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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...

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Related Experiment Video

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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
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Published on: December 23, 2022

Shunt reduction with a fenestrated Amplatzer device.

Oliver Kretschmar1, Anca Sglimbea, Roberto Corti

  • 1Division of Pediatric Cardiology, University Children's Hospital, Zurich, Switzerland. oliver.kretschmar@kispi.uzh.ch

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 1, 2010
PubMed
Summary

This study shows that using modified Amplatzer devices for partial shunt closure in high-risk congenital heart disease patients is a successful treatment option. These interventional procedures offer a feasible alternative when complete closure is not possible.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pediatric Cardiology

Background:

  • Complete closure of intracardiac defects/shunts is not always feasible in high-risk congenital heart disease (CHD) patients.
  • An interventional approach using modified self-fabricated Amplatzer devices was explored for shunt reduction.
  • This study reports institutional experiences with this novel technique.

Observation:

  • Five patients with CHD underwent interventional partial shunt occlusion using modified Amplatzer devices.
  • Treatments included Amplatzer Septal Occluders (ASO) for atrial septal defects (ASD) with restrictive left ventricle (LV) or pulmonary arterial hypertension (PAH), and ASO or Amplatzer Vascular plugs for Fontan circulation with large fenestrations.

Findings:

  • Partial shunt occlusion led to immediate volume release and maintained normal pulmonary artery pressure and LV function in ASD patients.
  • In Fontan patients, stented devices remained patent, maintaining oxygen saturation >85% and stable pulmonary artery pressures with good clinical condition.

Implications:

  • Modified Amplatzer devices offer a feasible and successful therapeutic option for partial shunt closure in specific high-risk CHD patients.
  • Balloon-dilated fenestrations may close spontaneously, while sutures or stenting can ensure long-term patency.