The Patent Ductus Arteriosus in Adults with Special Focus on Role of CT

The primary imaging modality for the diagnosis of patent ductus arteriosus (PDA) is echocardiography. However, CT may be the technique on which an incidental PDA is first recognized because of the increasing number of chest CT scans performed for a variety of causes. Identification of PDA on CT may lead to earlier closure using a PDA occluder device. Immediate identification of incidental PDA is important, but a high rate of missed diagnosis of PDA has been reported due to its small size and anatomic location. In addition, echocardiography may overlook the presence of even a large PDA due to decrease in the amount of shunting through the PDA caused by high pulmonary artery pressures. This review provides the basic CT anatomy and clinical perspective of PDA, and discusses the role of CT in the evaluation of PDA as well as methods to avoid overlooking a small PDA on CT.

Mechanical hemolysis secondary to percutaneous repair of an iatrogenic Gerbode defect with the Amplatzer™ Septal Occluder

The Gerbode defect is defined as an abnormal communication between the left ventricle and the right atrium, and is etiologically classified as congenital or acquired (iatrogenic or not). The typical treatment consists of surgical repair of the shunt, but transcatheter occlusion of this condition has proven to be a safe and effective therapeutic alternative for such patients, especially for those with prior surgeries. The aim of this study was to report a case of transcatheter closure of an acquired Gerbode defect, using the Amplatzer™ Septal Occluder device, in a 58-year-old patient, with two prior mitral valve replacements, and the consequent post-procedure mechanical hemolysis.

Gore Cardioform Atrial Septal Occluder: Deployment Procedure and Techniques for Closing Challenging Secundum Atrial Septal Defects

Ostium secundum atrial septal defects are mostly closed in the cardiac catheterization laboratories using either Amplatzer® (Abbott Laboratories, IL) atrial septal occluder, Gore® Cardioform septal occluder and more recently using the recently approved (US FDA approval June 2019) Gore® Cardioform atrial septal defect occluder (W. L. Gore & Associates, AZ). Similar to any new device in the market, there is a learning curve to the deployment of this device. We therefore aim to report the key features about this new Gore Cardioform atrial septal defect occluder device with special emphasis on technical aspects that can be employed during transcatheter closure of challenging ostium secundum atrial septal defects using this device.

Percutaneous closure of giant ascending aortic pseudoaneurysm: 22 years after modified BlalockTaussig shunt with a septal occluder device

Pseudoaneurysm of the ascending aorta is rare (1–2%) and a potentially fatal complication following cardiac surgeries. Surgical repair is still the gold standard treatment of ascending aortic pseudoaneurysm. However, endovascular repair methods including stent grafts and Septal Occluder devices have been reported. We report a case of 38-year-old female patient who presented with giant ascending aortic pseudoaneurysm, and aortopulmonary fistula 22 years after modified BlalockTaussig shunt was managed by the transcatheter method. Septal Occluder device 20 mm diameter was delivered to seal the ostium.