Charles H. Gaymes

Origin of the left pulmonary artery from the aorta: embryologic considerations

We observed a case of anomalous origin of the left pulmonary artery from the aorta in which the media of the abnormal vessel and the main pulmonary artery were fused, but without communication. This is the fifth isolated case of repair without the use of cardiopulmonary bypass reported in the literature. This pathology should be included in the aortic arch anomalies as a partial or complete failure of development of the left sixth arch.

Closure of a large pulmonary arteriovenous malformation using multiple Gianturco-Grifka vascular occlusion devices

A large pulmonary arteriovenous malformation was successfully occluded using multiple Gianturco‐Grifka vascular occlusion devices. The filler wire protruded from one of the devices and was successfully retrieved 3 weeks after implantation. Cathet. Cardiovasc. Intervent. 49:426–429, 2000.

Catheter closure of accessory pulmonary blood flow after bidirectional Glenn anastomosis using Amplatzer duct occluder

Additional source of pulmonary blood flow in patients with bidirectional cavopulmonary anastomosis (Glenn shunt) may cause elevation of the pulmonary artery pressure precluding safe completion of the Fontan operation. A case is presented with single‐ventricle bidirectional cavopulmonary anastomosis and additional flow from the ventricle to the pulmonary artery resulting in elevated Glenn pressure. The communication was successfully occluded using Amplatzer duct occluder with satisfactory reduction in the Glenn pressure. Cathet Cardiovasc Intervent 2002;57:95–97.

Gianturco-Grifka Vascular Occlusion Device for Closure of Patent Ductus Arteriosus

We retrospectively reviewed the results of catheter closure of patent ductus areteriosus using the Ginaturco-Grifka vascular occlusion device in our institution. All patients in whom it was attempted had successful implantation, complete closure on follow-up, and no complications.

Percutaneous Serial Catheterization in Swine: A Practical Approach

In a model designed for experimental cryoablation of the His bundle in swine, a study that required multiple and follow-up cardiac catheterizations, femoral percutaneous cannulations were successfully performed in 14 of 15 swine: 6/6 Yucatan miniature, 5/6 Hanford miniature, and 3/3 Yorkshire farm pigs, weight range 15-50 kg. A follow-up cardiac catheterization was performed in 10 of these animals: 5 Hanford and 5 Yucatan. Femoral percutaneous cannulation was successful in 6. A cutdown approach was successful in the remaining 4 after failed attempts at percutaneous vascular access. The results show that percutaneous femoral cardiac catheterization is a feasible and practical technique for cardiovascular studies in swine, especially those that require multiple and serial catheterizations.

Transhepatic closure of atrial septal defect and assisted closure of modified Blalock/Taussig shunt.

The details of transhepatic closure of moderate – large size atrial septal defect as well as assisted closure of a modified Blalock Taussing shunt in a 2 1/2 year old patient with occluded femoral vessels are discussed. The technical variations as well as the potential advantages of this route are outlined.

Postsurgical use of Amplatzer septal occluder in cyanotic patients with pulmonary atresia/intact ventricular septum: Significance of cor triatriatum dexter and dilated right atrium

Percutaneous closure of secundum atrial septal defects (ASDs) has been shown to be safe and effective. However, its role after surgery in patients with cyanotic congenital heart disease who may have associated cor triatriatum dexter and a dilated right atrium has not been established. This article reports on successful closure in such patients, including precautions and results. Cathet. Cardiovasc. Intervent. 51:186–191, 2000.

Closure of External Tunnel Fontan Fenestration: A Novel Use of the Amplatzer Vascular Plug

Background Newer modifications of the Fontan operation include the external tunnel conduit with placement of an elongated type of fenestration. Atrial septal defect closure devices used traditionally to close fenestrations have short connecting waists with retention discs on each side. These may not be suitable for this type of Fontan fenestration. The length of the fenestration may not allow proper expansion of the retention discs on these devices. The Amplatzer vascular plug, a new occlusion device without a centering waist or retention discs designed to close vascular malformation, can be placed entirely within an elongated tube or vessel. Methods A retrospective review was used to study patients who underwent catheter closure of Fontan fenestration in our institution. Only patients whose procedure was performed after the commercial release of the Amplatzer vascular plug were included in the study. Results The vascular plug was implanted in 4 of 10 patients who underwent fenestration closure. The plug was successfully placed in all four patients without protrusion into either the systemic or pulmonary venous side of the baffle. There were no incidences of embolization, hemolysis, or infective endocarditis. All the patients experienced significant improvement in oxygen saturation. The technical aspects of this device are discussed as well as its safe and effective use. The satisfactory follow-up evaluation also is reported. Conclusions This study outlines a novel use of the Amplatzer vascular plug for successful closure of selected Fontan fenestrations.

Catheter conversion of classic glenn to bidirectional glenn with closure of left central shunt years after surgical attempts

Bidirectional Glenn shunt is usually performed in patients with single ventricle in preparation for a total cavo‐pulmonary connection. We present a patient born with complex congenital heart disease consisting of single ventricle, pulmonary atresia, non confluent pulmonary arteries, and anomalous pulmonary venous return in whom surgical bidirectional Glenn was attempted. After multiple surgical attempts she was converted to a Classic Glenn and a central ascending aorta to left pulmonary artery shunt. Several years later by the aid of radiofrequency wire the occluded pulmonary artery segment was canalized establishing continuity between the two pulmonary artery branches with stenting of the intervening segment. The central shunt to the left pulmonary artery was subsequently embolized. Thus this patient was converted in the catheterization laboratory from the physiology of a classic Glenn to the more preferred bidirectional Glenn physiology.

Catheter conversion of classic glenn to bidirectional glenn with closure of left central shunt years after surgical attempts: Catheter Completion of Bidirectional Glenn

Bidirectional Glenn shunt is usually performed in patients with single ventricle in preparation for a total cavo‐pulmonary connection. We present a patient born with complex congenital heart disease consisting of single ventricle, pulmonary atresia, non confluent pulmonary arteries, and anomalous pulmonary venous return in whom surgical bidirectional Glenn was attempted. After multiple surgical attempts she was converted to a Classic Glenn and a central ascending aorta to left pulmonary artery shunt. Several years later by the aid of radiofrequency wire the occluded pulmonary artery segment was canalized establishing continuity between the two pulmonary artery branches with stenting of the intervening segment. The central shunt to the left pulmonary artery was subsequently embolized. Thus this patient was converted in the catheterization laboratory from the physiology of a classic Glenn to the more preferred bidirectional Glenn physiology.