% respectively. Patients of pharyngeal stricture combined with UPPP: The effective rate recently between two groups was 100%. Conclusion Patients of apnea with nasal septum deviation and nasal obstruction should be corrected by operation, and those with pharyngeal stricture can also be treated in combination with UPPP.%  目的研究鼻中隔偏曲矫正术治疗鼾症的临床疗效。方法2008年1月至2011年12月对56例伴有鼻中隔偏曲的鼾症患者进行鼻中隔偏曲矫正手术,对其中20例同时伴有咽部狭窄的患者在手术后行UPPP术(悬壅垂腭咽成形术)。结果单纯鼻中隔矫正手术:无咽部狭窄组及伴咽部狭窄组对鼾声响度和呼吸暂停指数的有效率分别为94.44%和71.43%;伴咽部狭窄组分别为80%和50%。咽部狭窄的患者联合UPPP术:二者近期的有效率均为100%。结论鼾症患者在有鼻中隔偏曲阻塞时应该进行手术矫正,伴有咽部狭窄者还可以联合UPPP术治疗。

  19. 基于三维建模的眼镜遮挡下人脸识别%A Glasses-Occluded Face Recognition Method Based on 3D Face Reconstruction

    Institute of Scientific and Technical Information of China (English)

    熊鹏飞; 刘昌平; 黄磊

    2011-01-01

    The instability of eyeglasses treated as facial features is the primary obstacle in glasses-occluded face recognition. The facial features are easily lost by the existing method while eliminating the influence of instable glasses characteristics. To avoid this problem, a 3D realistic face model reconstruction is applied for virtual face images generation to compensate the instability of the glasses. In the method, the glasses are set as an inherent part of face. 3D face reconstruction increases the feasibility of parameter adjustment for different glasses models. Based on this, various influences of glasses segment on face recognition are analyzed. Also, corresponding solutions to image distortion by lens blur and reflection are carried out. Experiments on CAS-PEAL database demonstrate the improvement of the proposed method on face recognition rate and verify the effectiveness of lens treatment.%眼镜作为人脸特征的不稳定性是眼镜遮挡人脸识别的主要问题.为避免现有方法消除不稳定眼镜特征时带来的人脸特征丢失,将眼镜视为人脸固有部分,提出一种基于三维建模生成人脸虚拟样本补偿眼镜不稳定性的方法.三维建模方便眼镜模型参数的调节.通过调节眼镜参数,具体分析眼镜不同部分对人脸识别的影响,同时,针对影响严重的镜片模糊和反光,均做相应处理.CAL-PEAL的实验表明本文方法对识别性能的大幅度改善,并验证镜片处理的有效性.

  20. 儿童室间隔缺损合并重度肺动脉高压术后护理%Postoperation Care for Ventricular Septal Defect with Serious Pulmonary Hypertension in Children

    Institute of Scientific and Technical Information of China (English)

    吴芳兰; 陆雪英; 吴卓媚

    2002-01-01

    Objective To review the experience of postoperation caring for ventricular septal defect with seriouspulmonary hypertension in children. Methods To keep calm absolutely during postoperation 48 ~ 72h, use pulmonaryvasodilators and drugs of improving pulmonary circulation, maintain circulation stability, maintain within limits excessiveventilation and effectively oxygen supply, select suitable time points of draw out sputum for reducing stimulation, maintainadequate warm and humidity for airways, strengthen nutrition and energy supply by gastroenteric tract, monitoring central veinpressure(CVP), PaO2, SO2, PCO2. Results Hemodynamics tability, ventilator tube in 11 cases to be drawn withinpostoperation 72h, 2 case died of pulmonary hypertension critical, mortality is 12.5 % (2/16), rest children recovered smoothly.Conclusion To make enough preoperation prepare, improve and reinforce postoperation care of respiratory tract, keep calmabsolutely during postoperation 48 ~ 72h, reduce obvious pulmonary pressure and improve pulmonary circulation with Regitinand Prostaglandin(PGE- 1 ), better clinical effect can be achieved.