CHIUSURA PERCUTANEA AURICOLA Sn 2015 case report
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The document discusses the AMPLATZERTM AMULET device, which is a percutaneous transcatheter device intended for closure or occlusion of cardiac structures not involving the septal wall, including the left atrial appendage (LAA). The device requires careful patient selection, imaging, and sizing. The device is contraindicated for patients with intracardiac thrombus, active endocarditis or infections. Measurements of the LAA from previous studies are provided, showing variability in size and morphology between individuals. Potential anatomical relationships that could be at risk during LAA occlusion are identified.
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Atrial septal defect (ASD) closure can be performed surgically or percutaneously. Percutaneous closure is preferred for secundum ASDs that meet criteria such as defect size less than 38mm and adequate rim tissue. Echocardiography guides device placement and confirms closure. Complications include device embolization, arrhythmias, and erosion. Most studies report high success rates with percutaneous closure and shorter hospital stays than surgery. Surgical closure is preferred for sinus venosus, primum, or coronary sinus defects.
Asd device closure
This document discusses atrial septal defect (ASD) closure procedures. It describes that ASDs are often asymptomatic until adulthood but can lead to complications if left untreated. Preprocedural assessment includes echocardiography and additional imaging if needed. Surgical closure is preferred for primum, sinus venosus, and coronary sinus defects. Percutaneous closure is an alternative to surgery for secundum ASDs of appropriate size and anatomy. Percutaneous closure has comparable efficacy to surgery but shorter hospital stays and fewer complications. Complications of percutaneous closure include device embolization, arrhythmias, and erosion.
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2) Surgical techniques discussed include different types of composite graft replacements, valve sparing procedures, and re-do operations. Specific procedures mentioned are the Bentall procedure and the Ross procedure.
3) Factors that determine whether the aortic valve should be replaced or repaired are discussed. Guidelines for intervention based on aortic root size are also provided.
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cardiac bypass.pptx iulhihuliuFHQIULHFLIhiluhI
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Successful Valve in Ring Abolishing the Stenosis and Regurgitation with Robus...
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The document provides an overview of transcatheter aortic valve implantation (TAVI), including a brief history of its development, descriptions of the Edwards Sapien valve and delivery systems, approaches for TAVI, and complications. It also discusses patient screening and risk stratification, as well as newer valve devices that are being developed.
Neo innovation in Limb Ischemia Management
Neo innovation in Limb Ischemia Management
diagnosis
treatment
clinical investigation
follow up
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TEVAR.pptx
1) The document discusses considerations for perioperative management of patients undergoing thoracic endovascular aortic repair (TEVAR). It covers preoperative optimization, indications for TEVAR, neurological management including cerebrospinal fluid drainage and risks of stroke and spinal cord injury, hemodynamic management, and respiratory care.
2) Key aspects of management include preoperative optimization of comorbidities, use of cerebrospinal fluid drainage in high risk patients, maintaining adequate blood pressure and perfusion pressure postoperatively to prevent spinal cord injury, and lung-protective ventilation.
3) Complications of TEVAR like stroke, spinal cord injury, and paraplegia require multidisciplinary care including interventions to optimize
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Cardiac surgery and ptca
The document summarizes different cardiac procedures including percutaneous transluminal coronary angioplasty (PTCA), stenting, laser angioplasty, atherectomy, and coronary artery bypass grafting (CABG). PTCA involves inserting a balloon catheter into narrowed coronary arteries to widen them. Stents may be placed to keep arteries open. CABG is a surgical technique that uses leg veins or arteries to bypass blocked portions of coronary arteries. The document discusses indications, contraindications, pre-operative preparations, intraoperative and postoperative care for these procedures.
Arritmias/Insuficiencia cardiaca
Lo mejor del ACC 2015 (San Diego)
Miércoles, 18/3/15 De 14:00 a 15:30
Casa del Corazón. Sociedad Española de Cardiología.
http://acc15.secardiologia.es/
Arritmias/Insuficiencia cardiaca
Dr. Romàn Freixa Pamias
Servicio de Cardiología. Hospital Moisés Broggi, Barcelona
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- 1. Alberto Maria Lanzone Istituto Clinico HUMANITAS Gavazzeni Bergamo AMPLATZER™ AMULET
- 2. The AMPLATZER™ Cardiac Plug or AMULET are percutaneous transcatheter devices intended for cardiac structures not involving the septal wall, which require closure or occlusion. One intended use is the nonsurgical closure of the left atrial appendage. Patient selection, imaging and device selection is critical for the successful implantation of the ACP.
- 3. The AMPLATZER™ AMULET is contraindicated for the following: Patients with the presence of intracardiac thrombus. Patients with active endocarditis or other infections producing bacteremia. Patients where placement of the device would interfere with any intracardiac or intravascular structures. (mitral valve, circumflex artery, etc.)
- 4. MV LSPV LIPV LAA LSPV LIPV RIPV RSPV RIPV LS LI RSPV A B C D LSPV LIPV LAA Mitral valve superior wall posteriorwall anteriorwall 23% of hearts
- 5. Left Atrial Appendage Measurements Veinot, John; Harrity, Phillip; Gentile, Federico; Khandheria, Bijoy; Bailey, Kent; Eickholt, Jeffrey; Seward, James; Tajik, A; Edwards, William. Circulation. 96(9):3112-3115, November 4, 1997. Anatomy of the Normal Left Atrial Appendage: A Quantitative Study of Age-Related Changes in 500 Autopsy Hearts: Implications for Echocardiographic Examination. Diameter: 1,11± 0,33 Width: 1,70 ± 0,60 Length: 2,56 ± 0,72
- 6. The appendages had 2–5 branches and 0–12 twigs The mean angle of the first bend was 134° The morphological appearance of the LAA could be classified into two types: slender like a crooked finger (81.8%) and stump-like (18.2%). The principal axis was: - tortuosus and spiraled in 42% of hearts, - extremely bent and slightly spiraled in 24%, - slightly bent and extremely spiraled in 5% - and slighly bent and spiraled in 23% P Su, K P McCarthy, S Y Ho Heart 2008;94:1166–1170.
- 7. Mitral Valve Pectinate Muscles VI Frontal Section (four chamber) INTERNAL MORPHOLOGY Pectinate Muscles are inside But ……….. not only
- 9. Circunflex Artery Major Coronary Vein Mitral Valve Coronary sinus orifice Left Atrium Left Superior PulmonaryVein ICV Frontal Section (four chambers) Cortesy of: Profesor Damián Sánchez Quintana Dpto. de Anatomia Humana Facultad de Medicina Universidad Extremadura
- 10. Circunflex Artery Major Coronary Vein Mitral Valve Coronary sinus orifice Left Atrium Left Superior PulmonaryVein ICV Extra-appendicular Pectinate Muscle Potentially, the left superior pulmonary vein, mitral valve and anterior descendingCA can be at risk during occlusion of the LAA.