John Rhodes, Author at Clinical Advisor

John Rhodes

All articles by John Rhodes

Congenital Intervention – PDA, Coarctation, Pulmonary AVM, and Coronary Fistulae

General description of procedure, equipment, technique Patent ductus arteriosus A patent ductus arteriosus (PDA) accounts for 5% to 10% of all congenital heart disease and, if left unclosed, can lead to congestive heart failure, pulmonary hypertension, or infective arteritis. Currently, most PDAs can be safely and effectively closed percutaneously using coils or other devices, including…

Congenital Intervention – Pulmonary Valve Replacement

General description of procedure, equipment, technique Transcatheter management of conduit stenosis with bare metal stents has been used to effectively relieve conduit stenosis to delay the need for surgical valve replacement. Unfortunately, bare metal stenting may exacerbate chronic pulmonary insufficiency. More recently, percutaneous PV replacement has become an option to approach this patient population to…

Congenital Intervention – Angioplasty (Pulmonary Arteries and Veins)

General description of procedure, equipment, technique Angioplasty of the pulmonary arteries Balloon or stent angioplasty of the branch pulmonary arteries is occasionally necessary for patients with a history of complex congenital heart disease, such as transposition after the arterial switch operation and with tetralogy of Fallot. Branch pulmonary artery obstructions may be isolated, multiple, or…

Congenital Intervention – Atrial Septal

General description of procedure, equipment, technique Atrial septal interventions include the following: Transseptal Puncture Septoplasty /Atrial Septal Defect Creation Transseptal Puncture Currently, many of the percutaneous catheter-based treatments for adult “structural” heart diseases require access to the left heart via transseptal puncture. However, septal anatomy can often in this patient population be complex due to…

Congenital Intervention – Systemic Venous

General description of procedure, equipment, technique Venovenous collateral occlusion Venovenous collaterals can occur in patients with elevated systemic venous pressure, such as in the Fontan physiology. These vessels can result in connections from the systemic veins to the pulmonary venous return. Consequently, they can cause systemic hypoxemia and thus contribute to the polycythemia seen in…

Congenital Intervention – Vascular Access

General description of procedure, equipment, technique Options for patients with complex congenital heart disease Vascular access is obtained using the standard Seldinger technique. This is often difficult for adults with a history of complex congenital heart disease due to multiple previous vascular procedures. Also, vascular adverse events is one of the most common complications for…

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