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Paradoxical embolism: Myth or reality?
Abstract Paradoxical embolism should be suspected in front of a clinical phenomenon of thromboembolism associated with an anatomical right-to-left shunt. Others potential cardiac sources of thromboembolism must be ruled out. Strokes constitute the most frequent clinical manifestations of paradoxical embolism. Right-to-left left shunts are in connection with intracardiac defects (atrial septal defect and patent foramen ovale) or pulmonary arteriovenous malformations. The probability that a discovered PFO is stroke-related can be evaluated by a score. Therapeutic approaches for secondary prevention of recurrent stro...
Source: Annales de Cardiologie et d'Angeiologie - October 30, 2017 Category: Cardiology Authors: Aubry P, Demian H, Brochet E, Juliard JM Tags: Ann Cardiol Angeiol (Paris) Source Type: research

Quantification of the area and shunt volume of multiple, circular, and noncircular ventricular septal defects: A 2D/3D echocardiography comparison and real time 3D color Doppler feasibility determination study
ConclusionsThree‐dimensional echocardiography (3DE) is a feasible method for determining VSD area and is more accurate than 2DE for evaluating the area of multiple or noncircular VSDs. Real‐time 3D color Doppler echocardiography (RT3D‐CDE) is a feasible method for quantifying the shunt volume of multiple or noncircular VSDs.
Source: Echocardiography - October 29, 2017 Category: Cardiology Authors: Evan Tracy, Meihua Zhu, Cole Streiff, David J. Sahn, Muhammad Ashraf Tags: ORIGINAL INVESTIGATION Source Type: research

Left atrial appendage closure for primary primary prevention during percutaneous closure of septal defects in patients with large atria but no atrial fibrillation.
CONCLUSIONS: Concomitant closure of ASD or PFO in the presence of enlarged atria and LAA for primary primary prevention appears feasible and safe but has yet to prove its justification. PMID: 28840592 [PubMed - as supplied by publisher]
Source: Cardiology Journal - August 25, 2017 Category: Cardiology Authors: Kuwata S, Vierecke J, Gloekler S, Maisano F, Meier B, Nietlispach F Tags: Cardiol J Source Type: research

Simplified Percutaneous Closure of Patent Foramen Ovale and Atrial Septal Defect With Use of Plain Fluoroscopy: Single Operator Experience in 110 Consecutive Patients
Conclusion Percutaneous placement of an Amplatzer occluder was safe and effective with use of local anesthesia and fluoroscopy alone. There were no recurrent strokes over >4years. Migraine relief was reported by >80% of patients.
Source: Indian Heart Journal - August 8, 2017 Category: Cardiology Source Type: research

Ebstein's anomaly in adults: Modified cone reconstruction of the tricuspid valve is associated with promising outcomes.
CONCLUSION: The cone repair of the tricuspid valve in adults with Ebstein's anomaly provided excellent mid-term results and significantly improved functional status. This procedure might be considered even in mildly symptomatic patients in the presence of severe valve regurgitation. PMID: 28566198 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - May 26, 2017 Category: Cardiology Authors: Belli E, Rabot M, Petit J, Gouton M Tags: Arch Cardiovasc Dis Source Type: research

Arrhythmias in Patients with Atrial Defects
Publication date: June 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 2 Author(s): Tahmeed Contractor, Ravi MandapatiTeaser Atrial arrhythmias are common in patients with atrial septal defects. A myriad of factors are responsible for these that include remodeling related to the defect and scar created by the repair or closure. An understanding of potential arrhythmias, along with entrainment and high-density activation mapping can result in accurate diagnosis and successful ablation. Atrial fibrillation is being seen increasingly after patent foramen ovale closure and may be the primary etiology of recurre...
Source: Cardiac Electrophysiology Clinics - April 28, 2017 Category: Cardiology Source Type: research

Long-term Risk of Atrial Fibrillation and Stroke in Patients with Atrial Septal Defect Diagnosed in Childhood
The aim of this study is to evaluate the long-term risk of atrial fibrillation (AF) and stroke in patients with atrial septal defect (ASD) diagnosed before the age of 18 years. Patients diagnosed with ASD between 1963-2011 were identified through national Danish registers, of which 1,111 fulfilled the inclusion criteria. Each patient was matched with 10 controls on age and gender. Risk of AF and stroke was assessed using Cox proportional hazards regression. Cumulative incidences were calculated using Fine and Gray ’s competing risk regression.
Source: The American Journal of Cardiology - October 30, 2016 Category: Cardiology Authors: Zarmiga Karunanithi, Camilla Nyboe, Vibeke Elisabeth Hjortdal Source Type: research

New Ventricular Septal Defects Following Balloon-Expandable Transcatheter Aortic Valve Replacement.
Authors: Rene AG, Jagasia D, Wickramasinghe SR, Desai N, Szeto W, Vallabhajosyula P, Li RH, Silvestry FE, Giri J, Jha S, Herrmann HC, Anwaruddin S Abstract Transcatheter aortic valve replacement (TAVR) has been commercially approved in the United States for the treatment of high-risk and inoperable patients with severe symptomatic aortic stenosis. While TAVR has proven benefits with regard to survival and quality of life in studied populations, the procedure is also associated with several well-described complications including stroke, vascular injury, and paravalvular regurgitation. More infrequent complications a...
Source: The Journal of Invasive Cardiology - June 29, 2016 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Imaging Techniques in Percutaneous Cardiac Structural Interventions: Atrial Septal Defect Closure and Left Atrial Appendage Occlusion
Publication date: Available online 25 June 2016 Source:Revista Española de Cardiología (English Edition) Author(s): Antonio Rodríguez Fernández, Armando Bethencourt González Because of advances in cardiac structural interventional procedures, imaging techniques are playing an increasingly important role. Imaging studies show sufficient anatomic detail of the heart structure to achieve an excellent outcome in interventional procedures. Up to 98% of atrial septal defects at the ostium secundum can be closed successfully with a percutaneous procedure. Candidates for this type of procedure can be identified through a ...
Source: Revista Espanola de Cardiologia - June 25, 2016 Category: Cardiology Source Type: research

Percutaneous Closure of Intracardiac Defects in Adults: State of the Art.
Authors: Pineda AM, Mihos CG, Singla S, Santana O, Rhodes J, Sommer RJ, Rihal CS, Beohar N Abstract The number of adults with congenital heart disease is expected to increase over the next decade. Although acquired defects are being increasingly recognized in adults, congenital heart disease remains the most common etiology. With advances in cardiac imaging, device technology, and transcatheter techniques, percutaneous closure is now feasible and safe for most intracardiac defects. Device closure is considered the first-line therapy for a variety of congenital intracardiac defects, including ostium secundum atrial ...
Source: The Journal of Invasive Cardiology - March 11, 2016 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Atrial Septal Defects and Cardioembolic Strokes
Atrial septal defects (ASDs) can be complicated by cardioembolic strokes, but the exact incidence is unknown. Patients with large and small shunts may present with a cardioembolic stroke. Patients with cryptogenic strokes should have cardiac ultrasound to see if an ASD is present. Cardioembolic strokes associated with ASD principally occur with 2 mechanisms. The first is paradoxic embolism involving a venous-based source of thrombus, which may subsequently pass through the ASD by right-to-left shunting, causing a cardioembolic stroke. The second is atrial fibrillation that can complicate the course of patients with ASDs, e...
Source: Cardiology Clinics - March 9, 2016 Category: Cardiology Authors: Michelle Leppert, Sharon N. Poisson, John D. Carroll Source Type: research

Ischemic Stroke in Children and Young Adults With Congenital Heart Disease Congenital Heart Disease
Conclusions The risk of developing ischemic stroke was almost 11 times higher in young patients with CHD than in the general population, although absolute risk is low. Cardiovascular comorbidities were strongly associated with the development of ischemic stroke in young CHD patients.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Mandalenakis, Z., Rosengren, A., Lappas, G., Eriksson, P., Hansson, P.-O., Dellborg, M. Tags: Epidemiology, Congenital Heart Disease, Ischemic Stroke Source Type: research

Morphological study of fossa ovalis and its clinical relevance
Conclusion As no study of this nature has been carried out in the Indian population, this provides pertinent information on the morphology of FOv, which may be useful for device selection in treating ASD and PFO.
Source: Indian Heart Journal - January 18, 2016 Category: Cardiology Source Type: research

Risk of Recurrent Neurologic Stroke or Transient Ischemic Attack in Patients with Cryptogenic Stroke and Intrapulmonary Shunt
ConclusionsPatients with IPS and cryptogenic stroke or TIA did not have a higher recurrence of ischemic cerebral events. Warfarin was significantly higher at follow‐up in the IPS compared to the non‐IPS group, which may explain these findings. A study randomizing patients with IPS and cryptogenic stroke or TIA to warfarin or no warfarin would be of great interest.
Source: Echocardiography - July 22, 2015 Category: Cardiology Authors: Rahul S. Sinha, Zeeshan Hussain, Nirmanmoh Bhatia, Marcus F. Stoddard Tags: Original Investigation Source Type: research

Interventional closure of atrial septal defects, patent oval foramen and ventricular septal defects.
Authors: Hornung M, Franke J, Id D, Sievert H Abstract Percutaneous transcatheter closure techniques and devices for congenital intracardiac shunts have considerably improved; therefore, catheter closure is now the treatment of choice for atrial septal defects (ASD). This is technically feasible in more than 80 % of patients with a secundum ASD and the success rate is higher than 99 %. General anesthesia is as a rule unnecessary and the hospital stay is very short. A patent oval foramen (POF) is a potential cause of cryptogenic stroke and peripheral embolisms. The catheter occlusion has many advantages in compa...
Source: Herz - July 3, 2015 Category: Cardiology Tags: Herz Source Type: research

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