Next article Search Articles Instructions for authors  Access Statistics | Citation Manager  
ORIGINAL ARTICLE  

 Article Access Statistics
    Viewed1013    
    Printed20    
    Emailed0    
    PDF Downloaded108    
    Comments [Add]    

Recommend this journal

Transcatheter closure of congenital portosystemic shunts – A multicenter experience


1 Department of Pediatric Cardiology, Rainbow Children's Heart Institute, Hyderabad, Telangana, India
2 Department of Pediatric Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
3 Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
4 Department of Pediatric Cardiology, Kokilaben Ambani Hospital, Mumbai, Maharashtra, India
5 Department of Pediatric Cardiology, Jupiter Hospital, Thane, Maharashtra, India

Correspondence Address:
Dr. Nageswara Rao Koneti
Department of Pediatric Cardiology, Rainbow Children's Heart Institute, Hyderabad, Telangana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_5_22

Rights and Permissions

Year : 2022  |  Volume : 15  |  Issue : 2  |  Page : 114-120

 

SEARCH
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles

  Article in PDF (1,973 KB)
Email article
Print Article
Add to My List
Background: Congenital portosystemic shunts (CPSS) are rare and present variably with hepatic encephalopathy, pulmonary arteriovenous malformations (PAVMs), and pulmonary hypertension (PH). Objective: The objective of the study was to see the feasibility of transcatheter closure of CPSS and their outcome. Materials and Methods: We analyzed the data of 24 patients of CPSS who underwent transcatheter closure from five institutions (March 2013 to April 2019). Baseline evaluation included echocardiography with bubble contrast study, ultrasound examination of the abdomen, computed tomography angiogram, and cardiac catheterization with test balloon occlusion of the CPSS. The evaluation showed cyanosis due to PAVM in 12, PH in 8, and respiratory distress in 2. Two had both cyanosis and PH. Criteria for eligibility for complete catheter closure of CPSS included demonstration of intrahepatic portal vein (PV) radicals together with a PV pressure of ≤18 mmHg on occlusion. Results: The median age and weight were 8 years (0.5–21) and 19.5 kg (4.2–73), respectively. Transcatheter closure was performed in 21 patients (22 procedures) using a variety of occlusive devices and stent-graft exclusion was done in one patient. Closure was not done in 3 in view of high portal venous pressures and hypoplastic PVs. During the follow-up (median: 42 months and range: 61 days–4.8 years), saturation normalized in 14 patients with PAVM. PH declined in all eight patients who underwent the procedure. Respiratory distress improved in two patients. Conclusions: Early and short-term follow-up results of catheter closure of CPSS appear promising. However, further, follow-up is needed to demonstrate long-term effectiveness.






[FULL TEXT] [PDF]*
 

 

 

 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 
 
 Reader Comments
 Email Alert *
  *
 * Requires registration (Free)
 
 ORIGINAL ARTICLE
 




1 Department of Pediatric Cardiology, Rainbow Children's Heart Institute, Hyderabad, Telangana, India
2 Department of Pediatric Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
3 Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
4 Department of Pediatric Cardiology, Kokilaben Ambani Hospital, Mumbai, Maharashtra, India
5 Department of Pediatric Cardiology, Jupiter Hospital, Thane, Maharashtra, India

Correspondence Address:
Dr. Nageswara Rao Koneti
Department of Pediatric Cardiology, Rainbow Children's Heart Institute, Hyderabad, Telangana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_5_22

Rights and Permissions

Background: Congenital portosystemic shunts (CPSS) are rare and present variably with hepatic encephalopathy, pulmonary arteriovenous malformations (PAVMs), and pulmonary hypertension (PH). Objective: The objective of the study was to see the feasibility of transcatheter closure of CPSS and their outcome. Materials and Methods: We analyzed the data of 24 patients of CPSS who underwent transcatheter closure from five institutions (March 2013 to April 2019). Baseline evaluation included echocardiography with bubble contrast study, ultrasound examination of the abdomen, computed tomography angiogram, and cardiac catheterization with test balloon occlusion of the CPSS. The evaluation showed cyanosis due to PAVM in 12, PH in 8, and respiratory distress in 2. Two had both cyanosis and PH. Criteria for eligibility for complete catheter closure of CPSS included demonstration of intrahepatic portal vein (PV) radicals together with a PV pressure of ≤18 mmHg on occlusion. Results: The median age and weight were 8 years (0.5–21) and 19.5 kg (4.2–73), respectively. Transcatheter closure was performed in 21 patients (22 procedures) using a variety of occlusive devices and stent-graft exclusion was done in one patient. Closure was not done in 3 in view of high portal venous pressures and hypoplastic PVs. During the follow-up (median: 42 months and range: 61 days–4.8 years), saturation normalized in 14 patients with PAVM. PH declined in all eight patients who underwent the procedure. Respiratory distress improved in two patients. Conclusions: Early and short-term follow-up results of catheter closure of CPSS appear promising. However, further, follow-up is needed to demonstrate long-term effectiveness.






[FULL TEXT] [PDF]*


        
Print this article     Email this article