Techniques for transcatheter recanalization of completely occluded vessels and pathways in patients with congenital heart disease

Abstract

Occlusions of major vessels in patients with congenital heart disease may occur due to a variety of factors. These occlusions are often felt to be best addressed surgically; however, we and others have been successful in recanalizing most of these vessels in the catheterization laboratory. Most of these patients will require multiple procedures in the catheterization laboratory to ensure vessel patency and to facilitate vessel growth. Physicians performing the procedure should have a thorough understanding of the anatomic considerations for the intended procedure and have access to a variety of devices and equipment to optimize the result of the procedure. In this article, we review some of the technical aspects that are vital for the success of the procedure.

Efficacy and safety of catheter‐based rheolytic and aspiration thrombectomy in children

“…Thrombosis is a cause of significant morbidity and mortality in children . Placement of central lines, cardiac catheterizations, surgical procedures, low cardiac output states, and coagulopathies may all result in significant thrombus formation in vessels of children . Recanalization of vessels and shunt grafts using methods such as balloon maceration have been previously described in children .…”

“…Placement of central lines, cardiac catheterizations, surgical procedures, low cardiac output states, and coagulopathies may all result in significant thrombus formation in vessels of children . Recanalization of vessels and shunt grafts using methods such as balloon maceration have been previously described in children . However, published data regarding the use of specific rheolytic and manual aspiration thrombectomy systems in children have thus far has been limited to small series or case reports .…”

Angiographic follow‐up of infants and children undergoing percutaneous carotid artery interventions

“…The CA may be used for interventions on the surgical Blalock- Taussig (BT) shunts, for patent ductus arteriosus (PDA) stenting or for aortic valvuloplasty [1][2][3][4]. Transcatheter intervention from the CA traditionally has been achieved via surgical cutdown [5][6][7]. However, surgical cutdown has been associated with post-intervention stenosis and even intentional CA ligation [7][8][9][10].…”

A Case Series Describing Percutaneous Management of Aortic Isthmic Atresia

“…The methods used include recanalization using the stiff end of guide wires, recanalization using coronary total occlusion wires and radiofrequency ablation with covered stent placement. [4][5][6][7][8][9][10] We describe 3 cases of aortic isthmic atresia that was successfully treated using a percutaneous approach, in a tertiary hospital in Ireland between 2011 and 2015.…”