review contributions to Catheterization and Cardiovascular Interventions

review contributions to Clinical Case Reports

Vieussens’ ring and retroaortic Kugel’s ring

Vieussens’ ring  and retroaortic Kugel’s ring

coronary artery angiograghic views

Rotation describes the position of the image intensifier around the longitudinal axis of the patient. LAO refers to rotating the camera to the patient's left (catheter and spine will be on the right side of the image), RAO to the patient's right (catheter and spine on the left side of the image). Angulation describes the position of the image intensifier in the short axis of the patient. Camera can pivit toward (cranial) or away (caudal) from the patient's head

Transcatheter closure of aortopulmonary window with Amplatzer duct occluder II

Transcatheter closure of aortopulmonary window with Amplatzer duct occluder II: additional size

The procedure was done under general anesthesia. All the children underwent transesophageal echocardiography (TEE) for reassessment of the defect size and surrounding margins prior to device closure. The ASO was used in all the cases. The device size was selected based on the maximum diameter of the ASD as determined on TEE at 0°, 45°, and 90°. The ASO used was either equal to or about 10% more than the maximum ASD diameter. Balloon sizing was not done in any of the patients. The length of the IAS was measured at 0° and 90° and the longer of the two measurements was used to define the length. Although the IAS length was estimated, it did not determine the maximum size of the device to be used. After obtaining the venous access, heparin was administered in the dose of 100 i.u/kg. Thereafter, 50 i.u./kg of heparin was administered every 30 min if the procedure time extended beyond 60 min. Activated clotting time was not monitored during the procedure. Intravenous (IV) antibiotic was given 1 h before and 8 and 24 h after the procedure. Postprocedure, children were observed for 24 h and were discharged on oral aspirin in the dose of 5 mg/kg/day for 6 months. All of them underwent predischarge ECG and TTE.

Radial to renal and 5x20mm NC balloon would not deflate! I pulled the balloon/guide back to the brachial and then punctured with a micropuncture needle. Problem solved!