Off-pump transapical closure of a mitral periprosthetic leak: a new approach to a difficult problem

dc.contributor.authorGaia, Diego Felipe [UNIFESP]
dc.contributor.authorBreda, Joao Roberto [UNIFESP]
dc.contributor.authorFischer, Claudio Henrique [UNIFESP]
dc.contributor.authorFonseca, José Honório de Almeida Palma da [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:34:45Z
dc.date.available2016-01-24T14:34:45Z
dc.date.issued2013-12-01
dc.description.abstractA 60-year old male patient with multiple risk factors and two previous interventions over the mitral valve was admitted to the emergency unit with symptoms of cardiac failure. Initial examination revealed a competent mitral bioprosthesis with severe perivalvular mitral insufficiency. Based on previous experiences with transapical procedures, a transapical transcatheter closure of the perivalvular leak was performed. the apex was punctured with a 7 French introducer sheath, and a hydrophilic guidewire was advanced with the aid of a right Judkins catheter and positioned across the defect in the left atrium. Fluoroscopic and tridimensional transoesophageal echocardiography was used to guide the manoeuvre. Next, a long introducer sheath was advanced through the guidewire and positioned inside the left atrium. Two Amplatzer Vascular Plug II (St Jude Medical) were deployed, resulting in a significant reduction in the perivalvular leak. the procedure was considered to be successful. the patient regained consciousness, and the orotracheal tube was removed in the operating theatre. No neurological deficits were detected, and the patient was transferred to the intensive care unit. the patient recovered well and was transferred to the ward after 1 day. Discharge was accomplished after 4 days.en
dc.description.affiliationUniversidade Federal de São Paulo, Dept Cardiovasc Surg, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Cardiol & Echocardiog, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Cardiovasc Surg, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Cardiol & Echocardiog, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent1048-1050
dc.identifierhttp://dx.doi.org/10.1093/icvts/ivt395
dc.identifier.citationInteractive Cardiovascular and Thoracic Surgery. Oxford: Oxford Univ Press, v. 17, n. 6, p. 1048-1050, 2013.
dc.identifier.doi10.1093/icvts/ivt395
dc.identifier.issn1569-9293
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/37005
dc.identifier.wosWOS:000327456100038
dc.language.isoeng
dc.publisherOxford Univ Press
dc.relation.ispartofInteractive Cardiovascular and Thoracic Surgery
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.licensehttp://www.oxfordjournals.org/access_purchase/self-archiving_policyb.html
dc.subjectCardiac catheterization/interventionen
dc.subjectHeart valveen
dc.subjectTransapicalen
dc.subjectPercutaneousen
dc.subjectMitral valveen
dc.titleOff-pump transapical closure of a mitral periprosthetic leak: a new approach to a difficult problemen
dc.typeinfo:eu-repo/semantics/article
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