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Transcatheter umbrella closure of congenital heart defects

 

作者: JAMES LOCK,   JOHN COCKERHAM,   JOHN KEANE,   JOHN FINLEY,   PAUL WAKELY,   KENNETH FELLOWS,  

 

期刊: Circulation  (OVID Available online 1987)
卷期: Volume 75, issue 3  

页码: 593-599

 

ISSN:0009-7322

 

年代: 1987

 

出版商: OVID

 

数据来源: OVID

 

摘要:

ABSTRACTBetween October 1984 and September 1986, we attempted transcatheter umbrella closure, using the Rashkind PDA occluder, of 12 congenital or postoperative cardiovascular defects (other than patent ductus arteriosus [PDA]) in 11 patients. In each, we used the umbrella for closure because the defect was too short and/or too large to close with conventional transcatheter methods. The defects included three post-Glenn venous communications (superior vena cava-right atrium, n = 2; azygos vein to inferior vena cava), four congenital “interatrial defects” producing cyanosis (“coronary sinus” septal defect, left superior vena cava to left atrium, patent foramen ovale, left inferior vena cava to left atrium), and five non-PDA systemic-to-pulmonary arterial communications (two congenital and three postoperative). Ten of 12 defects were embolized successfully; nine had complete or subtotal closure, and one was partially closed. The first attempted closure resulted in embolization of a 12 mm device to a lower-lobe pulmonary artery, without clinical sequelae. No other complications occurred. Clinical improvement was most dramatic in those patients whose cyanosis was relieved and less obvious when pulmonary blood flow was reduced. The Rashkind umbrella device, originally designed for closure of PDA, considerably expands the list of congenital or operative defects that can be closed nonsurgically.

 

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