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Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Cardiac Catheterization III: Left Heart Catheterization01:24

Cardiac Catheterization III: Left Heart Catheterization

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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

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Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
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Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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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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Implantation of Total Artificial Heart in Congenital Heart Disease
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Alternative Access in Congenital Heart Disease.

Caitlin M Heyden1, John W Moore1, Justin R Ryan1

  • 1Department of Cardiology, Rady Children's Hospital, San Diego, California.

JACC. Case Reports
|October 1, 2020
PubMed
Summary

Transcatheter intervention was enabled by transcaval access when limited arterial access was a barrier. This novel approach offers a promising solution for adults with congenital heart disease requiring complex procedures.

Keywords:
adult congenital heart diseasecongenital heart diseaseendovasculartranscatheter electrosurgerytranscaval access

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Congenital Heart Disease

Background:

  • Adults with congenital heart disease (ACHD) often require complex interventions.
  • An interrupted aortic arch presents unique challenges for vascular access.
  • Limited arterial access can impede necessary transcatheter procedures in ACHD patients.

Purpose of the Study:

  • To describe an alternative vascular access strategy for transcatheter intervention in a patient with interrupted aortic arch.
  • To evaluate the feasibility of transcaval access for percutaneous therapy in complex ACHD.

Main Methods:

  • A 22-year-old woman with repaired interrupted aortic arch type B underwent transcatheter intervention.
  • Transcaval vascular access was utilized due to limitations in traditional arterial access.
  • Percutaneous transluminal angioplasty was successfully performed via the transcaval route.

Main Results:

  • Successful percutaneous transcatheter intervention was achieved using transcaval access.
  • This alternative access method overcame limitations posed by inadequate arterial routes.
  • The procedure was technically feasible and provided a therapeutic solution.

Conclusions:

  • Transcaval vascular access is a viable alternative for transcatheter interventions when arterial access is limited in ACHD.
  • This technique expands treatment options for complex congenital heart disease in adults.
  • This practice evolution is crucial for managing the growing population of adults with congenital heart disease.