Echocardiographic and Radionuclide Pulmonary Blood Flow Patterns After Transcatheter Closure of Patent Ductus Arteriosus

Dessy, Hugues; Hermus, Joris P.S.; Heuvel, Frank Van den; Oei, H. Y.; Krenning, E. P.; Hess, John

doi:10.1161/01.cir.94.2.126

Cited by 33 publications

(29 citation statements)

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“…Concern has been expressed regarding possible encroachment of the occluder into the left pulmonary artery leading to stenosis and subsequent reduction in left pulmonary perfusion. 4,5,8) Recently we 9) and others 4) have demonstrated there was radionuclide evidence of left pulmonary blood flow reduction in around 14 to 19% of the patients who received a Rashkind prosthesis. All were asymptomatic at follow up and there seems to be no immediate clinical significance.…”

Section: Discussionmentioning

confidence: 93%

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Transcatheter Closure of the Patent Ductus Arteriosus Using an Amplatzer Duct Occluder in Adults.

2001

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SUMMARYPatent ductus arteriosus (PDA) is a congenital heart disease that frequently escapes detection until the patient reaches adulthood. Percutaneous closure of the PDA has been established as a safe alternative to surgery. the Amplatzer duct occluder (ADO) is a new device that has been recently reported in paediatric patients. Our initial experience with an of ADO in an adult population appears to be encouraging and as good as in paediatric patients. (Jpn Heart J 2001; 42: 533-537)

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Section: Discussionmentioning

confidence: 93%

“…4,5) Several percutaneous closure devices have been developed in the past decades to overcome these limitations. The Rashkind, buttoned, Botalloocluder devices and coils have been used for transcatheter closure of PDA with variable degrees of success and complications.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of the Patent Ductus Arteriosus Using an Amplatzer Duct Occluder in Adults.

2001

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“…1,2 Pulmonary perfusion abnormalities in patients with a Fontanlike circulation are clinically of particular interest and may have substantial consequences. Patients with atriopulmonary anastomosis (APA), 3 total cavopulmonary connection (TCPC), 4 or partial cavopulmonary connection (PCPC) have been studied using lung perfusion scintigraphy.…”

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confidence: 99%

More Accurate Quantification of Pulmonary Blood Flow by Magnetic Resonance Imaging Than by Lung Perfusion Scintigraphy in Patients With Fontan Circulation

et al. 2002

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Background-Quantitative evaluation of pulmonary perfusion using lung perfusion scintigraphy in patients with atriopulmonary anastomosis (APA) or total cavopulmonary connection (TCPC) or partial cavopulmonary connection (PCPC) is difficult because of preferential draining of the venae cavae to one lung. Scintigraphy is the gold standard. Phase-velocity MRI (PV-MRI) is a new technique for determining pulmonary perfusion. The aim of this study was therefore to determine whether PV-MRI is more accurate than scintigraphy for quantitative evaluation of pulmonary perfusion ratios in patients with APA, TCPC, or PCPC. Methods and Results-We studied 15 patients with APA, TCPC, or PCPC (16Ϯ7 years old, 4 female). Twelve patients (15Ϯ8 years old, 3 female) with a single pulmonary blood source supplied by a subpulmonary ventricle, ensuring complete mixing of the radioactive tracer before entering the pulmonary circulation, served as controls. Pulmonary scintigraphy and PV-MRI were performed in all patients. Bland-Altman analysis showed a clinically unacceptable difference of 7.1% right pulmonary blood flow (27.2% upper and Ϫ13.0% lower limit of agreement) between the two methods in the study group. The two methods agreed excellently in the control group (difference, 1.6%; 4.0% upper and Ϫ7.2% lower limit of agreement), showing that the bad agreement in the study group was caused by the problems encountered using pulmonary scintigraphy in patients with APA, TCPC, or PCPC. Conclusions-Because of preferential caval flow into either lung, PV-MRI is more accurate for evaluating pulmonary perfusion ratios than lung perfusion scintigraphy in patients with Fontan-like circulation.

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“…Transkateter tedavi sonrası gelişe-bilecek komplikasyonlardan rezidüel şant kalması, cihaz embolizasyonu, hemoliz, kapak zedelenmeleri ve azalmış sol akciğer perfüzyonu en sık bildirilenlerdir (3)(4)(5)(6)(7).…”

Section: Introductionunclassified

“…Belirtilen komplikasyonlardan PDA kapatılma işlemi sonrası sol akciğer perfüzyonunda azalma tüm cihaz tiplerinde bildirilmiştir (4)(5)(6)(7)(8)(9). Buna karşılık transkateter yöntemle PDA kapatılmasında koil kullanımı oldukça sık olmasına rağmen, sol akciğer perfüzyonunu değerlendiren çalışma sayısı oldukça azdır ve sonuçlar çelişkilidir.…”

Section: Introductionunclassified

Radionuclide evaluation of lung perfusion after transcatheter closure of patent ductus arteriosus: analysis of frequently used two different type of coils

Polat

Çelebi²,

Hacımahmutoğlu³

et al. 2011

Anadolu Kardiyol Derg

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ÖZETAmaç: Transkateter patent duktus arteriyozus (PDA) tedavisi sonrası sol akciğer perfüzyonun da bozulma daha önce bildirilmiştir. Bu çalışmada PDA tedavisinde sıkça kullanılan kontrollü salınımlı Cook koil ve kontrolsüz salınımlı Gianturco koil lerin sol akciğer perfüzyona etkisinin radyonüklit yöntemle değerlendirilmesi amaçlanmıştır. Yöntemler: Bu prospektif çalışmada 49 olguda Cook koil ve 40 olguda Gianturco koil kullanılmak üzere toplam 89 olgunun transkateter yöntemiyle PDA'sı kapatıldı. Olgular PDA tedavisinden medyan 18 ay sonra akciğer perfüzyon sintigrafisi yapıldı. Azalmış sol akciğer perfüzyonunu öngörebile-cek parametreler incelendi. Akciğer sintigrafisi kantitatif değerleri ile hasta parametrelerinin istatistiksel ilişkisi Pearson korelasyon katsayısı ile hesaplandı, düşük akciğer perfüzyonunu predikte eden değişkenlerden optimal kestirim değeri bulabilmek için 'Receiver Operating Characteristic' (ROC) eğrisi analizi kullanıldı. Bulgular: Sol akciğer perfüzyonunda bozulma 10'u Cook koil kullanımı sonrası, 3 olgu Gianturco koil kullanımı sonrası olmak üzere toplam 13 olguda saptandı (p=0.077). Tüm olgular ele alındığında pulmoner arter tarafında bırakılan sarmal sayısı, koil/duktal çap oranı ve birden fazla koil kullanımı ile ilişkilidir (sırasıyla, p=0.002, p=0.006 ve p=0.009). Pulmoner arter tarafındaki sarmal sayısı 1.4 üzerindeki olgularda %77 özgüllük ve %85 duyarlılık ile ilk koil çapı/duktus en dar çapı oranı 1.85 üzerindeki olgular %70 özgüllük ve %77 duyarlılık ile akciğer perfüzyon sintigrafisinde bozulma öngörü-lebilmektedir (ROC eğrisi altındaki alanlar sırasıyla, 0.804, %95GA 0.661-0.947, p<0.001 ve 0.747, %95GA 0.423-0.790, p<0.005). Sonuç: Transkateter PDA tedavisi sonrası sol akciğer perfüzyon bozukluğu Cook koil ya da Gianturco koil kullanımı sonrası gelişebilir. Bu durum pulmoner arter tarafında bırakılan sarmal sayısı, duktus en dar çapına göre koil'in daha büyük seçilmesi ve birden fazla koil kullanımı ile ilişkilidir. ABSTRACTObjective: Impaired left lung perfusion (LLP) has been described after transcatheter closure of the patent ductus arteriosus (PDA). In this study, we aimed to evaluate lung perfusion scans (LPSs) following occlusion of PDA with two frequently used coils: Cook detachable coil and Gianturco coil. Methods: A prospective study of 89 patients who underwent PDA occlusion using the Cook coils in 49 and the Gianturco coils in 40, was conducted. LPSs were performed after a median period of 18 months. The relationships between the LPSs and continuous variables were assessed by Pearson correlation analysis and the cut-off value of the best correlated parameters to predict abnormal LPSs obtained by the Receiver Operating Characteristic (ROC) analysis. Results: Decreased left lung perfusion (LLP) was found in 13 patients including 10 after using Cook coils and 3 after using Gianturco coils (p=0.077). LLP values were significantly correlated with the loops deployed at the pulmonary side, coil/ductal diameter ratio and number of coils 218

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Echocardiographic and Radionuclide Pulmonary Blood Flow Patterns After Transcatheter Closure of Patent Ductus Arteriosus

Cited by 33 publications

References 11 publications

Transcatheter Closure of the Patent Ductus Arteriosus Using an Amplatzer Duct Occluder in Adults.

Transcatheter Closure of the Patent Ductus Arteriosus Using an Amplatzer Duct Occluder in Adults.

More Accurate Quantification of Pulmonary Blood Flow by Magnetic Resonance Imaging Than by Lung Perfusion Scintigraphy in Patients With Fontan Circulation

Radionuclide evaluation of lung perfusion after transcatheter closure of patent ductus arteriosus: analysis of frequently used two different type of coils

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