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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patent ductus arteriosus should be closed because of its hemodynamic significance and/or the risk of infective endocarditis. Mortality of surgery is low. In adults, however, technical problems can arise due to calcification of the ductus walls. Using the transfemoral plug technique, developed by Porstmann, we attempted a ductus closure without surgery on 35 patients. The youngest was an 11-year-old girl, the oldest a 63-year-old woman (mean age of all patients: 37 years). The pressure in the pulmonary artery ranged from 15/5 to 70/27 mmHg, the diameter of the ductus from 2 to 9 mm (mean: 4.4 mm). According to the size and shape of the ductus, a plug of polyvinyl alcohol (Ivalon) with an inner steel wire frame was prepared. Threaded over a long arterio-transductal venous track wire, the plug was introduced into the femoral artery and advanced into the ductus by a pushing catheter. After removal of the track wire the plug remained wedged in the ductus. In all 35 patients, transfemoral ductus closure was possible. Patients with complaints improved remarkably within some days. Heart size and pulmonary congestion decreased considerably. All patients were followed for a period of 1-46 months. In two of them, the ivalon plug embolized into a side branch of the left pulmonary artery 7 and 2 weeks after the procedure, but without serious consequences.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transfemoral plug closure of patent ductus arteriosus. 343 63

Surgical treatment of various septal defects has been long established. With the advances in transcatheter therapy dilatation techniques for valvular stenosis and vascular obstruction have become established procedures. Closure of septal defects in the catheterization laboratory has also been introduced; some of these have come into regular use in current practice. In 1967, Porstmann et al reported the use of Ivalon plug to close patent ductus arteriosus (PDA). Since then, several devices have been used including Rashkind PDA ocluder (not being used now), Gianturco coils, detachable coils (for small PDA), CardioSEAL and other umbrella devices and Amplatzer PDA occluder. Closure rates vary from 95-98% in most series, however, some of these devices are very expensive, more so, when compared to the cost of surgical ligation of PDA. Catheter closure of secundum atrial septal defect (ASD) has also been done by various devices like clamshell device, Sideris Buttoned device, ASDOS device, Amplatzer device and cardioSEAL. So far no device has been accepted as ideal for every case, however, Amplatzer device has been used most extensively. Issues such as completeness of endothelialisation, incidence of late arrhythmias, endocarditis remain uncertain. However, in select population of ASD cases with a central secundum defect, device closure is being used increasingly. Device closure of ventricular septal defect remains challenging and controversial and is probably available to a small group of children with defects that are difficult to close surgically and involve higher risk.
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PMID:Interventional pediatric cardiology: device closures. 1095 36

Surgical treatment of various septal defects has been long established. With the advances in transcatheter therapy dilatation techniques for valular stenosis and vascular obstruction have become established procedures. Closure of septal defects in the catheterization laboratory has also been introduced; some of these have come into regular use in current practice. In 1967, Porstmann et al reported the use of Ivalon plug to close patent ductus arteriosus (PDA). Since then, several devices have been used including Rashkind PDA occluder (not being used now), Gianturco coils, detachable coils (for small PDA), CardioSEAL and other umbrella devices and Amplatzer PDA occluder. Closure rates vary from 95-98% in most series, however, some of these devices are very expensive, more so, when compared to the cost of surgical ligation of PDA. Catheter closure of secundum atrial septal defect (ASD) has also been done by various devices like clamshell device, Sideris Buttoned device, ASDOS device, Amplatzer device and cardioSEAL. So far no device has been accepted as ideal for every case, however, Amplatzer device has been used most extensively. Issues such as completeness of endothelialisation, incidence of late arrhythmias, endocarditis remain uncertain. However, in a select population of ASD cases with a central secundum defect, device closure is being used increasingly. Device closure of ventricular septal defect remains challenging and controversial and is probably available to a small group of children with defects that are difficult to close surgically and involve higher risk.
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PMID:Interventional pediatric cardiology: device closures. 1112 18