The role of transcatheter closure of the patent foramen ovale in the occurrence of various complications remains a controversial issue. Atrial arrhythmias and bleeding are common complications, while infectious complications are extremely rare. In this clinical case we would like to report a patient who underwent transcatheter closure of a patent foramen ovale complicated by subacute endocarditis of a fully endothelized device 5 years after surgery. A 49-year-old patient was admitted to the surgical department with diffuse chest pain, sweating and fever. Three weeks earlier the patient had a fever associated with a cold. The data of the general and biochemical blood analysis indicated the presence of an inflammatory reaction of the body. After transthoracic and transesophageal echocardiography, infective endocarditis was diagnosed. The patient underwent surgery as planned. After removal of the occluder and excision of the mitral valve cusps, implantation of a mechanical mitral valve prosthesis was performed. At the site of the removed occluder, the atrial septal defect was repaired with an autologous pericardial patch. Transesophageal echocardiography showed no residual blood flow through the interatrial septum. The postoperative period was uneventful. The patient was discharged in satisfactory condition 10 days after surgery. The total duration of the antibiotic therapy was 5 weeks. Key words: open oval window, infectious endocarditis, transcatheter closure of the defect.
Background. Extracorporeal membrane oxygenation has become an effective method in the treatment of adults and children with severe cardiac and pulmonary dysfunction resistant to conventional therapy. The aim of this article was to summarize an experience of extracorporeal membrane oxygenation usage for cardiac dysfunction, which develops in patients with coronary heart disease du-ring percutaneous transluminal coronary angioplasty. Materials and methods. The study comprised a retrospective, single-center analysis of 23 patients with coronary heart disease (19 men and 4 women, average age — 65.7 ± 12.3 years), who undertook the extracorporeal membrane oxygenation technique during percutaneous transluminal coronary angioplasty. Results. Thirteen (56.52 %) patients died directly in the hospital, or 30 days after a discharge. Independent predictors of fatal outcomes were: diabetes mellitus (OR = 17.58; 95% CI = 6.47–47.48; p = 0.00125), chronic renal failure (OR = 20.81; 95% CI = 5.95–72.21; p = 0.00014), damage to the right coronary artery (OR = 25.51; 95% CI = 8.27–79.12; p = 0.00013). For deceased patients, the “no-reflow” phenomenon was indicated in a larger portion of cases (23.1 % in the group of deceased versus 10 % in the group of survivors). A routine connection to extracorporeal membrane oxygenation before the occurrence of cardiac events was significantly more often used in the group of survived patients (90 % of cases) compared with the deceased (p = 0.0000001). Conclusions. Diabetes mellitus, chronic renal failure, and damage to the right co-ronary artery were independent predictors of mortality during percutaneous transluminal coronary angioplasty in patients with coronary heart disease. The routine use of extracorporeal membrane oxyge-nation in high-risk patients with percutaneous transluminal coronary angioplasty was a positive prognostic factor of patient survival.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.