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Cardiac Intervention Service

Cardiac Intervention Service

PDA Closure

The PDA is a persistent connection between the aorta and pulmonary artery which has not closed after birth. Untreated, it will result in left sided heart failure in many patients. The heart failure signs are usually difficult to control. Further, it can trigger changes in the pulmonary vessels resulting in severe pulmonary hypertension. Both scenarios have a huge impact on the patients’ quality of life and will sadly lead to premature death. Treated early in life will, however, provide many patients with a completely normal life expectancy. Early diagnosis and treatment are therefore very important. Continuous heart murmurs which are typical for patients with a PDA should always prompt cardiac workup.

The team at SCVS has a novel keyhole method for PDA closure in the UK, which allows us to close PDAs in patients as small as 1kg and preserve the femoral artery, which is not possible with the more routinely used ACDO technique. At SCVS, the PDA is closed with a special vascular plug. It is positioned in the ductus following percutaneous punction of the femoral vein and retrograde catheterisation of the heart. The recovery time is very short and patients can usually be discharged the following day.

Key facts

  • Technique used at SCVS which allows PDA closure also in very small patients
  • Very short recovery time
  • High success rate
  • Early diagnosis and treatment are key to a successful outcome.
More info about PDA Closure

Balloon Valvuloplasty

Balloon valvuloplasty is a technique used to improve the function of stenotic valves. The most common stenosis we see is pulmonic stenosis. Patients with marked pulmonic stenosis usually present with a systolic heart murmur. Untreated, the pressure in the right ventricle can be very high, which results in myocardial damage and subsequently arrhythmias and/or heart failure. Patients will develop syncope, exercise intolerance and/or ascites over time or they can suffer from sudden cardiac death. Performing a balloon valvuloplasty will dramatically improve the function of the abnormal valve, improving life expectancy and alleviating clinical signs.

The earlier in life the intervention is performed the better the chances for a good outcome. In addition, the use of high-pressure balloons has an impact on the outcome. At SCVS we exclusively use high-quality, high-pressure balloons for these procedures to achieve the best possible outcome.

Our percutaneous technique allows for rapid recovery and patients are usually discharged the following day.

Besides the pulmonic valve, there are also other heart valves such as the aortic valve or tricuspid valve and other obstructions like a Cor Triatriatum Dexter which can be approached by balloon valvuloplasty if indicated.

Key facts

  • Only high-quality, high-pressure balloons are used to achieve the best possible outcome
  • Percutaneous technique with very short recovery time
  • Early diagnosis and treatment are important for a successful outcome
More info about Balloon Valvulplasty

Pacemaker Implantation

Bradyarrhythmias as AV-block or Sinusarrest, often require implantation of a pacemaker to restore a normal heart rate. Untreated, these conditions lead to exercise intolerance, syncope, heart failure or even sudden cardiac death. More commonly, these problems are found in older patients, but are sometimes also seen in younger patients.

Implantation of a pacemaker provides patients usually with a normal quality of life. Clinical signs like exercise intolerance and syncope will disappear.

Many different pacemaker systems exist. More commonly, single chamber pacemaker systems, with only one pacemaker lead in the right ventricle, are fitted in dogs.

This is probably sufficient for many patients and takes care of the risk of sudden cardiac death. Nevertheless, implantation of the more complex dual chamber pacemaker units which we also offer at SCVS can be beneficial in certain patients and could result in a superior outcome. 

Implantation of pacemakers is performed via cutdown to the jugular vein. The vein is used to feed the electrode(s) into the heart. The pacemaker itself is then positioned subcutaneously in the neck area. Implantation is therefore very minimally invasive, and patients can usually be discharged 1-2 days following surgery.

Optimal programming of the pacemaker is essential for best results. We are running pacemaker clinics, a cooperation with human electrophysiologists, to ensure pacemakers for all our patients are set in the best possible way.

Key facts

  • SCVS offers the option of single and dual chamber pacemakers to achieve best results for all patients
  • Predominant use of active electrodes to minimise the risk of lead dislodgement
  • Pacemaker clinics with electrophysiologist to ensure best possible pacemaker programming
More about Pacemakers
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