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Transcatheter biopsy for intracardiac masses
Introduction Intracardiac masses (ICMs) are rare entities in clinical practice. The differential diagnosis is wide, including pathologies such as infective, thrombotic, neoplastic, autoimmune, iatrogenic, or hamartomatous lesions. Unless clearly associated with a specific clinical scenario, such as valvar vegetations in…
Pulmonary balloon angioplasty for chronic thromboembolic pulmonary hypertension
Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary vascular disease that results from fibrotic transformation of thromboemboli causing obstruction in the pulmonary vasculature. If left untreated, pulmonary artery pressure worsens, affecting right ventricular function and causing significant morbidity and mortality,…
Pseudoaneurysm diagnosis and management
Introduction Cardiac pseudoaneurysms are an uncommon occurrence; however, they are associated with significant risk of complications. , A pseudoaneurysm is a contained rupture of the arterial vessel or myocardial wall. A single layer of pericardium or adhesions lines the sac,…
Pulmonary valve interventions: Valvuloplasty and transcatheter pulmonary valve replacement
Pulmonary valvuloplasty Background Pulmonary valve stenosis (PS) is a common form of congenital heart disease that may present at any age, but often in infancy or early childhood in its more severe forms. The adult patient with PS tends to…
Closure of abnormal coronary communications: Coronary, fistulae, congenital, and iatrogenic
Introduction Congenital fistulae cover a wide spectrum of vascular disorders including a variety of arteriovenous (AV) malformations, but also can include venovenous communications. Structural and congenital cardiology interventionalists most often may be asked to evaluated those fistulae involving the heart,…
Coarctation and PDA closure
Coarctation of the aorta can most simply be characterized as a discrete stenosis of the upper descending thoracic aorta. Since in many cases coarctation occurs at or near the origin of the ductus arteriosus, these can be described as juxtaductal…
Novel percutaneous tricuspid repair techniques
Introduction The tricuspid valve apparatus is a complex and dynamic structure that interacts intricately with surrounding anatomy. The vast majority of patients with tricuspid valve disease have tricuspid valve regurgitation (TR), whereas a minority present with tricuspid stenosis (TS). TR…
Tricuspid valve-in-valve/valve-in-ring therapy
Background Transcatheter valve replacement is becoming an increasingly favored option to treat a failing tricuspid bioprosthetic valve (BPV). As clinical experience grows and valve technology expands, the option of implanting a new tricuspid valve in the cardiac catheterization laboratory is…
Pulmonary vein stenosis: Management and outcomes
Introduction Pulmonary vein stenosis (PVS) is a relatively infrequent yet detrimental complication of atrial fibrillation (AF) ablation thought to be related to intimal thermal or barotrauma of the pulmonary veins (PV). Early AF ablative techniques focusing specifically on the PV…