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Towards Image-Guided Pediatric Atrial Septal Defect Repair, Fuad Mefleh Aug 2014

Towards Image-Guided Pediatric Atrial Septal Defect Repair, Fuad Mefleh

All Dissertations

Congenital heart disease occurs in 107.6 out of 10,000 live births, with Atrial Septal Defects (ASD) accounting for 10\% of these conditions. Historically, ASDs were treated with open heart surgery using cardiopulmonary bypass, allowing a patch to be sewn over the defect. In 1976, King et al. demonstrated use of a transcatheter occlusion procedure, thus reducing the invasiveness of ASD repair. Localization during these catheter based procedures traditionally has relied on bi-plane fluoroscopy; more recently trans-esophageal echocardiography (TEE) and intra-cardiac echocardiography (ICE) have been used to navigate these procedures. Although there is a high success rate using the transcatheter occlusion …


Diversion Of The Inferior Vena Cava Following Repair Of Atrial Septal Defect Causing Hypoxemia, Ellen A. Thompson, Silvestre Cansino, Dennis Moritz, Romaine Perdue Perdue Apr 2014

Diversion Of The Inferior Vena Cava Following Repair Of Atrial Septal Defect Causing Hypoxemia, Ellen A. Thompson, Silvestre Cansino, Dennis Moritz, Romaine Perdue Perdue

Silvestre P. Cansino

Atrial septal defects (ASDs) are a common congenital abnormality, and operative repair is a routine, safe procedure. Diversion of the inferior vena cava (IVC) into the left atrium is an unusual complication following ASD closure. We report a case that illustrates the problem created by this right-to-left shunt. A middle-aged woman underwent ASD repair. She developed hypoxemia postoperatively. A transthoracic echocardiogram confirmed a right-to-left shunt, found only with agitated saline injected into the femoral vein, not into the basilic vein. Surgical reexploration revealed a residual ASD diverting IVC flow into the left atrium, which was repaired with a pericardial patch. …


Diversion Of The Inferior Vena Cava Following Repair Of Atrial Septal Defect Causing Hypoxemia, Ellen A. Thompson, Silvestre Cansino, Dennis Moritz, Romaine Perdue Perdue Apr 2014

Diversion Of The Inferior Vena Cava Following Repair Of Atrial Septal Defect Causing Hypoxemia, Ellen A. Thompson, Silvestre Cansino, Dennis Moritz, Romaine Perdue Perdue

Ellen A. Thompson

Atrial septal defects (ASDs) are a common congenital abnormality, and operative repair is a routine, safe procedure. Diversion of the inferior vena cava (IVC) into the left atrium is an unusual complication following ASD closure. We report a case that illustrates the problem created by this right-to-left shunt. A middle-aged woman underwent ASD repair. She developed hypoxemia postoperatively. A transthoracic echocardiogram confirmed a right-to-left shunt, found only with agitated saline injected into the femoral vein, not into the basilic vein. Surgical reexploration revealed a residual ASD diverting IVC flow into the left atrium, which was repaired with a pericardial patch. …