CLINICAL SCIENCE
Percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder
Er-Ping XiI, Jian ZhuI,II,
, Shui-Bo ZhuI,II, Gui-Lin YinI, Yong LiuI, Yong-Qiang DongI, Yu ZhangI, Feng XiaIII
Corresponding author
I Wuhan General Hospital of Guangzhou Command, Department of Thoracic Cardiovascular Surgery, Wuhan, People's Republic of China.
II Southern Medical University, Guangzhou, People's Republic of China.
III Liaocheng People's Hospital, Liaocheng, Department of Cardiovascular Surgery, People's Republic of China.
Read
750
Timeswas read the article
289
Total PDF
461
Total HTML
Share statistics
array:25 [ "pii" => "S1807593222021974" "issn" => "18075932" "doi" => "10.6061/clinics/2012(11)10" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "2197" "copyright" => "CLINICS" "copyrightAnyo" => "2012" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "fla" "cita" => "Clinics. 2012;67:1281-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S1807593222021986" "issn" => "18075932" "doi" => "10.6061/clinics/2012(11)11" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "2198" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "fla" "cita" => "Clinics. 2012;67:1285-90" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">CLINICAL SCIENCE</span>" "titulo" => "<span class="elsevierStyleItalic">PIK3CA</span> exon 20 mutations are associated with poor prognosis in breast cancer patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1285" "paginaFinal" => "1290" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "cln-67-11-1285-g002.jpeg" "Alto" => 795 "Ancho" => 751 "Tamanyo" => 48554 ] ] "descripcion" => array:1 [ "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Kaplan-Meier curves showing long-term survival in primary breast cancer patients, stratified according to <span class="elsevierStyleItalic">PIK3CA</span> mutation status. (A) Overall survival and (B) disease-free survival curves were calculated for the stratified patient groups. 'No’ indicates patients with tumors with no <span class="elsevierStyleItalic">PIK3CA</span> mutations; 'PIK9’ indicates patients with tumors with <span class="elsevierStyleItalic">PIK3CA</span> mutations in exon 9; and 'PIK20’ indicates patients with tumors with <span class="elsevierStyleItalic">PIK3CA</span> mutations in exon 20. (C) Overall survival and (D) disease-free survival curves were calculated for the stratified patient groups. 'No’ indicates patients with tumors with no <span class="elsevierStyleItalic">PIK3CA</span> mutations in exon 20, and 'Yes’ indicates patients with tumors with <span class="elsevierStyleItalic">PIK3CA</span> mutations in exon 20. <span class="elsevierStyleItalic">p</span>-values were calculated using the log-rank test.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Flavia R. Mangone, Irina G. Bobrovnitchaia, Sibeli Salaorni, Erika Manuli, Maria A. Nagai" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Flavia R." "apellidos" => "Mangone" ] 1 => array:2 [ "nombre" => "Irina G." "apellidos" => "Bobrovnitchaia" ] 2 => array:2 [ "nombre" => "Sibeli" "apellidos" => "Salaorni" ] 3 => array:2 [ "nombre" => "Erika" "apellidos" => "Manuli" ] 4 => array:2 [ "nombre" => "Maria A." "apellidos" => "Nagai" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222021986?idApp=UINPBA00004N" "url" => "/18075932/0000006700000011/v1_202212011245/S1807593222021986/v1_202212011245/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1807593222021962" "issn" => "18075932" "doi" => "10.6061/clinics/2012(11)09" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "2196" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "fla" "cita" => "Clinics. 2012;67:1275-80" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">CLINICAL SCIENCE</span>" "titulo" => "Increased IgE serum levels are unrelated to allergic and parasitic diseases in patients with juvenile systemic lupus erythematosus" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1275" "paginaFinal" => "1280" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "cln-67-11-1275-g001.jpeg" "Alto" => 496 "Ancho" => 759 "Tamanyo" => 26203 ] ] "descripcion" => array:1 [ "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">IgE serum concentrations in 69 patients with juvenile systemic lupus erythematosus. Individual values were plotted in the graph with normal values for IgE obtained from a standard curve previous established<span class="elsevierStyleSup">21</span>. White circles represent patients WITH atopic manifestations, while black circles represent patients WITHOUT atopic manifestations.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Bernadete L. Liphaus, Adriana A. Jesus, Clovis A. Silva, Antonio Coutinho, Magda Carneiro-Sampaio" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Bernadete L." "apellidos" => "Liphaus" ] 1 => array:2 [ "nombre" => "Adriana A." "apellidos" => "Jesus" ] 2 => array:2 [ "nombre" => "Clovis A." "apellidos" => "Silva" ] 3 => array:2 [ "nombre" => "Antonio" "apellidos" => "Coutinho" ] 4 => array:2 [ "nombre" => "Magda" "apellidos" => "Carneiro-Sampaio" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222021962?idApp=UINPBA00004N" "url" => "/18075932/0000006700000011/v1_202212011245/S1807593222021962/v1_202212011245/en/main.assets" ] "asociados" => array:1 [ 0 => array:19 [ "pii" => "S1807593222020890" "issn" => "18075932" "doi" => "10.6061/clinics/2013(03)ER01" "estado" => "S300" "fechaPublicacion" => "2013-01-01" "aid" => "2089" "copyright" => "CLINICS" "documento" => "simple-article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "err" "cita" => "Clinics. 2013;68:435" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:8 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ERRATA</span>" "titulo" => "ERRATA" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "435" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222020890?idApp=UINPBA00004N" "url" => "/18075932/0000006800000003/v1_202212011730/S1807593222020890/v1_202212011730/en/main.assets" ] ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">CLINICAL SCIENCE</span>" "titulo" => "Percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1281" "paginaFinal" => "1283" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Er-Ping Xi, Jian Zhu, Shui-Bo Zhu, Gui-Lin Yin, Yong Liu, Yong-Qiang Dong, Yu Zhang, Feng Xia" "autores" => array:8 [ 0 => array:3 [ "nombre" => "Er-Ping" "apellidos" => "Xi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] ] ] 1 => array:4 [ "nombre" => "Jian" "apellidos" => "Zhu" "email" => array:1 [ 0 => "zhudandan2008@163.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">II</span>" "identificador" => "aff2" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 2 => array:3 [ "nombre" => "Shui-Bo" "apellidos" => "Zhu" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">II</span>" "identificador" => "aff2" ] ] ] 3 => array:3 [ "nombre" => "Gui-Lin" "apellidos" => "Yin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "Yong" "apellidos" => "Liu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] ] ] 5 => array:3 [ "nombre" => "Yong-Qiang" "apellidos" => "Dong" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] ] ] 6 => array:3 [ "nombre" => "Yu" "apellidos" => "Zhang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] ] ] 7 => array:3 [ "nombre" => "Feng" "apellidos" => "Xia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">III</span>" "identificador" => "aff3" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Wuhan General Hospital of Guangzhou Command, Department of Thoracic Cardiovascular Surgery, Wuhan, People's Republic of China." "etiqueta" => "I" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Southern Medical University, Guangzhou, People's Republic of China." "etiqueta" => "II" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Liaocheng People's Hospital, Liaocheng, Department of Cardiovascular Surgery, People's Republic of China." "etiqueta" => "III" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Tel.: 86-13871161122" ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "cln-67-11-1281-g001.jpeg" "Alto" => 403 "Ancho" => 742 "Tamanyo" => 37436 ] ] "descripcion" => array:1 [ "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">A) Picture of the PDA Occluder. B) After initial surgical repair, the transthoracic echocardiography image revealed an angulated defect. C) The angiogram image indicated that the PDA Occluder was well mounted. D) Follow-up postoperative echocardiography showed complete closure of the defects with no residual left-to-right shunt. E) Follow-up postoperative 320-slice computerized tomography showed the Occluder was well placed and had normal morphology.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle60">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">Post-traumatic ventricular septal defect (VSD) is an uncommon, if not rare, sequel of penetrating or blunt trauma, post-surgical contusion, and myocardial infarction (<a class="elsevierStyleCrossRef" href="#bib1">1</a>). Open-heart surgery has been the standard method of treatment (<a class="elsevierStyleCrossRef" href="#bib2">2</a>), but percutaneous closure has emerged as a new technique to address this important and challenging surgical problem. In this procedure, an Amplatzer VSD Occluder has usually been employed (<a class="elsevierStyleCrossRef" href="#bib3">3</a>), or occasionally, an Atrial Septal Defect (ASD) Occluder has been used (<a class="elsevierStyleCrossRef" href="#bib4">4</a>). We present our experience with percutaneous closure of post-traumatic VSDs utilizing a PDA Occluder (Lifetech Scientific (Shenzhen) Co., LTD, Guangdong, China). The PDA Occluder is shown in <a class="elsevierStyleCrossRef" href="#fig1">Figure 1A</a>.</p><elsevierMultimedia ident="fig1"></elsevierMultimedia></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">MATERIALS AND METHODS</span><p id="para20" class="elsevierStylePara elsevierViewall">Three previously healthy patients who were stabbed in the left anterior chest presented with knives lodged in the fourth left intercostal space that moved synchronously with the heartbeat. The patients were awake but restless and in severe pain, with cardiac tamponade, dyspnea, hypotension, and elevated central venous pressure. The results of patients' physical examinations are described in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>. The knives were surgically removed, and perforations of the right ventricle were repaired with pledgeted-reinforced mattress sutures. On the second post-operative day, a loud holosystolic murmur was detected in all three of the patients. Transthoracic echocardiography revealed a large VSD in the muscular septum of each patient, and their pulmonary/systemic flow ratios (Qp/Qs) were over 1.7. Pulmonary arterial pressure was mildly elevated. The transthoracic echocardiography data are listed in <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a> and one patient’s echocardiography image is shown in <a class="elsevierStyleCrossRef" href="#fig1">Figure 1B</a>.</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="tbl2"></elsevierMultimedia><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">Percutaneous closure</span><p id="para30" class="elsevierStylePara elsevierViewall">Cardiac catheterization with a femoral approach was performed using local anesthesia. A pigtail catheter was introduced into the left ventricle. A left ventricular angiogram disclosed a significant left-to-right shunt across a large defect in the muscular ventricular septum. The pigtail was withdrawn, and a multi-purpose catheter was guided from the left ventricle into the right ventricle and advanced through the VSD into the pulmonary artery. A second catheter was introduced into the femoral vein and advanced into the pulmonary artery. The defect in the first patient was closed with a Muscular VSD Occluder. The device became trapped during placement of the occluder because the right plate had an inappropriate configuration. The device was retrieved.</p><p id="para40" class="elsevierStylePara elsevierViewall">A PDA Occluder was selected to close the defect. The device's size was similar to that of the VSD or ASD Occluder, judged by the maximum diameter viewed by echocardiography and angiography. The delivery sheath was introduced into the left ventricle and ascending aorta in a loop. The PDA Occluder was then mounted and inserted into the delivery sheath (<a class="elsevierStyleCrossRef" href="#fig1">Figure 1C</a>). After release of the device, left ventriculography revealed no left-to-right shunt. In the following two patients, the PDA Occluder was our primary choice.</p></span></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">RESULTS</span><p id="para50" class="elsevierStylePara elsevierViewall">The transthoracic echocardiogram revealed that the device was in place with no left-to-right shunt. Ventricular size and function were normal. Pulmonary arterial pressure was normal (<a class="elsevierStyleCrossRef" href="#fig1">Figure 1D</a>). In addition, 320-slice computerized tomography showed that the Occluder was well placed and had normal morphology (<a class="elsevierStyleCrossRef" href="#fig1">Figure 1E</a>).</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">DISCUSSION</span><p id="para60" class="elsevierStylePara elsevierViewall">Penetrating cardiac injuries are among the most common causes of violent death (<a class="elsevierStyleCrossRef" href="#bib5">5</a>). Cardiac injury occurs in approximately 20-30% of cases of major chest trauma (<a class="elsevierStyleCrossRef" href="#bib6">6</a>). In the majority of cases, the injuries are fatal. Approximately 20% of patients are alive when they arrive in the hospital, and up to 70% of these patients survive to hospital discharge (<a class="elsevierStyleCrossRef" href="#bib7">7</a>). Survival depends upon rapid diagnosis and immediate treatment.</p><p id="para70" class="elsevierStylePara elsevierViewall">A VSD due to penetrating cardiac injury can occur directly, due to perforation of the septum, or indirectly, following injury of an epicardial coronary artery with necrosis and subsequent rupture. VSD is the most common complication of penetrating heart injuries. There are reports of delayed VSD presentation in which initial echocardiography was normal, but subsequent echocardiograms revealed a defect (<a class="elsevierStyleCrossRef" href="#bib8">8</a>). The most common location of a post-traumatic VSD is at the apex (<a class="elsevierStyleCrossRef" href="#bib9">9</a>). Surgical repair of a traumatic VSD can incur significant morbidity and mortality (<a class="elsevierStyleCrossRef" href="#bib10">10</a>).</p><p id="para80" class="elsevierStylePara elsevierViewall">Surgical repair may not be feasible immediately after injury because of the patient's poor clinical condition. In addition, an increase in the defect's size can result from progressive tissue necrosis due to injury of the septal coronary arteries after perforation of the interventricular septum. Delay allows time for the development of fibrotic scarring on the rims of the defect, facilitating delineation on transthoracic echocardiography, which is important for optimal device selection and fixation (<a class="elsevierStyleCrossRef" href="#bib2">2</a>).</p><p id="para90" class="elsevierStylePara elsevierViewall">Percutaneous closure has been successful in children with congenital VSD, approximately 90% of which are in the perimembranous septum (<a class="elsevierStyleCrossRef" href="#bib11">11</a>). In most studies, the Amplatzer Muscular VSD Occluder and ASD Occluder were employed. Complete closure using the Amplatzer Muscular VSD Occluder or ASD Occluder is achieved in 92% of patients with a perimembranous VSD and in 95% of patients with a muscular VSD (<a class="elsevierStyleCrossRef" href="#bib11">11</a>).</p><p id="para100" class="elsevierStylePara elsevierViewall">In a previous report, an Amplatzer device was successfully implanted in 16 of 18 patients with a post-infarction VSD; however, the 30-day-mortality was as high as 28% (<a class="elsevierStyleCrossRef" href="#bib12">12</a>). In a group of mixed cases, successful VSD closure was reported in 30 of 32 patients (<a class="elsevierStyleCrossRef" href="#bib13">13</a>). Prior our experience, only sporadic cases of successful percutaneous closure of traumatic VSD had been reported (<a class="elsevierStyleCrossRef" href="#bib3">3</a>),(<a class="elsevierStyleCrossRef" href="#bib9">9</a>). For repair of post-traumatic VSDs, an Amplatzer Muscular VSD Occluder (<a class="elsevierStyleCrossRef" href="#bib3">3</a>) or an ASD Occluder is usually chosen (<a class="elsevierStyleCrossRef" href="#bib4">4</a>). The use of a PDA Occluder in this type of procedure has not been previously reported. We successfully repaired three post-traumatic VSDs with percutaneous with PDA occluders. A Muscular VSD Occluder initially employed in the first patient failed for two reasons. The post-traumatic VSD is almost angulated (<a class="elsevierStyleCrossRef" href="#fig1">Figure 1B</a>), but the congenital VSD or ASD is straight. The Amplatzer Muscular VSD Occluder or ASD Occluder is designed for congenital heart disease, so the length was insufficient (the perforations in our three patients were more than 9 mm long, while the metal waist length of the Amplatzer Muscular VSD Occluder implant is only 4 mm). The Amplatzer Muscular VSD Occluder and ASD Occluder, which have two discs, are difficult to release in an angulated pathway. However, the PDA Occluder has only one disc. The higher blood pressure in the left ventricle serves the PDA Occluder's left disc; thus, it is safe. During the follow-up periods of the three patients (the longest for five years), the PDA Occluders remained securely implanted in each case.</p><p id="para110" class="elsevierStylePara elsevierViewall">Use of the PDA Occluder in a VSD closure has several advantages in comparison to the Amplatzer Muscular VSD Occluder or the ASD Occluder. The PDA Occluder cannot cause ventricular outflow tract obstruction because it only has a left disc. In addition, the metal waist of a PDA Occluder is both more flexible and softer than other Occluder implants, so it is more easily released and molded. The implant moves synchronously with the heartbeat. Fatigue damage of the metal material (<a class="elsevierStyleCrossRef" href="#bib14">14</a>) occurs under the action of the dynamic load, and the implant's main cause of failure is fatigue rupture. The fatigue life of the PDA Occluder is increased in comparison to the other implant types.</p><p id="para120" class="elsevierStylePara elsevierViewall">Our experiences indicate that percutaneous closure of a post-traumatic VSD using a PDA Occluder device is feasible, safe and effective. However, more experience is warranted before recommending widespread use of the PDA Occluder in this procedure.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:2 [ "identificador" => "xpalclavsec1582079" "titulo" => "KEYWORDS" ] 1 => array:2 [ "identificador" => "cesec10" "titulo" => "INTRODUCTION" ] 2 => array:3 [ "identificador" => "cesec20" "titulo" => "MATERIALS AND METHODS" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "cesec30" "titulo" => "Percutaneous closure" ] ] ] 3 => array:2 [ "identificador" => "cesec40" "titulo" => "RESULTS" ] 4 => array:2 [ "identificador" => "cesec50" "titulo" => "DISCUSSION" ] 5 => array:2 [ "identificador" => "xack639150" "titulo" => "ACKNOWLEDGMENTS" ] 6 => array:1 [ "titulo" => "REFERENCES" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-06-14" "fechaAceptado" => "2012-07-23" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "KEYWORDS" "identificador" => "xpalclavsec1582079" "palabras" => array:4 [ 0 => "Post-Traumatic Ventricular Septal Defect" 1 => "Cardiac Injury" 2 => "Percutaneous Closure" 3 => "Patent Ductus Arteriosus Occlude" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">OBJECTIVE:</span><p id="spara40" class="elsevierStyleSimplePara elsevierViewall">Ventricular septal defects resulting from post-traumatic cardiac injury are very rare. Percutaneous closure has emerged as a method for treating this disorder. We wish to report our experience in three patients who underwent percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder.</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">METHODS:</span><p id="spara50" class="elsevierStyleSimplePara elsevierViewall">We treated three patients with post-traumatic ventricular septal defects caused by stab wounds with knives. After the heart wound was repaired, patient examinations revealed ventricular septal defects with pulmonary/systemic flow ratios (Qp/Qs) of over 1.7. The post-traumatic ventricular septal defects were closed percutaneously with a patent ductus arteriosus occluder (Lifetech Scientific (Shenzhen) Co., LTD, Guangdong, China) utilizing standard techniques.</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">RESULTS:</span><p id="spara60" class="elsevierStyleSimplePara elsevierViewall">Post-operative transthoracic echocardiography revealed no residual left-to-right shunt and indicated normal ventricular function. In addition, 320-slice computerized tomography showed that the occluder was well placed and exhibited normal morphology.</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">CONCLUSION:</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">Our experiences indicate that closure of a post-traumatic ventricular septal defect using a patent ductus arteriosus occluder is feasible, safe, and effective.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "OBJECTIVE:" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "METHODS:" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "RESULTS:" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "CONCLUSION:" ] ] ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">No potential conflict of interest was reported.</p> <p class="elsevierStyleNotepara" id="cenpara20">Zhu J, Zhang Y and Xia F contributed to the written paper. Xi EP, Zhu SB, Yin GL, Liu Y and Dong YQ contributed to patient treatment. Zhu SB conceived the study. Xi EP is the first surgical doctor for these patients. Zhu J was responsible for the manuscript first draft.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "cln-67-11-1281-g001.jpeg" "Alto" => 403 "Ancho" => 742 "Tamanyo" => 37436 ] ] "descripcion" => array:1 [ "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">A) Picture of the PDA Occluder. B) After initial surgical repair, the transthoracic echocardiography image revealed an angulated defect. C) The angiogram image indicated that the PDA Occluder was well mounted. D) Follow-up postoperative echocardiography showed complete closure of the defects with no residual left-to-right shunt. E) Follow-up postoperative 320-slice computerized tomography showed the Occluder was well placed and had normal morphology.</p>" ] ] 1 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Patient \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">2 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">3 \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Blood pressure (systolic/diastolic; mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70/30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82/54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68/45 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Heart rate (beats/minute) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">132 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">118 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">129 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Respiratory rate (breaths/minute) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Oxygen saturation (%) on room air \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">83 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Clinical data collected on the day of injury.</p>" ] ] 2 => array:7 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Patient \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">2 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">3</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">VSD position \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">muscular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">muscular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">muscular</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">VSD size (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Qp/Qs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">1.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">1.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">2.0</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Data from transthoracic echocardiography following initial surgical repair of the VSD.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Traumatic ventricular septal defect: case report and review of the English literature since 1970" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ MD Rollins \n \t\t\t\t\t\t\t\t """ 1 => """ RP Koehler \n \t\t\t\t\t\t\t\t """ 2 => """ MH Stevens \n \t\t\t\t\t\t\t\t """ 3 => """ KJ Walsh \n \t\t\t\t\t\t\t\t """ 4 => """ DB Doty \n \t\t\t\t\t\t\t\t """ 5 => """ RS Price \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Trauma" "fecha" => "2005" "volumen" => "58" "numero" => "1" "paginaInicial" => "80" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Percutaneous closure of postoperative and post-traumatic ventricular septal defects" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ CA Pedra \n \t\t\t\t\t\t\t\t """ 1 => """ SC Pontes Jr \n \t\t\t\t\t\t\t\t """ 2 => """ SR Pedra \n \t\t\t\t\t\t\t\t """ 3 => """ L Salerno \n \t\t\t\t\t\t\t\t """ 4 => """ JB Sousa \n \t\t\t\t\t\t\t\t """ 5 => """ MA Miaira \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Invasive Cardiol" "fecha" => "2007" "volumen" => "19" "numero" => "11" "paginaInicial" => "5" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[Multicentre study of percutaneous closure of interventricular muscular defects with the aid of an Amplatzer duct occluder prosthesis]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ A Fraisse \n \t\t\t\t\t\t\t\t """ 1 => """ G Agnoletti \n \t\t\t\t\t\t\t\t """ 2 => """ P Bonhoeffer \n \t\t\t\t\t\t\t\t """ 3 => """ Y Aggoun \n \t\t\t\t\t\t\t\t """ 4 => """ A Benkhalifa \n \t\t\t\t\t\t\t\t """ 5 => """ JF Piechaud \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Mal Coeur Vaiss" "fecha" => "2004" "volumen" => "97" "numero" => "5" "paginaInicial" => "8" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transcatheter closure of a traumatic VSD in an adult requiring an ASD occluder device" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ WM Suh \n \t\t\t\t\t\t\t\t """ 1 => """ MJ Kern \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Catheter Cardiovasc Interv" "fecha" => "2009" "volumen" => "74" "numero" => "7" "paginaInicial" => "5" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Penetrating cardiac injuries: a prospective study of variables predicting outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ JA Asensio \n \t\t\t\t\t\t\t\t """ 1 => """ J Murray \n \t\t\t\t\t\t\t\t """ 2 => """ D Demetriades \n \t\t\t\t\t\t\t\t """ 3 => """ J Berne \n \t\t\t\t\t\t\t\t """ 4 => """ E Cornwell \n \t\t\t\t\t\t\t\t """ 5 => """ G Velmahos \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Coll Surg" "fecha" => "1998" "volumen" => "186" "numero" => "1" "paginaInicial" => "34" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[A rare case of a post-traumatic intraventricular defect]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ G Argento \n \t\t\t\t\t\t\t\t """ 1 => """ R Fiorilli \n \t\t\t\t\t\t\t\t """ 2 => """ G Del Prete \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ital Heart J Suppl" "fecha" => "2002" "volumen" => "3" "numero" => "3" "paginaInicial" => "4" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Demography of penetrating cardiac trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ MJ Naughton \n \t\t\t\t\t\t\t\t """ 1 => """ RM Brissie \n \t\t\t\t\t\t\t\t """ 2 => """ PQ Bessey \n \t\t\t\t\t\t\t\t """ 3 => """ MM McEachern \n \t\t\t\t\t\t\t\t """ 4 => """ JM Donald Jr \n \t\t\t\t\t\t\t\t """ 5 => """ HL Laws \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00000658-198901000-00012" "Revista" => array:7 [ "tituloSerie" => "Ann Surg" "fecha" => "1989" "volumen" => "209" "numero" => "6" "paginaInicial" => "81" "paginaFinal" => "83" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2910217" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delayed presentation of traumatic ventricular septal defect and mitral leaflet perforation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ JA Vecht \n \t\t\t\t\t\t\t\t """ 1 => """ MF Ibrahim \n \t\t\t\t\t\t\t\t """ 2 => """ AO Chukwuemeka \n \t\t\t\t\t\t\t\t """ 3 => """ PR James \n \t\t\t\t\t\t\t\t """ 4 => """ GE Venn \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/emj.2004.021212" "Revista" => array:6 [ "tituloSerie" => "Emerg Med J" "fecha" => "2005" "volumen" => "22" "numero" => "7" "paginaInicial" => "2" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15611530" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transcatheter closure of a posttraumatic ventricular septal defect with an Amplatzer Occluder Device" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ G Bauriedel \n \t\t\t\t\t\t\t\t """ 1 => """ DA Redel \n \t\t\t\t\t\t\t\t """ 2 => """ C Schmitz \n \t\t\t\t\t\t\t\t """ 3 => """ A Welz \n \t\t\t\t\t\t\t\t """ 4 => """ HH Schild \n \t\t\t\t\t\t\t\t """ 5 => """ B Lüderitz \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ccd.1122" "Revista" => array:6 [ "tituloSerie" => "Catheter Cardiovasc Interv" "fecha" => "2001" "volumen" => "53" "numero" => "4" "paginaInicial" => "12" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11329211" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transcatheter treatment of a large traumatic ventricular septal defect" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ CG Cowley \n \t\t\t\t\t\t\t\t """ 1 => """ RE Shaddy \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Catheter Cardiovasc Interv" "fecha" => "2004" "volumen" => "61" "numero" => "1" "paginaInicial" => "6" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Catheter closure of congenital/acquired muscular VSDs and perimembranous VSDs using the Amplatzer devices" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ BD Thanopoulos \n \t\t\t\t\t\t\t\t """ 1 => """ E Karanassios \n \t\t\t\t\t\t\t\t """ 2 => """ G Tsaousis \n \t\t\t\t\t\t\t\t """ 3 => """ GS Papadopoulos \n \t\t\t\t\t\t\t\t """ 4 => """ C Stefanadis \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Interv Cardiol" "fecha" => "2003" "volumen" => "16" "numero" => "5" "paginaInicial" => "407" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transcatheter closure of postinfarction ventricular septal defects using a new Amplatzer muscular VSD occluder: results from the US registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ R Holzer \n \t\t\t\t\t\t\t\t """ 1 => """ D Balzer \n \t\t\t\t\t\t\t\t """ 2 => """ Z Amin \n \t\t\t\t\t\t\t\t """ 3 => """ CE Ruiz \n \t\t\t\t\t\t\t\t """ 4 => """ J Feinstein \n \t\t\t\t\t\t\t\t """ 5 => """ J Bass \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Catheter Cardiovasc Interv" "fecha" => "2004" "volumen" => "61" "numero" => "2" "paginaInicial" => "201" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transcatheter closure of congenital and acquired muscular ventricular septal defects using the Amplatzer devices" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ M Chessa \n \t\t\t\t\t\t\t\t """ 1 => """ M Carminati \n \t\t\t\t\t\t\t\t """ 2 => """ QL Cao \n \t\t\t\t\t\t\t\t """ 3 => """ G Butera \n \t\t\t\t\t\t\t\t """ 4 => """ S Giusti \n \t\t\t\t\t\t\t\t """ 5 => """ RM Bini \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Invasive Cardiol" "fecha" => "2002" "volumen" => "14" "numero" => "6" "paginaInicial" => "7" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rationale and feasibility study of a mechanical model for the testing of material fatigue in metal ureteral stents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ N Bafaloukas \n \t\t\t\t\t\t\t\t """ 1 => """ M Birch \n \t\t\t\t\t\t\t\t """ 2 => """ N Buchholz \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Endourol" "fecha" => "2008" "volumen" => "22" "numero" => "2" "paginaInicial" => "92" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack639150" "titulo" => "ACKNOWLEDGMENTS" "texto" => "<p id="para130" class="elsevierStylePara elsevierViewall">The authors wish to thank Dr. Joseph K. Perloff, Professor of Medicine and Pediatrics at UCLA Medical Center, for his careful revision of the manuscript.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/18075932/0000006700000011/v1_202212011245/S1807593222021974/v1_202212011245/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/18075932/0000006700000011/v1_202212011245/S1807593222021974/v1_202212011245/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222021974?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 2 | 11 |
| 2024 October | 19 | 25 | 44 |
| 2024 September | 20 | 25 | 45 |
| 2024 August | 36 | 18 | 54 |
| 2024 July | 34 | 34 | 68 |
| 2024 June | 33 | 5 | 38 |
| 2024 May | 66 | 18 | 84 |
| 2024 April | 38 | 16 | 54 |
| 2024 March | 65 | 9 | 74 |
| 2024 February | 43 | 13 | 56 |
| 2024 January | 14 | 10 | 24 |
| 2023 December | 7 | 15 | 22 |
| 2023 November | 9 | 16 | 25 |
| 2023 October | 13 | 20 | 33 |
| 2023 September | 14 | 25 | 39 |
| 2023 August | 8 | 6 | 14 |
| 2023 July | 10 | 19 | 29 |
| 2023 June | 6 | 4 | 10 |
| 2023 April | 1 | 1 | 2 |
| 2023 March | 3 | 2 | 5 |
| 2023 February | 3 | 2 | 5 |
| 2023 January | 1 | 3 | 4 |
| 2022 December | 9 | 1 | 10 |
Show all