Транскатетер перкутано затворање на ductus arteriosus

Ductus arteriosus persistens (DAP) е честа аномалија со 9%- 15% од сите адулти со вродени срцеви маани (VSM) и во 25% кај други VSM. Новородени со коплексни VSM може да имаат DAP зависна циркулација (прекинат аортен лак, пулм. атрезија без VSD). Протокот зависи од ширината и пулмоналната васкуларна рестенција

Asessment of coronary arteries with ECG GATED 64-multidetector computed tomography (MDCT) in patients with suspected aortic dissection Stanford type A

The purpose of our study is to show the value of ECG gated 64-MDCT as an non - invasive and reliable method for simultaneous assessment of coronary arteries as part of the aortic root evaluation. Methods and Materials. From February 2009 until March 2010 we performed 46 ECG - gated, 64 MDCT examinations to confirm a diagnosis of suspected aorta ascendens dissection . A transthoracic (TTE) and/or transesophageal (TEE) echocardiography was initially performed in all patients ( mostly TEE) Patients (pts) with arrhythmia and non-stable haemodynamic conditions were excluded. All MDCT scans were performed with retrospectively ECG gated technique (0,625mm slice thickness). Premedicaton with i.v. betaBlocker (propranolol) was administrated in all with heart rate> 70 bpm

Amplatzer оклузија на паравалвуларен leak на механичка протеза по реоперација на дехисценција на митрална механичка протеза- Приказ на случај

Во трудот се опишува случајот на 46-годишна жена со парававуларното протекување или leak по второ заменување на митрална механичка протеза, кој е успешно третиран со Amplatzer оклузија на паравалвуларниот leak

Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis.AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate.MATERIAL AND METHODS: The study included 43 patients, where 33 (74%) of them were children between the age of 1 month and 15 years.RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg) to 39.1 mmHg (20-80 mmHg). Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9%) required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55%) patients, and four (9%) patients developed moderate regurgitation, without affecting the function of the right ventricle.CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results.Â

Transcatheter Closure of Patent Foramen Ovale: A Single Center Experience

BACKGROUND: Percutaneous transcatheter closure (PTC) of patent foramen ovale (PFO) is implicated in cryptogenic stroke, transitional ischemic attack (TIA) and treatment of a migraine.AIM: Our goal was to present our experience in the interventional treatment of PFO, as well as to evaluate the short and mid-term results in patients with closed PFO.MATERIAL AND METHODS: Transcatheter closure of PFO was performed in 52 patients (67.3% women, mean age 40.7 ± 11.7 years). Patients were interviewed for subjective grading of the intensity of headaches before and after the PFO closure.RESULTS: During 2 years of follow-up, there was no incidence of new stroke, TIA and/or syncope. Follow-up TCD performed in 35 patients showed complete PFO closure in 20 patients (57.1%). Out of 35 patients, 22 (62.9%) reported having a migraine before the procedure with an intensity of headaches at 8.1 ± 1.9 on a scale from 1 to 10. During 2 years of follow-up, symptoms of a migraine disappeared in 4 (18.2%) and the remaining 18 patients reported the significant decrease in intensity 4.8 ± 2.04 (p = 0.0001). In addition, following PFO closure the incidence of the headaches decreased significantly (p = 0.0001).CONCLUSIONS: Percutaneous transcatheter closure of PFO is a safe and effective procedure showing mid-term relief of neurological symptoms in patients as well as significant reduction of migraine symptoms

Evaluation of coronary arteries with ECG gated 64-multislice computed tomography (MSCT)in patients with suspected aortic dissection stanford type A

The purpose of our study is to show the value of ECG gated 64-MDCT as a non - invasive and reliable method for simultaneous assessment of coronary arteries as part of the aortic root evaluation

Инвазивни и неинвазивни резултати на перкутана балон валвулопластика на пулмоналната валвула

Пулмоналната стеноза претставува 10% од сите вродени срцеви мани. Третманот на ова срцева мана со перкутана балон валвулопластика(БВП) е добар етаблиран и алтернативен третман на хирургија во многу кардиолошки центри. Целта на нашата студија е да ги прикажеме нашите искуства и резултати на перкутана БВП на изолирана умерена и тешка пулмонална стеноза. Материјал и методи: Помеѓу 2003-2009 година од сите интервентни процедури на конгенитални мани(148) изведувани во ангиографската лабораторија на Филип Втори и перкутаната БВП на пулмоналната валвула е применета кај 39(26%) пациенти. Сите пациенти беа со умерена и тешка пулмонална стеноза со ПГ>50 ммхг

PCI vs CABG во третман на повеќесадовна коронарна артериска болест

Целта на студијата е анализа на големите кардиоваскуларни и цереброваскуларни збидувања(MACE) кај пациенти третирани со CABG и PCI, со цел донесување на стратегија на Материјали и методи: во студијата се вклучени 296 пациенти: мажите 198(71%), жени 96(29%), со мултисадовна КАБ (141 третирани со стент, 155 пациенти со CABG). Критериуми на ексклузија- поранешна реваскуларизација, ЛМН стеноза, ЛБ анеуризма, дополнителна валвуларна болсет, АИМ и кардиоген шок. Пациентите беа поделени и врз основа на возраста, клиничката слика, присуство или отсуство на Дијабет, ЛВ функција и промените на коронарните артерии

ALCAPA Syndrome (Anomalous Left Coronary Artery from the Pulmonary Artery): A case report

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA)Syndrome is a rare development anomaly of the coronary arteries. ALCAPA was first described in 1866. The first clinical description in conjunction with autopsy findings was described by Bland and colleagues in 1933, so the anomaly is also called Bland-White-Garland syndrome.1 In 1962, Fontana and Edwards reported a series of 58 post mortem specimens that demonstrated that most patients had died at a young age. 2 There are two types of AlCAPA syndrome: Infant type and adult type Rarely, ALCAPA syndrome manifests in adults. when it may be an Important cause of sudden cardiac death. The development of ECG gated MDCT coronary angiography enables accurate non-Invasive imaging and direct visualization of the left coronary artery arising from the pulmonary artery

ALCAPA (Anomalous Left Coronary Artery from the Pulmonary Artery) Syndrome : a case report

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) Syndrome is a rare development anomaly of the coronary arteries. ALCAPA was first described in 1866. The first clinical description in conjunction with autopsy findings was described by Bland and colleagues in 1933, so the anomaly is also called Bland-White-Garland syndrome1