Transcatheter Closure of Large-Sized Coronary Artery Fistula

We report our experience with the use of AMPLATZER?? Vascular Plug for the closure of coronary artery fistulas. Three patients (age: 3, 12, 14 years) were diagnosed with coronary fistulas (pulmonary-to-systemic blood flow ratio: 1.5 to 3). Two of the fistulas originated each, from the proximal right and left coronary artery and had maximal diameter 9 and 10 mm respectively; their narrowest diameter (6 mm) was proximal to their entrance into the right atrium creating a form of a saccular aneurysm.The third fistula (maximal diameter: 16 mm) originated from the circumflex artery and entered the right atrium with unobstructed flow (narrowest diameter: 8 mm). Interventional closure was considered optimal and the decision was made to use devices sized twice the size of the narrowest diameter of the fistulas (12, 12 and 16 mm respectively). An arterio-venous loop was established through the fistula by snaring an exchange guide-wire. All plugs were implanted from the femoral vein with the use of a seven or eight French guide catheter, reaching the narrowest segment of the fistula and leading to complete closure of the two fistulas, immediately after the procedure. The fistula arising from the circumflex artery that received the largest plug continued to have residual flow up to 12 months after the procedure, when follow-up echocardiography revealed its complete occlusion. We present and consider the use of the AMPLATZER?? Vascular Plug as a safe and effective method for the transcatheter closure of large-sized coronary fistulas. The plug potentially offers an alternative method to coil occlusion techniques as well as open heart surgery

Transcatheter Closure of Secundum Atrial Septal Defect Using the Amplatzer Device: Single Center Experience in 140 Patients

BACKGROUND: Transcatheter closure of secundum atrial septal defect (ASD) is nowadays widely practiced and has replaced surgical ASD closure in many centers. Improvements in design have made the closure devices retrievable, and reduction in the size of the introduction systems allows interventional treatment even in young patients. In this paper we present our experience with the Amplatzer septal occluder device in patients with ASD. PATIENTS AND METHODS: Between October 2002 and February 2006, 206 consecutive patients with a significant ASD, demonstrated by initial transthoracic echocardiography (TTE), were considered for transcatheter closure with the Amplatzer septal occluder. A total of 156 patients underwent cardiac catheterization, and 140 patients had successful transcatheter ASD closure. Routine examination before catheterization included a standard ECG, a chest x ray, blood tests and TTE. The initial TTE showed the location of the ASD, its septal rim, and its diameter and also helped to measure the length of the interatrial septum in the four-chamber view. These measurements were used to assess the feasibility of transcatheter closure with the Amplatzer device. The “stretched” diameter of the ASD, determined by a balloon sizing catheter, was used to select the diameter of the waist of the device. The size of the selected device was 1 to 2 mm larger than the stretched diameter of the defect. Transesophageal echocardiography was used to monitor the implantation procedure. RESULTS: The Amplatzer device was finally employed in 140 patients for percutaneous closure of ASD. The age of patients ranged between 5.3 and 70 years, median 21.9 years. Procedure time ranged between 25 and 240 minutes, median 60 minutes; fluoroscopy time ranged between 3.5 and 45 minutes, median 12 minutes. The size of the selected device ranged between 6-40 mm. Two devices were implanted in two patients. Serious procedure related complications (embolization and perforation of the left atrial wall) occurred in two cases. At follow up (10 days to 3.4 years, median 2.3 years) complete closure was documented in 97% of this patient group. Unrecognized during implantation, but detected after release, small additional defect with trivial residual shunt was documented in 4 patients. A young critically ill patient, cyanotic due to right-to-left shunt, with complex congenital heart disease developed a brain abscess three months after implantation. CONCLUSION: Percutaneous ASD closure with use of the Amplatzer device in this cohort of 140 patients was highly successful with a low complication rate

Transcatheter Closure of Secundum Atrial Septal Defect Using the Amplatzer Device: Single Center Experience in 140 Patients

In this paper we present our experience with the Amplatzer septal occluder device, employed in 140 patients for percutaneous closure of atrial secundum defect (ASD), from October 2002 to February 2006. The age of patients ranged between 5.3 and 70 years, median 21.9 years. Procedure time ranged between 25 and 240 minutes, median 60 minutes; fluoroscopy time ranged between 3.5 and 45 minutes, median 12 minutes. Transoesophageal echocardiography was used to monitor the implantation procedure. The size of the selected device was 1 to 2 mm larger than the stretched diameter of the defect and ranged between 6-40 mm. Two devices have been implanted in two patients. Serious procedure related complications (embolization and perforation of the left atrial wall) occurred in two cases. At follow up (10 days to 3.4 years, median 2.3 years) complete closure was documented in 97% of this patient group. Unrecognized during implantation, but detected after release, small additional defect with trivial residual shunt was documented in 4 patients. A young critically ill patient, cyanotic due to right-to-left shunt, with complex congenital heart disease developed a brain abscess three months after implantation. In conclusion, percutaneous ASD closure with use of the Amplatzer device in this patient cohort was highly successful with a low complication rate

An Annotated Corpus of Tonal Piano Music from the Long 19th Century

We present a dataset of 264 annotated piano pieces of nine composers, composed in the long 19th century (https://doi.org/10.5281/zenodo.7483349). Annotations adhere to the DCML harmony annotation standard and include Roman numerals, phrase boundaries, and cadence types. The scores are encoded in the XML-based MuseScore 3 format. Annotations are embedded within the MuseScore files. In addition, all harmony information, alongside key features of the encoded measure and note objects, is provided in the form of plaintext TSV-formatted tables for increased interoperability with other datasets and analysis tools. Annotations were collaboratively created and reviewed by a pool of trained music theorists. Collaboration took place asynchronously online via a semi-automated GitHub-based workflow designed for quality assurance, allowing cycles of revisions and reviews until consensus is reached. The full revision history is retained, providing data for further empirical research on inter-annotator agreement and related topics. We also present descriptive statistics about the nine corpora and the dataset as a whole, including comparisons of pitch-class contents, phrase lengths, modulations, and cadence types. We conclude with a discussion of our musicological principles for corpus building and considerations of representability