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Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach.

Tefera E, Bermudez-Cañete R - Ann Pediatr Cardiol (2014)

Bottom Line: The sheath was then unsnared once the aortic disc was completely out.The device was then released and it attained a stable position.An aortic angiogram was performed which showed complete occlusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics and Child Health, Cardiology Unit, School of Medicine, Addis Ababa University and Cardiac Center, Addis Ababa, Ethiopia.

ABSTRACT
Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA) and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion.

No MeSH data available.


Related in: MedlinePlus

(a) Terumo wire advanced into the descending aorta through a snared Terumo guide catheter; (b) Delivery sheath advanced over the guide wire into the descending aorta
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Figure 2: (a) Terumo wire advanced into the descending aorta through a snared Terumo guide catheter; (b) Delivery sheath advanced over the guide wire into the descending aorta

Mentions: Under general anesthesia, arterial access was established through the right femoral artery with a 4F introducer and aortic pressure was measured (86/53 mmHg, mean: 69 mmHg). Then, aortic angiogram was done [Figure 1]. A duct measuring 5 mm was seen. On right heart catheterization, it was found that the inferior caval vein was interrupted and that there was azygos continuation. A Terumo catheter was advanced and snared in the descending aorta. An AGA exchange wire (.035" × 260 cm) was advanced through the catheter and snared in the descending aorta. While snaring the wire, an Amplatzer TorqVue 2 delivery sheath 6F, 60 cm long (AGA Medical Corporation, Golden Valley, MN) was advanced over the wire from the venous side and again snared in the descending aorta [Figures 2a and b]. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare [Figure 3a–c]. The device was opened, again with the sheath still snared. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted [Figure 4]. The device was then released and it attained a stable position [Figure 5]. An aortic angiogram was done after the device was released, showing complete occlusion. The patient remained stable and there was no hemodynamic instability anytime during the procedure. She was extubated immediately.


Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach.

Tefera E, Bermudez-Cañete R - Ann Pediatr Cardiol (2014)

(a) Terumo wire advanced into the descending aorta through a snared Terumo guide catheter; (b) Delivery sheath advanced over the guide wire into the descending aorta
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3959065&req=5

Figure 2: (a) Terumo wire advanced into the descending aorta through a snared Terumo guide catheter; (b) Delivery sheath advanced over the guide wire into the descending aorta
Mentions: Under general anesthesia, arterial access was established through the right femoral artery with a 4F introducer and aortic pressure was measured (86/53 mmHg, mean: 69 mmHg). Then, aortic angiogram was done [Figure 1]. A duct measuring 5 mm was seen. On right heart catheterization, it was found that the inferior caval vein was interrupted and that there was azygos continuation. A Terumo catheter was advanced and snared in the descending aorta. An AGA exchange wire (.035" × 260 cm) was advanced through the catheter and snared in the descending aorta. While snaring the wire, an Amplatzer TorqVue 2 delivery sheath 6F, 60 cm long (AGA Medical Corporation, Golden Valley, MN) was advanced over the wire from the venous side and again snared in the descending aorta [Figures 2a and b]. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare [Figure 3a–c]. The device was opened, again with the sheath still snared. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted [Figure 4]. The device was then released and it attained a stable position [Figure 5]. An aortic angiogram was done after the device was released, showing complete occlusion. The patient remained stable and there was no hemodynamic instability anytime during the procedure. She was extubated immediately.

Bottom Line: The sheath was then unsnared once the aortic disc was completely out.The device was then released and it attained a stable position.An aortic angiogram was performed which showed complete occlusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics and Child Health, Cardiology Unit, School of Medicine, Addis Ababa University and Cardiac Center, Addis Ababa, Ethiopia.

ABSTRACT
Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA) and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion.

No MeSH data available.


Related in: MedlinePlus