Frank-Thomas Riede

Catheter interventional treatment of Sano shunt obstruction in patients following modified Norwood palliation for hypoplastic left heart syndrome.

Shunts placed between the right ventricle and the pulmonary arteries, called Sano shunts, recently modified Norwood surgery for hypoplastic left heart syndrome. Patients with Sano shunts tend to be more stable thus reducing the interstage mortality of this still challenging complex cardiac anomaly. However, Sano shunt stenosis may develop and is a life threatening complication. We report on our experience in patients with Sano shunt obstruction.PatientsEight infants presenting with decreasing transcutaneous oxygen saturations (43–63%, median 58%) following modified Norwood procedures were shown to have relevant Sano shunt stenosis. None was suited for early stage two surgery (cavopulmonary Glenn anastomosis). Catheterization was performed at the age of 21 to 112 (median 85) days. Weight was 3.9 to 6.0 (median 4.8) kg.TechniqueFemoral 5F venous access. Long sheaths were not used. The shunt was entered with a 4F right Judkins catheter and a selective angiography was performed. The stenosis was localized proximal in 5, distal in 1 and proximal and distal in 2 patients. Ten coronary stents were implanted.ResultsThere were no procedure related complications. Oxygen saturation increased immediately to 75–86% (median 80%) and remained above 70% during follow-up in all. Seven patients had successful stage two surgery 61–288 (median 134) days after stent implantation, one is awaiting this.ConclusionsSano shunt obstruction can be treated safely and effectively by stent implantation. Early in-stent restenosis does not seem to be a problem.

Closure of Secundum Atrial Septal Defects by Using the Occlutech Occluder Devices in More Than 1300 Patients: The IRFACODE Project: A Retrospective Case Series.

The Occlutech Figulla ASD device series (OFSO) shows an improved device design for interventional ASD closure, larger follow‐up series are missing.

Closure of Secundum Atrial Septal Defects by Using the Occlutech Occluder Devices in More Than 1300 Patients

The Occlutech Figulla ASD device series (OFSO) shows an improved device design for interventional ASD closure, larger follow‐up series are missing.

Transcatheter aortic valve closure to treat severe aortic regurgitation in a patient failing stage I palliation for hypoplastic left heart syndrome.

We present a patient with borderline left ventricle, in whom significant aortic regurgitation after failed attempt of biventricular repair with balloon valvuloplasty and consecutive Norwood stage 1 procedure substantially contributed to persisting hemodynamic instability. Transcatheter closure of the aortic valve using an Amplatzer® septal occluder was performed and led to clinical stabilization. At medium‐term follow‐up, there was neither residual aortic regurgitation nor obstruction of the coronary artery origins.© 2009 Wiley‐Liss, Inc.

Partial anomalous pulmonary venous drainage of the left upper pulmonary vein -- catheter interventional treatment is sometimes possible.

Prof. Martin Kostelka, MD, PhD Dept. Pediatric Cardiac Surgery, Universität Leipzig Sirs: Partial anomalous pulmonary venous drainage (PAPVD) of the left upper pulmonary vein (LUPV) is a rare congenital anomaly leading to left to right shunt. Embryogenesis is thought to consist of nondevelopment of the connection between LUPV and left atrium and the persistence of a primitive “vertical” vein between LUPV and the left brachiocephalic (innominate) vein [1]. The lesion must not be confused with a persistent left superior caval vein with connection to the left atrium. Standard treatment is surgical redirection of the LUPV to the left atrium [2]. This is the first description of interventional treatment of this lesion. Methods and patients

Transient sirolimus serum levels after implantation of a sirolimus eluting stent in an infant

Frank-Thomas Riede, MD Peter Schneider, MD, PhD Ingo Dähnert, MD ()) Klinik für Kinderkardiologie Herzzentrum Leipzig GmbH Universität Leipzig Strümpellstraße 39 04289 Leipzig, Germany Tel.: +49-3 41 / 8 65 10 36 Fax: +49-3 41 / 865 11 43 E-Mail: ingo.daehnert@med.uni-leipzig.de Sirs: Drug eluting stents have been shown to reduce early coronary artery restenosis when compared to uncoated stents [1–3]. No data exist concerning the use and safety of these devices in children. We report on an infant treated with a sirolimus eluting stent for occlusion of a xenograft.

Pulse Oximetry Screening in Germany—Historical Aspects and Future Perspectives

In January 2017, pulse oximetry screening was legally implemented in routine neonatal care in Germany. The preceding developments, which were the prerequisite for this step, are described in the specific context of Germany’s health care system. Continued evaluation of the method is imperative and may lead to modifications in the screening protocol, ideally in accordance with the efforts in other countries.

Lung Abscess as Delayed Manifestation of Pulmonary Arterial Narrowing After Sleeve Resection

A patient who had undergone right upper bilobectomy because of a carcinoid experienced lung abscesses 17 months after operation. After recurrences, despite different antibiotic agents, dual-energy computed tomography showed subtotal stenosis of the right lower lobe pulmonary artery with marked pulmonary perfusion-reduction. Rare causes of lung-abscesses should be considered.

Odd Acoustic Window and Elongated Ventricles: Echocardiographic Diagnosis of Congenital Absence of the Pericardium

A 14-year-old boy with a heart murmur was referred to the authors’ department because structural heart disease could not be ruled out by standard echocardiographic views. The best apical four-chamber view was obtained with the patient turned to a right lateral decubitus position and the transducer shifted almost to the posterior axillary line. A biplane chest x-ray also showed a counterclockwise heart axis deviation. Magnetic resonance imaging confirmed the suspected congenital absence of the pericardium.