Papers by anita dumitrescu
Heart, Jun 14, 2007
Objectives. We aimed to explore the radiologic characteristics and interventional strategies for ... more Objectives. We aimed to explore the radiologic characteristics and interventional strategies for perimembranous ventricular septal defect (pmVSD) with aneurysm. Methods. 257 patients who underwent transcatheter closure of pmVSD with aneurysm were included in our study. We retrospectively reviewed the left ventricular opening of the aneurysm (a), diameter of the midsegment of the aneurysm (b), and diameter of the right ventricular opening of the aneurysm (c). If there were multiple defects within the aneurysm, the largest defect was denoted as c 1 and so forth. We developed a novel VSD classification method in which pmVSD with aneurysm was classified into three types (A, B, and C). When a >b ≥ c, it was classified as type A, when b > a ≥ c, it was type B, and when c > a ≥ b, it was type C; c/c 1 described the relationship among defects. Results. All of the 257 cases of pmVSD with aneurysm were defined using left ventriculography: type A, 60, type B, 58, and type C, 139. Transcatheter closure was attempted in 244 patients and succeeded in 227 cases (success rate was 93.0%; 227/244). Forty symmetric VSD occluders and 13 asymmetric VSD occluders were used for type A aneurysm occlusion; 31 symmetric VSD occluders, 19 asymmetric VSD occluders, and one Amplatzer duct occluder II (ADOII) were used for type B; 59 VSD symmetric occluders, 59 asymmetric VSD occluders, three eccentric VSD occluders, and two ADOII were used for type C. Within 24 hours after procedure, 2.2% patients had postprocedural residual shunt, and 2.2% experienced malignant arrhythmia (including type II second-degree AVB, cAVB, and CLBBB). Two hundred and twelve patients completed follow-up (93%, 212/227). No new severe complications were reported during follow-up, except in one patient who underwent surgery (removal of the device, VSD repair, and tricuspid valvuloplasty) due to severe postprocedural tricuspid regurgitation. Conclusions. It is safe and effective to apply this method for the classification of pmVSD with aneurysm and its interventional strategy.
the british journal of cardiology, 2006
Patients with Eisenmenger syndrome generally die patients with Eisenmenger syndrome generally die... more Patients with Eisenmenger syndrome generally die patients with Eisenmenger syndrome generally die prematurely from complications directly due to their pulmonary hypertension and cyanosis, or due to intercurrent events that are poorly tolerated because of the underlying inadequate cardiopulmonary reserve. To date, clinical management has aimed at avoiding situations that would destabilise their condition and treatment of its complications. However, therapeutic prospects are starting to look more encouraging. Results from a small study with the oral dual endothelin receptor antagonist, bosentan, have shown improved exercise capacity. Additionally, there appears to be a possible role for the phosphodiesterase-5-inhibitor, sildenafil, in the treatment of Eisenmenger pulmonary hypertension.
British Journal of Cardiology, 2006
Percutaneous Device Closure of the Atrial Septum, 2006
Heart (British Cardiac Society), 2007
The late development of heart block in paediatric patients following device closure of a perimemb... more The late development of heart block in paediatric patients following device closure of a perimembranous ventricular septal defect may be a cause for concern.
Heart (British Cardiac Society), 2007
Pediatric Cardiology, 2008
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Papers by anita dumitrescu