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Interatrial Communication (interatrial + communication)

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Medical Sciences100%

Selected Abstracts

Prenatal diagnosis of atrial septal aneurysm

JOURNAL OF CLINICAL ULTRASOUND, Issue 1 2008
Jeng-Hsiu Hung MD
Abstract We report the prenatal diagnosis of fetal atrial septal aneurysm based on the observation of a fluttering flap in the left atrium. The aneurysm was associated with an interatrial communication. In a 4-chamber view, separate arms of the aneurysm could be seen contracting in and extending out in response to the fetal cardiac cycle, giving the fluttering appearance of a jellyfish. The aneurysm disappeared 1 month after birth with no complications. The findings in this case indicate that isolated atrial septal aneurysm is a natural transient phase of spontaneous closure of the foramen ovale during normal fetal development. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2008 [source]

Efficacy and long-term patency of fenestrated amplatzer devices in children

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 4 2007
Astrid E. Lammers MD
Abstract Introduction: Novel transcatheter techniques to control interatrial communications exist. Devices with restrictive fenestrations can be implanted to maintain patency of an atrial septostomy, or reduce an interatrial communication. Experience with these devices in children is limited. Patients and Methods: Fenestrated atrial septal devices were implanted into 10 children (5 male, age 1.5,15.5 years). Devices were modified by the manufacturer (MM, n = 6), or by a modification of an atrial septal occlusion device by the operator (OM, n = 4). Seven devices were implanted after atrial septal puncture and septostomy for severe symptomatic pulmonary hypertension (PHT) [4 heart failure, 3 syncope], according to World Health Organisation Guidelines. Two devices were implanted to reduce left to right shunting through large atrial septal defects with associated PHT. One device was implanted acutely to offload the left atrium during extracorporal circulatory support prior to heart transplantation. Warfarin (n = 5), aspirin (n = 4), or heparin (n = 1) were used for prevention of fenestration thrombosis. Results: Symptoms in all patients with PHT improved after implantation; syncope recurred with fenestration occlusion in one patient. Nine patients were followed up to a mean of 26 months. Five devices (all MM; warfarin n = 4, aspirin n = 1) remained patent on echocardiography. Fenestrations occluded in 4 children after median follow-up of 10 months (MM n = 1, OM n = 3, warfarin n = 1, aspirin n = 3). Conclusions: Implantation of fenestrated atrial devices is feasible and effective; but the occlusion rate is high. Further research on fenestrated atrial septal devices with better long-term patency, and effective antithrombotic drug treatment is necessary. © 2007 Wiley-Liss, Inc. [source]

Initial transcatheter palliation of hypoplastic left heart syndrome

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 5 2006
FACC, K.C. Chan MBBS
Abstract Initial percutaneous transcatheter palliation of hypoplastic left heart syndrome is now feasible. The primary procedures for palliation include stenting of the ductus arteriosus with a self expanding nitinol stent to secure an adequate systemic blood flow, placement of an internal pulmonary arterial band to protect the pulmonary vascular bed and to prevent pulmonary overcirculation, and widening of the interatrial communication by blade and balloon septostomy or static balloon dilation to decompress the left atrium. Anatomic variations of the ductus arteriosus have important implications for technical success with ductal stenting. Patients who have undergone complete transcatheter palliation with the internal pulmonary band appear to have less immediate morbidity at the time of transplant, with preserved integrity and growth of the branch pulmonary arteries at one year follow-up. © 2006 Wiley-Liss, Inc. [source]

Efficacy and long-term patency of fenestrated amplatzer devices in children

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 4 2007
Astrid E. Lammers MD
Abstract Introduction: Novel transcatheter techniques to control interatrial communications exist. Devices with restrictive fenestrations can be implanted to maintain patency of an atrial septostomy, or reduce an interatrial communication. Experience with these devices in children is limited. Patients and Methods: Fenestrated atrial septal devices were implanted into 10 children (5 male, age 1.5,15.5 years). Devices were modified by the manufacturer (MM, n = 6), or by a modification of an atrial septal occlusion device by the operator (OM, n = 4). Seven devices were implanted after atrial septal puncture and septostomy for severe symptomatic pulmonary hypertension (PHT) [4 heart failure, 3 syncope], according to World Health Organisation Guidelines. Two devices were implanted to reduce left to right shunting through large atrial septal defects with associated PHT. One device was implanted acutely to offload the left atrium during extracorporal circulatory support prior to heart transplantation. Warfarin (n = 5), aspirin (n = 4), or heparin (n = 1) were used for prevention of fenestration thrombosis. Results: Symptoms in all patients with PHT improved after implantation; syncope recurred with fenestration occlusion in one patient. Nine patients were followed up to a mean of 26 months. Five devices (all MM; warfarin n = 4, aspirin n = 1) remained patent on echocardiography. Fenestrations occluded in 4 children after median follow-up of 10 months (MM n = 1, OM n = 3, warfarin n = 1, aspirin n = 3). Conclusions: Implantation of fenestrated atrial devices is feasible and effective; but the occlusion rate is high. Further research on fenestrated atrial septal devices with better long-term patency, and effective antithrombotic drug treatment is necessary. © 2007 Wiley-Liss, Inc. [source]