Massimo Chessa

effect of Bosentan on exercise capacity and clinical Worsening in patients With Dual Down and eisenmenger syndrome

This single-center, retrospective analysis evaluated long-term bosentan treatment in adult patients (n = 7) with both Down and Eisenmenger syndromes (DS-ES). Laboratory tests, 6-minute walk distance (6MWD), functional class, and Doppler echocardiography were assessed at baseline and during 2 years follow-up. Improvements or maintenance of 6MWD were observed (68 m improvement from baseline at month 12) after bosentan initiation. 6MWD was maintained up to year 2. Overall, 6 patients experienced a significant improvement in functional class during 2 years therapy (P = 0.01). There were no significant changes in parameters measured by Doppler echocardiography. None of the patients required either hospitalization or additional pulmonary arterial hypertension (PAH) therapy because of PAH progression. Bosentan treatment was generally well tolerated; no liver function abnormalities or serious adverse drug reactions were noted. In this DS-ES cohort, bosentan seemed to be well tolerated and clinically effective.

Percutaneous closure of ventricular septal defects

Isolated ventricular septal defect is the most common form of congenital heart disease. Surgery has been performed for many years and is considered the gold standard for the treatment of ventricular septal defects. However, it is associated with morbidity and mortality. Less invasive techniques have been developed and currently percutaneous closure of muscular and perimembranous ventricular septal defects has to be considered a possible alternative to the standard surgical approach.

The right ventricle in adults with tetralogy of Fallot

The Right Ventricle in Adults with Tetralogy of Fallot - Libros de Medicina - Cardiologia general - 103,95

Patent foramen ovale percutaneous closure: the no-implant approach

Evaluation of: Sievert H, Fischer E, Heinisch C, Majunke N, Roemer A, Wunderlich N. Transcatheter closure of patent foramen ovale without an implant: initial clinical experience. Circulation 116, 1701–1706 (2007). Currently available catheter techniques for closure of a patent foramen ovale (PFO) rely on the placement of an implantable closure device. Sievert et al. evaluated the safety and feasibility of transcatheter closure of PFO using radiofrequency energy without an implanted device in patients with cryptogenic stroke or transient ischemic attack. In total, 30 patients were enrolled (15 females; mean age 48 years). Technical success was achieved in 90% of the patients. All 30 patients did not present any serious procedure-related adverse events. No recurrent strokes, deaths or perforations occurred as a result of the procedure. The mean follow-up was 6 months, and 13 out of the 30 (43%) patients experienced PFO closure after the first procedure. Complete closure after a second procedure was achieved in 63% of the cases. The authors demonstrate that transcatheter closure of an intracardiac defect without a permanent implant is technically feasible. However, future improvements in the technique and materials are needed.

Hybrid Muscular Ventricular Septal Defect Closure: Literature and Results

Ventricular septal defects (VSDs) are the most common congenital cardiac malformation at birth, with an incidence reported in literature between 15 and 40 % of total congenital heart diseases. They are usually an isolated finding; however, they can be also associated to complex congenital heart diseases [1, 2]. VSDs may be also a mechanical complication of myocardial infarction, with an incidence reported in literature of 0.26 % [3].

Ventricular Septal Defects

The defects that may be suitable for percutaneous closure are located within the muscular septum (muscular ventricular septal defects, MVSD) or in the perimembranous septum (perimembranous ventricular septal defects, PVSD) with or without aneurysm, and they can be native of residual post surgery.

Melody Valve Implantation in Pulmonary Position

Surgical pulmonary valve replacement lacks longevity as conduit dysfunction usually occurs within 10–15 years and exposes patients to multiple risky operations over their lifetime. The recent availability of a percutaneous approach to treat RVOT dysfunction, therefore, offers an attractive solution, as it permits earlier intervention without the problems associated with surgery and cardiopulmonary bypass. Initial midterm results are promising, and the technique has proved safe and has provided efficacious relief of pressure and/or volume overload. These results are associated with improvement of symptoms and objective exercise capacity. However, PPVI is not free from possible complications. Due to anatomical (size and morphology) and dynamic reasons, with the current device, only 15 % of patients with RVOT dysfunction are eligible for such a treatment.

Cardiac Catheterization for Congenital Heart Disease: From Fetal Life to Adulthood

Cardiac catheterization for congenital heart disease : , Cardiac catheterization for congenital heart disease : , کتابخانه دیجیتالی دانشگاه علوم پزشکی ارومیه

Transcatheter Treatment of Tricuspid Valve

Tricuspid valve replacement is not a common operation and, in most series, is associated with high postoperative mortality. Although bioprosthetic valves appear to have improved the performance early after surgery, these valves will inevitably experience wear and degeneration, requiring a second implant. Redo valve surgery for bioprosthetic valve failure is challenging. In this context, there has been an understandable interest in percutaneous valve therapy to extend the life span of failing tricuspid valve prostheses.

Tricuspid Valve Injury After Surgical/Transcatheter Procedures

Tricuspid valve injury may be a complication of both a surgical and a transcatheter procedure. Surgical injury of the tricuspid valve is a quite uncommon complication that has been mainly associated with ventricular septal defect closure, partial or complete atrioventricular septal defect repair, and tetralogy of Fallot repair. Tricuspid valve injuries are described as a non-frequent complication of a cardiac catheterization and may occur as a result of chorda tendinea lesion during a pulmonary artery catheterization or as a consequence of ventricular septal defect device closure. The management and indication to treat these lesions remain controversial. The purpose of this chapter is to consider the possible causes of tricuspid valve injuries and how and when to treat these complications.