/library/oar/handle/123456789/3623 2026-01-02T19:17:58Z /library/oar/handle/123456789/4134 Title: Morphology of the patent arterial duct : features relevant to treatment Authors: Matsui, Hikoro; McCarthy, Karen; Ho, Siew Yen Abstract: Patent ductus arteriosus (PDA), one of the most common congenital heart defects, is an abnormal persistence of a patent lumen in the arterial duct due to an arrest of the natural process of closure after it has served its function as a vital channel in fetal circulation. The histological feature of the arterial duct is entirely different from its adjoining arteries and many intrinsic substances mediate in the process of its normal closure. When existing in isolation, catheter or surgical intervention is usually used for its treatment. Ductal aneurysm is a rare type of PDA. The PDA associated with other congenital heart disease has variable morphology and closing it naturally or by intervention may produce critical symptoms. The PDA and its ligament which represents a closed arterial duct can be part of a vascular ring with abnormal aortic arch formation. It is important to understand the morphological features of PDA so as to choose the optimal strategy for treatment. 2008-01-01T00:00:00Z /library/oar/handle/123456789/4133 Title: Coil occlusion of the large patent Ductus Arteriosus Authors: Kumar, Rajiv K.; Nair, Amrita C. Abstract: While coil occlusion is well accepted for the small patent ductus arteriosus (PDA), occlusive devices are preferred for the larger (> 3 mm) ducts by most institutions. Because of costs concerns, occlusive devices are not always realistic in many countries. The technique of simultaneous delivery of multiple coils with bioptome assistance works well for relatively larger ducts. This technique requires careful case selection through echocardiography. The duct anatomy plays a crucial part in determining the suitability for coil occlusion. Coil occlusion has a specific advantage for relatively larger ducts in selected small children and in preterm infants because it is possible to accomplish delivery of multiple coils through relatively small introducer sheaths. In addition, aortic narrowing is less likely because coils compact in the ampulla. This review describes case selection strategies and techniques of coil occlusion of the large PDA. Relevant illustrative images are shown. 2008-01-01T00:00:00Z /library/oar/handle/123456789/4132 Title: Balloon assisted technique for closure of large atrial septal defects Authors: Dalvi, Bharat V. Abstract: Amplatzer device closure of large atrial septal defects is challenging. A large device tends to malalign with the plane of the interatrial septum or prolapses through the defect. We describe a balloon assisted technique which has been successfully used in over 300 cases without a single technical failure. 2008-01-01T00:00:00Z /library/oar/handle/123456789/4131 Title: Central venous catheters in children and neonates (part 3) : access via the femoral vein Authors: Trieschmann, U.; Kruessell, Markus; Udink ten Cate, Floris; Sreeram, Narayanswami Abstract: Central venous access via the femoral vein (FV) is safe, relatively easy and very usual in infants and children undergoing cardiac surgery for congenital heart disease. It has a low insertion-related complication rate. It is therefore a good choice for short-term central venous lines and a preferred insertion site for less experienced staff. The maintenance-related complications of thrombus formation and infections are higher compared to the internal jugular and the subclavian venous access. Some of these complications are reduced by the use of heparin bonded catheters, routine use of antibiotics, and timely removal of these lines in patients with persistent signs of infection but without another focus being defined. 2008-01-01T00:00:00Z