Biomedical subjects

T P Lê

Publications and source records attributed to T P Lê.

7 recordsLinked to original sources

PubMed2005

Late coil displacement after interventional closure of a perimembranous ventricular septal defect: a case report.

Muscular and perimembranous ventricular septal defects can be closed with nitinol plugs or spiral coils. Displacement and embolization of the device are well known complications that usually occur during or early after the procedure. We present the case of a 12-year-old boy with asymptomatic coil displacement detected at a routine examination 5 months after closure of a perimembranous ventricular septal defect.

Cardiac Catheterization↗

PubMed2004

[Transcatheter closure of congenital ventricular septal defects].

We report on the transcatheter closure of ventricular septal defects (VSD) in 26 patients with Amplatzer Occluders and Nit- Occlud Coil Systems. Twenty-one patients had a perimembranous and 5 patients a muscular VSD. Patients' age range was 5 months to 59 years (median 8 years) and their body weight 4.5 kg to 167 kg (median 28 kg). Defect diameters were 3-11 mm (median 5 mm). Sixteen patients had left ventricular volume overload and 7 patients pulmonary hypertension (median 50% of systemic pressure). Seven patients suffered from trivial or mild aortic regurgitation. Twenty-eight devices (4-12 mm; median 8 mm) were implanted (16 Amplatzer, 12 Nit-Occlud) through sheaths of 4F to 9F (median 7F). Fluoroscopy times were 8.3- 56.5 min (median 26.2 min). One coil was surgically explanted directly after intervention. One patient needed pulmonary banding due to additional VSDs. After a follow-up of 7 months (1-12 months), 2 patients had a small and 9 a minimal residual shunt. Thirteen defects were completely closed. Transcatheter closure of VSDs with new devices seems to be a promising therapy for suitable defects in different hemodynamic conditions in patients of every age.

Adolescent↗

PubMed2001

Echocardiography before, during, and after interventions.

Before intervention, a detailed echocardiographic examination is mandatory for the decision whether this procedure will be necessary, possible, and safe. During intervention, transesophageal echocardiography (TEE) is needed for the continuous monitoring of the procedure, immediate assessment of results, and complications. TEE results in a significant reduction of fluoroscopy time. After intervention, echocardiography provides information on long-term results and newly developed complications.

Echocardiography↗

PubMed1998

Transvasal closure of interatrial defects using the Babic double-umbrella occluder system.

The purpose of the study was to assess the feasibility and safety of closure of atrial septal defects and patent foramen ovale by means of a new interventional technique. Transvasal closure of ostium secundum atrial septal defect and patent foramen ovale was performed in 18 patients using an occluder system for atrial septal defects. Two patients had undergone unsuccessful direct surgical closure years before. Implantation and follow-up were controlled using radiographic views both with and without contrast injection, transthoracic and multiplane transesophageal echocardiographic imaging, color Doppler sonography, and computed tomography. The defect was closed in 16 patients using 19 procedures. Removal of the devices through the sheath was indicated in 4 patients because of placement failure. Intraprocedural complications were ventricular fibrillation in one patient and fixation of the device in Chiari's network in an additional one. During 7-26 months follow-up occluder damage was seen in two patients and perforation of the left atrium in one patient. Thickening on the occluder surface was observed in two patients. There was no death. The system for closure of atrial septal defect is feasible and safe in patients with defects < or = 27 mm in diameter. Long-term observation of outcome is limited yet.

Adult↗

PubMed1997

Color Doppler echocardiographic evaluation of tricuspid regurgitation and systolic pulmonary artery pressure in the full-term and preterm newborn.

Color Doppler echocardiography of tricuspid valve regurgitation (TR) is a valid, noninvasive method of determining systolic pulmonary artery pressure (SPAP). In a prospective study the authors examined 56 healthy full-term newborns (group I), 36 healthy preterm newborns (group II), and 10 preterm newborns with severe respiratory distress syndrome requiring surfactant replacement therapy (group III). Doppler studies were repeated until the transtricuspid gradient was < 20 mm Hg. In 83.3% of children a reproducible spectral curve was recorded at least once. The authors estimated the transtricuspid gradient delta p (RV-RA) by using the modified Bernoulli equation. Within the first twenty-four hours delta p (RV-RA) was < 20 mm Hg in 72.7%, 50%, and 25% of children with measurable TR in groups I, II, and III, respectively, increasing to 91.1%, 78.6%, and 55.6% within forty-eight hours. There was no significant correlation between SPAP and gestational age, birth weight, mode of delivery, and ductal closing time. Continuous holosystolic envelope tracing of TR was recorded in 16.6%. In these patients delta p (RV-RA) was measured markedly higher (mean of 30.1 mm Hg) than in the others (mean 17.3 mm Hg). The authors conclude that there is a high prevalence of TR in neonates, which allows estimation of SPAP in > 80% of newborns without considerable impairment. Normalization of SPAP takes place within four days in most patients, but there is a delay in preterm infants with severe respiratory distress syndrome.

Blood Pressure↗

PubMed1986

[Diagnosis of congenital heart defects using color-coded Doppler echocardiography].

Color Doppler echocardiography (CDE) enables visualization of blood flow and of cardiac morphology within color coded two-dimensional images. The diagnostic usefulness of this method in pediatric cardiology has been analyzed based on studies performed in 2414 children. Normal cardiac findings were seen in 769 patients according to the clinical and echocardiographic examinations. Normal diastolic inflow into the ventricles in the apical four-chamber-view is characterized by a similar distribution of the color spectrum across the inflow tracts, blood flowing on the two sides of the heart is completely separated from each other. Normal systolic outflow imaged from parasternal position shows an increase in velocity in the outflow tract passing through the semilunar valves without any change in flow patterns. Heart disease was present in 1645 patients, simple cardiac defects were found in 1473 cases and complex heart disease in 172 cases. Shunt lesions are detectable by the demonstration of blood flow in regions where normally no flow is detectable, flow velocities being pathologically increased in many cases. Diagnostic sensitivity and specificity of CDE as compared to invasive procedures is between 96 and 98%. In left-to-right shunting the shunt flow can be followed into the right-sided cardiovascular regions where its extent is a measure for the size of the shunt as indicated by initial results. In ventricular septal defects, bidirectional shunting is indicative of a rise in pressure in the right ventricle and can be reliably detected with the use of CDE. In valvular stenoses high flow velocities are found in the appropriate time which are associated with turbulence and poststenotic eddies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

[Schizencephaly].

Schizencephaly is a developmental disorder of the human brain caused by a defect of neuronal migration. We observed a 7 month old african boy suffering from nystagmus and hemiparesis. The neuroimaging reveals a large cleft in cortical and subcortical structures and typical changes of polymicrogyria. In the differential-diagnosis encephaloclastic porencephaly should be considered.

Agenesis of Corpus Callosum↗