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Successful Implantation (successful + implantation)
Selected AbstractsSuccessful Implantation of a Coronary Sinus Lead After Stenting of a Coronary Vein StenosisPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2003BERRY M. VAN GELDER Dislodgment of the coronary sinus lead was observed in a 79-year-old patient 8 months after implantation of a biventricular pacing system. A severe stenosis in the posterolateral branch, in which the lead was previously positioned, prohibited reinsertion of the lead. Because no other branches with adequate anatomy for lead insertion were available in the targeted area, the stenosis was dilated and stented. Subsequently, the left ventricular lead could be reimplanted in the same vessel. (PACE 2003; 26:1904,1906) [source] Management of Cerebrospinal Fluid Leakage From Cochleostomy During Cochlear Implant SurgeryTHE LARYNGOSCOPE, Issue 11 2006Christopher T. Wootten MD Abstract Objectives: The objectives of this retrospective review were to determine the incidence of cerebrospinal fluid (CSF) otorrhea from the cochleostomy during cochlear implant surgery, to recognize patients at risk, and to determine the appropriate preoperative, postoperative and intraoperative management. Methods: A chart review from two cochlear implant centers was performed to determine the incidence of CSF otorrhea, patients at risk, and appropriate management. Results: The incidence of CSF gusher is low, encountered in approximately 1% of patients undergoing cochlear implant surgery, and is seen in equal incidence in children and adults in our series. Preoperative imaging was predictive in only 50% of cases. Mechanisms for otorrhea in specific cochlear malformations and in those in which no apparent malformation exists are discussed. Successful implantation is expected in most cases. Intraoperative management may require complete packing of the middle ear space in addition to the cochleostomy to control CSF leak. Lumbar drain is rarely necessary. Outpatient management is possible in the majority of cases. Vaccination and antibiotic prophylaxis is essential. Conclusions: CSF otorrhea can be encountered in cochlear malformations and in cochleas without apparent malformation. Successful implantation without short-term or long-term complications is expected. [source] Combined Use of Uncovered Duodenal and Covered Biliary Metallic Stent for Carcinoma of the Papilla of VaterDIGESTIVE ENDOSCOPY, Issue 4 2000Hitoshi Sano We have reported successful implantation of self-expandable metallic stents for palliative treatment in a case of an 87-year-old female patient with carcinoma of the papilla of Vater. She suffered from both duodenal and biliary stenoses, but refused surgical treatment. For the duodenal stenting, a self-expandable knitted nitinol metallic stent, for esophageal use, was inserted endoscopically. For the biliary stenting, a self-expandable metallic stent, partially polyurethane-covered on the proximal part to prevent tumor ingrowth and overgrowth, was inserted via the percutaneous transhepatic biliary drainage route. No major complications occured during these procedures. After the two stents were inserted in an end-to-side fashion, she was able to eat a normal diet adequately and suffered from no abdominal symptoms and jaundice during the follow-up period of 13 months. These stenting procedures might be less invasive and more useful than surgical treatment and provide long patency of biliary stenting and a good quality of life. [source] Biventricular Versus Right Ventricular Pacing in Patients with AV Block (BLOCK HF): Clinical Study Design and RationaleJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2007ANNE B. CURTIS M.D. Background: Right ventricular (RV) pacing restores ventricular systole in patients with atrioventricular (AV) block, yet recent studies have suggested that in patients with AV block and left ventricular (LV) dysfunction, RV pacing may exacerbate the progression to heart failure (HF). BLOCK HF is a prospective, multi-center, randomized, double-blind, controlled trial designed to determine whether patients with AV block, LV dysfunction (EF , 50%), and mild to moderate HF (NYHA I-III) who require pacing benefit from biventricular (BiV) pacing, compared with RV pacing alone. Objective: The primary objective of this trial is to determine whether the time to first event (all-cause mortality, heart failure-related urgent care, or a , 15% increase in left ventricular end systolic volume index [LVESVI]) for patients with BiV pacing is superior to that of patients with RV pacing. Methods: Patients with AV block and LV dysfunction who require permanent pacing and undergo successful implantation of a commercial Medtronic CRT device, with or without an ICD, will be randomized to BiV or RV pacing. Patients are followed at least every 6 months until study closure. Up to 1,636 patients may be enrolled in 150 centers worldwide. Conclusion: BLOCK HF is a large, randomized, clinical study in pacing-indicated patients with AV block, mild to moderate HF symptoms, and LV dysfunction to determine whether BiV pacing is superior to RV pacing in slowing the progression of HF. [source] Incidence and Treatment of Arterial Access Dissections Occurring during Cardiac CatheterizationJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 1 2008AMIT PRASAD M.D. Background: Arterial access dissections may complicate cardiac catheterization and can often be treated percutaneously. The goal of this study was to examine the incidence, consequences, and the treatment of arterial access dissections at a tertiary referral hospital with an active training program. Methods: Patients experiencing arterial access dissection during coronary angiography or intervention at our institution between October 1, 2004, and January 31, 2007, were identified and their records were retrospectively reviewed. Results: Thirteen of the 3,062 consecutive patients (0.42%) had arterial access dissection during the study period. The location of the dissection was in the common femoral artery (CFA) (n = 6), the external iliac artery (EIA) (n = 6), or in an aortobifemoral graft (n = 1). Three of the six patients with CFA dissection were diagnosed during coronary angiography, and because of significant comorbidities were treated with self-expanding stents. After a mean follow-up of 7 months, they experienced no stent fracture or other complication. Six patients had EIA dissections. In one such patient, the dissection was not flow limiting and was treated conservatively. The remaining five patients underwent successful implantation of self-expanding stents, and during a mean follow-up of 9.6 months, no patient had any symptoms or events related to lower extremity ischemia. Finally, one patient had an aortobifemoral graft dissection. Due to the patient's critical condition, secondary to sepsis, his family elected to withdraw care, and he subsequently expired. Conclusions: Arterial access dissections occur infrequently during cardiac catheterization. Routine femoral artery angiography may help identify vascular access complications, often allowing simultaneous endovascular treatment, with excellent short-term outcomes. [source] Inappropriate ICD Discharge Due to T-Wave Oversensing in a Patient with Short QT SyndromePACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1 2010YAXUN SUN M.D. A 45-year-old man with diagnosis of short QT syndrome underwent successful implantation of dual-chamber implantable cardioverter-defibrillator (ICD) to prevent sudden cardiac death. Ten days after implantation, the patient was treated by inappropriate ICD discharges for frequent T-wave oversensing. After careful reprogramming of the ICD, the T-wave oversensing was eliminated and no T-wave oversensing or inappropriate discharge was documented during 6-month follow-up period. (PACE 2010; 113,116) [source] Implant of a Biventricular Pacemaker in a Patient with Dextrocardia and Persistent Left Superior Vena CavaPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 8 2006CHRISTIAN POTT Congenital anomalies of the heart can pose challenges to cardiac invasive procedures. Here, we present the case of a 40-year-old man with the combination of dextrocardia, a persistent left superior vena cava, and idiopathic dilated cardiomyopathy. We describe the successful implantation of a biventricular pacemaker,defibrillator under this complex anatomic condition. [source] A Severe Case of Complex Regional Pain Syndrome I (Reflex Sympathetic Dystrophy) Managed with Spinal Cord StimulationPAIN PRACTICE, Issue 1 2010Bernard Canlas MD Abstract Complex regional pain syndrome is a condition that usually affects the upper or lower extremities. The cause is not clearly understood. We report a case of a severe form of a rapidly progressive complex regional pain syndrome type I developing after a right shoulder injury managed with spinal cord stimulation (SCS). After failed conservative treatments, a rechargeable SCS system was implanted in the cervical spine. Allodynia and dystonia improved but the patient subsequently developed similar symptoms in lower right extremity followed by her lower left extremity. The patient became wheelchair bound. A second rechargeable SCS with a paddle electrode was implanted for the lower extremity coverage. The patient's allodynia and skin lesions improved significantly. However, over time, her initial symptoms reappeared which included skin breakdown. Due to the need for frequent recharging, the system was removed. During explantation of the surgical paddle lead, it was noted by the neurosurgeon that the contacts of the paddle lead were detached from the lead. After successful implantation of another SCS system, the patient was able to reduce her medications and is now able to ambulate with the use of a left elbow crutch. [source] REVIEW ARTICLE: Inflammation and ImplantationAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 1 2010Nava Dekel Approximately half of all human embryo implantations result in failed pregnancy. Multiple factors may contribute to this failure, including genetic or metabolic abnormalities of the embryo. However, many of these spontaneous early abortion cases are attributed to poor uterine receptivity. Furthermore, although many fertility disorders have been overcome by a variety of assisted reproductive techniques, implantation remains the rate-limiting step for the success of the in vitro fertilization (IVF) treatments. It has been demonstrated that endometrial biopsies performed either during the spontaneous, preceding cycle, or during the IVF cycle itself, significantly improve the rate of implantation, clinical pregnancies and live births. These observations suggest that mechanical injury of the endometrium may enhance uterine receptivity by provoking the immune system to generate an inflammatory reaction. In strong support of this idea, we recently found that dendritic cells (DCs), an important cellular component of the innate immune system, play a critical role in successful implantation in a mouse model. In this review, we discuss the hypothesis that the injury-derived inflammation in the biopsy-treated patients generates a focus for uterine DCs accumulation that, in turn, enhances the endometrial expression of essential molecules, which facilitate the interaction between the embryo and the uterine epithelium. [source] Complete stent dislodgement after successful implantation-a rare case,,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 6 2010Hwa Wooi Gan MBBS, MRCP Abstract A successfully deployed stent is normally stable in position and unlikely to be dislodged from the coronary artery. We report a case of complete stent dislodgement after successful implantation in a patient with recent anterior myocardial infarction (AMI). Coronary angulation, a highly calcified coronary artery, an under-deployed stent, and the process of rewiring contributed to this unexpected event. Fortunately, no unwanted complication occurred as a consequence of this event. © 2010 Wiley-Liss, Inc. [source] Experimental evaluation of the JenaClip transcatheter aortic valve,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 3 2009Alexander Lauten Abstract Objective: Transcatheter techniques of aortic valve replacement are a treatment option for valvular heart disease in high-risk surgical candidates. We evaluated a self-expanding valve system with a novel mechanism of fixation in an experimental setting in an acute animal model and ex vivo in aortic root specimens. Method: A self-expanding nitinol stent containing a pericardial tissue valve was implanted in a transapical approach in 15 sheeps. The valve was introduced under fluoroscopic guidance through a 22F sheath by means of a specially designed delivery catheter. Deployment was performed on the beating heart without cardiopulmonary bypass or rapid ventricular pacing and facilitated by positioning feelers anchoring the device to the native aortic cusps. To investigate release and anchoring of the device during retrograde implantation, the stent was also implanted in aortic root specimens obtained from an autopsy series. Results: In animal experiments, stent deployment was primarily successful in 12 (80%) animals. Positioning feelers facilitated implantation by confirming the correct implantation plane of the stent and anchoring to the native aortic cusps. If primary location was not satisfactory the stent was retracted into the catheter and repositioned. After successful implantation no significant changes of hemodynamics were observed. Two animals (13%) developed ventricular fibrillation early in this experimental series due to displacement of one positioning element into a coronary ostium, major regurgitation was observed in two animals. Ex vivo evaluation of the device in aortic root specimens proved feasibility of stent release and leaflet fixation; ex vivo implantation was successful in all cases. Conclusion: .In this study, we demonstrate feasibility of a leaflet-fixation device in nondiseased aortic valves. The JenaClip provides an effective concept of fixation with positioning feelers that allows exact positioning without outflow obstruction and anchoring the valve to the native leaflets. Further studies are necessary to investigate this concept in diseased aortic valves. © 2009 Wiley-Liss, Inc. [source] | ||||||||||