1/177. Percutaneous vesicolithotomy: an alternative to open bladder surgery in patients with an impassable or surgically ablated urethra.PURPOSE: Although vesical calculi are routinely treated transurethrally, open vesicolithotomy is generally performed in patients with an impassable or surgically ablated urethra. We describe a technique of percutaneous vesicolithotomy which we used in patients who had undergone urethral ablation and concomitant continent diversion by appendicovesicostomy. MATERIALS AND methods: Bladder stones were detected in 3 patients with neurogenic bladder who had undergone continent urinary diversion with bladder neck closure and appendicovesicostomy. To treat the stones access to the bladder was achieved percutaneously and the tract was enlarged using a balloon dilator. An Amplatz sheath was slipped over the inflated balloon and after the dilator was removed the sheath provided a working channel through which stones were fragmented and removed using a nephroscope. RESULTS: Each patient was rendered stone-free and discharged home the same day as the procedure. CONCLUSIONS: Percutaneous vesicolithotomy provides an alternative approach for bladder stone removal in patients with an impassable urethra with decreased morbidity compared to open procedures.- - - - - - - - - - ranking = 1keywords = ablation (Clic here for more details about this article) |
2/177. Radiofrequency ablation of an accessory pathway years after heart transplant: a case report.A patient who had an orthotopic heart transplantation performed 9 years previously presented with a history of tachycardia lasting for three hours. He had only 1 previous episode of sustained tachycardia 4 years previously. Electrophysiological study showed a left antero-lateral accessory pathway which was successfully ablated using radiofrequency energy. This report indicates that some pathways may remain dormant for a long time after heart transplantation.- - - - - - - - - - ranking = 4keywords = ablation (Clic here for more details about this article) |
3/177. DDD-pacing-induced cardiomyopathy following AV node ablation for persistent atrial tachycardia.Ventricular rate control by catheter ablation of the AV node and pacing in patients with persistent atrial tachycardia has been reported to improve left ventricular function. However, this approach requires careful selection of the pacing mode. We report a patient who underwent AV node ablation for persistent multiple atrial tachycardias, and who then had a non-mode-switching pacemaker implanted. Because of an inappropriately programmed relatively high upper rate limit, the patient developed left ventricular dysfunction after 6 years. This resolved after programming the pacemaker to VVI at 70 bpm.- - - - - - - - - - ranking = 6keywords = ablation (Clic here for more details about this article) |
4/177. The failing Fontan with atrial flutter: a successful surgical option.Two successful cases of eliminated atrial flutter and improved clinical status for Fontan patients are presented. An operation combining introduction of an extracardiac conduit for the Fontan connection, to direct all systemic venous blood away from the atrium, and atrial pathway division and cryoablation, is a useful surgical option for failing Fontan patients.- - - - - - - - - - ranking = 1keywords = ablation (Clic here for more details about this article) |
5/177. Oromandibular reconstruction using a third free flap in sequence in recurrent carcinoma.Successful results of a second microsurgical reconstructive attempt have been reported previously in recurrent oral carcinoma. However, the feasibility of a third free flap following a third excision has remained to be determined. Six oral carcinoma patients with multiple recurrences, surgical excisions and free flap reconstructions on three separate occasions are presented. Resections had a curative intent in all cases in the first and second ablations and in four of the six cases in the third one. Five radial forearm flaps and one double free flap were used for the first reconstruction. During the second reconstruction two radial forearm, two fibula osteoseptocutaneous, one double free flap and one rectus femoris flap were used to reconstruct the larger defects resulting from excision of the recurrent tumours. However, no vascularised bone transfers were performed following the third excision and soft tissue free flap plus plate option was used for segmental mandibular defects. There was one partial flap loss among 21 free flaps performed. Three patients died within an average of 8 months following the third reconstruction while the others remained alive, surviving an average of 6 months. In conclusion, a third free tissue transfer for reconstruction in multiply recurrent oral carcinoma was found to be feasible, safe and effective. The use of free flaps contributed to the prevention of complications in these difficult cases and enabled the patients to spend the remaining days of their lives outside hospital.- - - - - - - - - - ranking = 1keywords = ablation (Clic here for more details about this article) |
6/177. Basket catheter localization of the origin of atrial tachycardia with atypical morphology after atrial flutter ablation.Atrial activation from a site in the low lateral right atrium will typically proceed in a superior direction. We present a case of a low lateral right atrial tachycardia with a surface electrocardiographic P wave morphology that appeared to have an inferiorly directed axis. The tachycardia occurred 2 years after successful atrial flutter ablation. The use of a multipolar basket catheter allowed confirmation of the focal origin of the tachycardia, permitted its rapid localization, facilitated catheter ablation, and provided clues to atrial activation that helped describe the appearance of the P wave.- - - - - - - - - - ranking = 6keywords = ablation (Clic here for more details about this article) |
7/177. catheter ablation of atrioventricular junction via retrograde route in a patient with single ventricle.Radiofrequency catheter ablation of the atrioventricular junction (AVJ) was performed by the retrograde route in a 19-year-old woman with atrial fibrillation and single ventricle following the bidirectional Glenn procedure. Two energy applications resulted in complete atrioventricular block and dependence on an epicardial ventricular pacemaker.- - - - - - - - - - ranking = 5keywords = ablation (Clic here for more details about this article) |
8/177. Radiofrequency ablation of an accessory pathway in a surgically created atrioventricular Fontan anastomosis: case report and review of previous published cases.Supraventricular tachyarrhythmias following the fontan procedure can be life-threatening. Though most are commonly due to intraatrial reentry, orthodromic reentrant tachycardia may also be present. Atrioventricular accessory pathways may develop across suture lines following right atrial to right ventricular anastomosis in patients with tricuspid atresia. We report a case of a patient who underwent this type of Fontan who developed orthodromic reentrant tachycardia and heart failure. An electrophysiological study revealed the presence of an atrioventricular accessory pathway traversing the Fontan anastomosis suture line. Successful radiofrequency ablation of the accessory pathway led to control of the tachyarrhythmia and improvement of heart failure.- - - - - - - - - - ranking = 5keywords = ablation (Clic here for more details about this article) |
9/177. Pathological findings of the isthmus between the inferior vena cava and tricuspid annulus ablated by radiofrequency application.Anatomically guided radiofrequency ablation for the treatment of atrial flutter was performed in a 41-year-old man with interstitial pneumonia. He died of respiratory failure 2 months after ablation, and an autopsy was performed. The whole layer of the ablation site showed a transluminal fibrosis.- - - - - - - - - - ranking = 3keywords = ablation (Clic here for more details about this article) |
10/177. Pulmonary vein stenosis complicating catheter ablation of focal atrial fibrillation.INTRODUCTION: A recently described focal origin of atrial fibrillation, mainly inside pulmonary veins, is creating new perspectives for radiofrequency catheter ablation. However, pulmonary venous stenosis may occur with uncertain clinical consequences. This report describes a veno-occlusive syndrome secondary to left pulmonary vein stenosis after radiofrequency catheter ablation. methods AND RESULTS: A 36-year-old man who experienced daily episodes of atrial fibrillation that was refractory to antiarrhythmic medication, including amiodarone, was enrolled in our focal atrial fibrillation radiofrequency catheter ablation protocol. The left superior pulmonary vein was the earliest site mapped, and radiofrequency ablation was performed. atrial fibrillation was interrupted and sinus rhythm restored after one radiofrequency pulse inside the left superior pulmonary vein. atrial fibrillation recurred and a new procedure was performed in an attempt to isolate (26 radiofrequency pulses around the ostium) the left superior pulmonary vein. Ten days later, the patient developed chest pain and hemoptysis related to severe left superior and inferior pulmonary veins stenosis. Balloon angioplasty of both veins was followed by complete relief of symptoms after 2 months of recurrent pulmonary symptoms. The patient has been asymptomatic for 12 months, without antiarrhythmic drugs. CONCLUSION: Multiple radiofrequency pulses applied inside the pulmonary veins ostia can induce severe pulmonary venous stenosis and veno-occlusive pulmonary syndrome.- - - - - - - - - - ranking = 8keywords = ablation (Clic here for more details about this article) |
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