Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.

Method and apparatus for thoracoscopic intracardiac procedures

Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial.

Devices for less invasive intracardiac interventions

The invention provides surgical systems and methods for ablating heart tissue within the interior and/or exterior of the heart. A plurality of probes is provided with each probe configured for introduction into the chest for engaging the heart. Each probe includes an elongated shaft having an elongated ablating surface of a predetermined shape. The elongated shaft and the elongated ablating surface of each probe are configured to ablate a portion of the heart. A sealing device affixed to the heart tissue forms a hemostatic seal between the probe and the penetration in the heart to inhibit blood loss therethrough.

Methods of epicardial ablation for creating a lesion around the pulmonary veins

Comparison of results and complications of surgical and Amplatzer device closure of atrial septal defects.

Objective To define the problems encountered during transcatheter occlusion of the patent arterial duct using Gianturco coils.

Methods Between January 1994 and November 1995, 93 patients were admitted in whom it was intended to occlude the patent arterial duct using Gianturco coils. Anterograde transcatheter coil occlusion was performed via the femoral vein in 81 patients. In the remaining 12 the procedure was done via the femoral artery.

Results Coils were implanted successfully in 82/93 (88%) patients. In 11 patients the procedure was a failure. In 19/93 patients (20%), inadvertent embolization of the coil occurred. The coils were retrieved in all except one patient. In 17 of these patients, new coils were then reimplanted successfully. Doppler echocardiography after the procedure showed that in 9/82 (11%) patients the left pulmonary artery Doppler peak velocity exceeded 1·5 m. s −1(mean 1·2 m. s.−1) raising concern about left pulmonary artery branch stenosis. The complete occlusion rate at discharge from hospital was 72/82 (88%). Follow-up ranges from 1 day to 14 months (mean 2/12 months) in the 82 patients in whom successful deployment of coils was possible. In two patients, the arterial duct became occluded at followup. One additional patient had complete occlusion after reocclusion using another coil. Thus, after short-term follow-up a total of 75/82 patients (91·4%) have a completely occluded arterial duct after coil implantation.

Conclusion Transcatheter occlusion of the patent arterial duct using Gianturco coils is an effective and safe technique. In the learning curve there is a relatively high rate of inadvertent embolization, but the coils can be retrieved in the vast majority of patients. The complication rate is offset by the high early occlusion rate and the inexpensiveness of the procedure.

/pdf/problems-encountered-during-introduction-of-gianturco-coils-4a3l5sn44u.pdf

Problems encountered during introduction of Gianturco coils for transcatheter occlusion of the patent arterial duct

Between March 1990 and November 1993 175 patients underwent successful closure of patent ductus arteriosus using the Rashkind double umbrella device. Of those patients seen on follow up, 13 (9 female, 4 male) had a residual leak and were admitted for implantation of a second device alongside the first device. The interval between the procedures ranged from 6 to 22 months. The mean age at the first procedure was 73.9 months (range 24–204 months) and the mean weight was 18.9 kg (range 8.4–64). The mean age at the second procedure was 86.9 months (30–213) and the mean weight was 21.4 kg (8.6–64). The first device was 17 mm in 11 patients and 12 mm in two. The second device was 17 mm in four patients and 12 mm in nine. Four patients required two 17 mm devices in total. There was no difference in the two procedures regarding the fluoroscopy time, procedure time, complications and length of hospital stay. The second procedure was uneventful; however, in one patient the residual ductus had to be dilated before successfully deploying a 12 mm device. Ten patients had immediate total occlusion and three had a trivial leak on echocardiography 24 h later. One of the three patients was found to have total occlusion on Doppler echocardiography 1 year later. The other patients are yet to be seen for follow up. Hence a total occlusion rate was in 11/13 patients (85%). In nine patients pulmonary artery angiography was performed immediately after the implantation of the second device to rule out left pulmonary artery stenosis; three of those developed mild indentation at the origin of the left pulmonary artery but there was no evidence of stenosis on withdrawal pressure recordings Doppler echocardiography in any of the 13 patients.

Re-occlusion of residual leaks after transcatheter occlusion of patent ductus arteriosus.

This study intends to provide a detailed overview of the types and rates of peri-operative complications after surgical correction of an isolated ASD II. The transvenous approach to the occlusion of atrial septal defects has yielded promising results during its first 5 years of clinical trials, but before it can be established as a routine measure, definite proof is needed to demonstrate that its rate of serious complications does at least not exceed that of the surgical closure. Between 1985 and 1992, 232 consecutive patients underwent surgical closure of a secundum atrial septal defect. Among the patients 118 were children (< 18 years; 79 girls and 39 boys) with a mean age of 8.9 +/- 5.2 years (4 months-17 years) and 114 adults (74 women and 40 men) with a mean age of 28.5 +/- 10.8 years (18-69 years). Pre-operatively eight children (6.8%) and eight adults (7%) were treated for right heart failure. Mean pulmonary artery pressure was 20.4 +/- 10.4 mmHg for the children and 19.3 +/- 7 mmHg for the adults. The average pulmonary artery to systemic flow ratios were 2.9:1 and 3:1 for children and adults, respectively. Thirty children (25.4%) and 15 adults (13.2%) underwent patch closure while direct suture was the method used for the remaining patients. Average cardiopulmonary bypass time was 35.7 +/- 17.9 min for the children and 41.5 +/- 19.9 min for the adults. The length of the procedure (skin to skin) was a mean of 116 min in the young group, and 141 min in the adult group.(ABSTRACT TRUNCATED AT 250 WORDS)

Peri-operative complications following surgical closure of atrial septal defect type II in 232 patients—a baseline study

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

F. Abbag

Author Tools

Chat about Author

Papers

Problems encountered during introduction of Gianturco coils for transcatheter occlusion of the patent arterial duct

Re-occlusion of residual leaks after transcatheter occlusion of patent ductus arteriosus.

Peri-operative complications following surgical closure of atrial septal defect type II in 232 patients—a baseline study