• Journal of Chest Surgery
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• v.26 no.11
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• pp.890-893
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• 1993

The first successful percutaneous transcatheter occlusion technique for patent ductus arteriosus achived by Rashkind in 1977.Transcatheter occlusion with the Rashikind double umbrella device is now widely accepted as treatment for patent ductus arterisus. The reported complications include embolization of the device, psudocoarctation left pulmonary artery stenosis, residual shunts, and mechanical hemolysis. We report two cases of severe hemolysis after occlusion of PDA with Rashkind occluder.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1035-1037
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• 2009

Patent ductus arteriosus (PDA) is a common congenital heart defect. All PDAs, regardless of size or degree of symptoms, require occlusion. Transcatheter PDA occlusion features fewer complications than trans-thoracic closure. It is also more cost-effective and has an excellent occlusion rate. Therefore, transcatheter PDA occlusion is accepted as the standard treatment option for PDA. However, tubular-type PDAs are difficult to close with ordinary detachable coils or the Amplatzer Duct Occluder; thus, these lesions remain a challenge for transcatheter closure. We attempted to occlude a tubular-type PDA by using an oversized Amplatzer Vascular Plug, which allowed intraluminal packing of the ductus. By using this treatment method, PDA occlusion was achieved safely with an excellent final outcome. We suggest that this approach may be a good option for transcatheter closure of a tubular-type PDA.

• Korean Journal of Veterinary Service
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• v.47 no.1
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• pp.55-59
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• 2024

A 4-year-old, spayed female German Shepherd dog (GSD) weighing 22.4 kg was referred to Chungnam National University Veterinary Medicine Teaching Hospital with the chief complaint of a cardiac murmur. A continuous murmur was detected at the left basilar region upon auscultation. In the thoracic radiographs, slight bulging of the aorta, the main pulmonary artery, and the left atrium were observed. Echocardiography revealed continuous turbulent flow directed from the main pulmonary artery towards the pulmonary valve and consistently within the main pulmonary artery. Based on all the results, a diagnosis of type II A patent ductus arteriosus (PDA) was made, and plans were established to treat it with transcatheter occlusion. Transcatheter occlusion was performed using a vascular plug and successfully deployed at the PDA. The patient did not exhibit any complications. GSDs are relatively less common compared to small-breed dogs in South Korea. Considering that GSDs are predisposed to PDA, it is crucial to periodically assess the presence of PDA through auscultation and echocardiography, even in the absence of clinical signs. Transcatheter occlusion using a vascular plug can be an option for treatment and can yield favorable outcomes.

• Clinical and Experimental Pediatrics
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• v.49 no.9
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• pp.917-929
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• 2006

Over the last several decades there has been a remarkable change in the therapeutic strategy of congenital heart disease. Development of new tools and devices, accumulations of experience, technical refinement have positively affected the outcome of interventional treatment. Many procedures including atrial septostomy, balloon valvuloplasty, balloon dilation of stenotic vessel with or without stent implantation, transcatheter occlusion of abnormal vascular structure, transcatheter closure of patent arterial duct and atrial septal defect, are now performed as routine interventional procedures in many institutes. In diverse conditions, transcatheter techniques also provide complementary and additive role in combination with surgery. Intraoperative stent implantation on stenotic vessels, perventricular device insertion, and hybrid stage 1 palliative procedure for hypoplastic left heart syndrome have been employed in high risk patients for cardiac surgery with encouraging results. Transcatheter closure of ventricular septal defect has been performed safely showing comparable result with surgery. Investigational procedures such as percutaneous valve insertion and valve repair are expected to replace the role of surgery in certain group of patients in the near future. Continuous evolvement in this field will contribute to reduce the risk and suffering from congenital heart disease, while surgery will be still remained as a gold standard for significant portion of congenital heart disease.

• Clinical and Experimental Pediatrics
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• v.53 no.12
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• pp.1012-1017
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• 2010

Purpose: Transcatheter closure has become an effective therapy in most patients with patent ductus arteriosus (PDA). However, there are difficulties in transcatheter closure of PDA in small children. We reviewed clinical outcomes of transcatheter closure of PDA in children weighing less than 10 kg in a single center. Methods: Between January 2003 and December 2009, 314 patients with PDA underwent transcatheter closure in our institute. Among them, 115 weighed less than 10 kg. All of these patients underwent transcatheter closure of PDA using either COOK Detachable $Coil^{(R)}$, PFM Nit-$Occlud^{(R)}$, or Amplatzer duct $occluder^{(R)}$. A retrospective review of the treatment results and complications was performed. Results: The mean age of patients was $9.1{\pm}5.9$ months (median, 8 months), and mean weight was $7.6{\pm}1.8kg$ (median, 7.8 kg). The mean diameter of PDA was $3.2{\pm}1.4mm$ (median, 3 mm). Complete occlusion occurred in 113 patients (98%). One patient was sent to surgery because of a failed attempt at device closure, and another patient had a small residual shunt after device placement. The average mean length of hospital stay was $3.0{\pm}3.3$ days, and mean follow-up duration was $21.0{\pm}19.6$ months. There were no major complications in any of the patients. Conclusion: Transcatheter closure of PDA is considered safe and efficacious in infants weighing less than 10 kg. With sufficient experience and further effort, transcatheter closure of PDA can be accepted as the gold standard of treatment for this group of patients.

• Journal of Chest Surgery
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• v.51 no.4
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• pp.290-292
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• 2018

Radiofrequency ablation is an effective treatment for atrial fibrillation. Pulmonary vein stenosis/occlusion is one of its rare complications. Herein, the case of a 50-year-old man with hemoptysis and migratory pulmonary infiltrations after transcatheter radiofrequency ablation for atrial fibrillation is presented. Initially, pneumonia, interstitial pulmonary disease, or lung cancer was suspected, but wedge resection revealed hemorrhagic infiltrations. Chest computed tomography pulmonary angiography detected no left superior pulmonary vein due to its total occlusion, and left upper lobectomy was performed. Post-ablation pulmonary vein occlusion must be strongly suspected in cases of migratory pulmonary infiltrations and/or hemoptysis.

• Korean Journal of Veterinary Research
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• v.57 no.1
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• pp.51-54
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• 2017

A 9-month-old intact male Maltese dog (1.52 kg) was diagnosed with a patent ductus arteriosus (PDA). Transcatheter occlusion of the PDA was performed by using the Amplatz canine duct occluder (ACDO). After occlusion, reflex bradycardia occurred and lasted for at least 15 h with normal systolic arterial pressure and slightly increased diastolic arterial pressure. The bradycardia slowly resolved, and the heart rate was normal in re-examinations after 7 and 30 days. This is the first case of reflex bradycardia after ACDO implantation, in which the bradycardia continued for a long time, even after recovery from anesthesia.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.158-164
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• 2005

Purpose : We reviewed the therapeutic results of various Duct-Occlud coils(pfm AG, $K{\ddot{o}}ln$, Germany) to evaluate the efficacy of the most-recently modified Duct-Occlud coil(Nit-Occlud) in the transcatheter closure of patent ductus arteriosus(PDA), including large defects more than 4 mm in diameter. Methods : Two hundred and five patients who underwent percutaneous PDA occlusion using Duct-Occlud devices from March 1996 to December 2003 were enrolled and four types of Duct-Occlud [Standard(S), Reinforced(R), Reinforced reverse cone(RR) and Nit-Occlud(N)] were used in this study. The patients were followed up by echocardiogram and physical examination before discharge, one month, six months and 12 months after the procedure. Results : The rate of residual shunt according to the type of Duct-Occlud were as follows : S-54%, R-72%, RR-50%, N-14%(P<0.05 compared with other devices) at one month, S-25%, R-44%, RR-37%, N-0%(P<0.05 compared with other devices) at six months, S-8%, R-8%, RR-4%, N-0%(P<0.05 compared with S and R) at 12 months and later. Nit-Occlud coil showed the complete occlusion of PDA after six months of follow-up, even in 12 patients with relatively large PDA(>4 mm). Conclusion : The transcatheter closure of PDA using Duct-Occlud was an effective treatment and our study revealed that a Nit-Occlud coil which showed higher rate of occlusion even in PDA with large diameters over than 4 mm, was a more effective modality compared to previous devices.

• Tuberculosis and Respiratory Diseases
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• v.67 no.1
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• pp.52-58
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• 2009

Pulmonary arteriovenous malformation (PAVM) is a rare pulmonary vascular anomaly due to an abnormal communication between the pulmonary artery and vein. The most common presenting symptom is a dyspnea on exertion related to this right-to-left shunt. If left untreated, PAVM has been known to result in serious complications. Incomplete pulmonary capillary network can be the cause of cerebral abscesses and other noninfectious neurological complications, such as stroke and transient ischemic attacks due to paradoxic embolism Transcatheter embolotherapy, using coils or balloons, has replaced surgical resection as the treatment of choice for PAVM. However, the risk of device embolization has limited the use of coil embolotherapy, while the size of PAVM is huge. Recently, Amplatzer$^{(R)}$ Vascular Plug has been proposed as an alternative endovascular occlusion device for arteriovenous malformation. We report a case of 81-year-old male patient with a giant PAVM, which was successfully treated by transcatheter embolotherapy using the Amplatzer$^{(R)}$ Vascular Plug.

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.150-153
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• 2006

Percutaneous transcatheter closure of atrial septal defects as a therapeutic alternative in appropriate patients provides superior cosmetic results, is less invasive, and allows for shorter hospital stays. Unfortunately, however, such percutaneous procedures can be associated with catastrophic procedure complications that may require immediate surgical intervention. We report a case of aorta-to-right atrial fistula two months after transcatheter occlusion of an atrial septal defect by an Amplatzer septal occluder. Revealed by dyspnea, palpitation and hemolysis, this complication needed an emergency surgical operation. The fistula between the noncoronary Valsalva sinus of the aorta and the right atrium was repaired. The atrial septal defect was closed by patch. The cause of this serious complication appears to be erosion into the aorta by the right atrial disk.