[New methods in the therapy of chronic heart failure. Is the positive inotropic action of L-dopa currently useful?].
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Biomedical subjects
Publications and source records attributed to H Sievert.
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In a 25-year-old female patient with pulmonary valve stenosis valvuloplasty could be successfully performed using a balloon catheter inserted via the femoral vein. Balloon measurements were 2 cm width and 3 cm length, the required pressure was 5 atm. There was a decrease of the pressure gradient form 60 to 25 mm Hg, systolic right ventricular pressure decreased from 88 to 50 mm Hg. Besides transluminal angioplasty of coronary stenoses and non-surgical occlusion of patent ductus arteriosus thus a further catheter technique for treatment of organic heart disease has become available, being able to replace surgery.
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Transcatheter closure of atrial septal defects (ASDs) has become a routine procedure in many countries of the world. It spares many patients cardiac surgery and has proven efficacy in long-term studies. Device improvements have resulted in a continuous reduction of complications and of residual shunt frequency. ASD closure devices are also used for transcatheter closure of patent foramen ovale (PFO) for prevention of paradoxical embolism. In the past few years, there has been increasing interest in developing devices specifically designed for PFO closure. Although transcatheter closure of ASDs is well established, interventional closure of the left atrial appendage is in its development stage. Closure of the left atrial appendage is designed to reduce the risk of stroke in patients with atrial fibrillation in whom anticoagulation with Warfarin-type drugs is contraindicated. This article describes the latest developments in catheter closure of PFO and the left atrial appendage.