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La fermeture de communication interventriculaire CIV est une procédure de la cardiologie interventionnelle qui consiste à fermer une communication anormale entre les ventricules. Cette communication est généralement présente dès la naissance (congénitale) ou acquise. Elle permet d'éviter la chirurgie classique de fermeture par patch et les risques liés à la circulation extracorporelle. Ventricular septal defect Ventricular septal defect is a hole between the ventricles Ventricular septal defect closure devices VSD Closure Percutaneous closure of ventricular septal defect using a device VENTRICULAR SEPTAL DEFECT CLOSURE in pediatrics What is a ventricular septal defect? In the normal heart, the wall separating the right and left ventricles, called the " interventricular septum ", is completely hermetic. Ventricular septal defect (VSD) corresponds to the presence of a more or less large orifice in this wall, allowing the direct passage of blood from one ventricle to the other. VSDs in children are said to be congenital (i.e. present at birth). The consequences of this malformation depend essentially on its size. Depending on the medical assessment, catheterization of the right heart cavities may be proposed before deciding on percutaneous closure of the VSD. So why is the closure of the VSD being proposed? Ventricular septal defect closure offers several benefits for patients. Here are some of them: Restore normal circulation: Closing the VSD restores normal blood circulation. Oxygenated blood can then be distributed efficiently throughout the body, without overloading the lungs. Preventing complications: Persistence of VSD can lead to complications, such as lung infections, valve infections, heart failure, and pulmonary arterial hypertension . Improved quality of life: After VSD closure, patients often experience a significant improvement in their quality of life. Dyspnea during feeding decreases, and growth retardation seen in infants improves. Procedure of VSD Closure: The examination takes place in the interventional cardiology unit. The child is laid flat and given general anesthesia so as not to move during the procedure. The doctor performs a venous and arterial puncture in the groin and inserts a thin catheter. The catheter is guided to the heart. The device is deployed in the VSD to close it. At the end of the procedure, the groin is compressed for about ten minutes and then a pressure bandage is applied. The child is monitored in the recovery room until he or she is fully conscious and then returned to the parents. Feeding is only allowed two hours after the end of the procedure to avoid the risk of aspiration. Discharge is usually the next day after an ultrasound check. What are the complications of a VSD closure procedure? The higher the child's weight, the lower the risk, but despite the experience of the operators and the significant technical progress in catheters and devices, it is an invasive procedure with complications: allergic complications most often linked to the use of anesthesia products. Vascular complications at the femoral puncture site: the most common is a hematoma which results in a bluish appearance usually without consequence and disappearing after a few days. Rarely (<1% of cases), a vascular injury may require surgical repair or transfusion. cardiovascular complications during the hospital period : they are very rare (<0.5% of cases) of stroke, hemorrhagic effusion around the heart or displacement of the devices, which may require additional intervention, sometimes surgical. Cardiac complications after hospital discharge : Very rarely, displacement of the device or localized infection may occur. complications leading to death : they are very exceptional (<0.1%). It is important to note that these complications are rare, and the benefits of VSD closure usually outweigh the risks. Ventricular septal defect Ventricular septal defect closure Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank your for your submission ! Demande d'information map

L'embolisation vasculaire est une procédure interventionnelle qui consiste à occlure des vaisseaux qui sont à risque de saignements internes. Ces vaisseaux en cardiopathie congénitale sont les collatérales aorto-pulmonaires MAPCA ou des collatérales veno-veineuses. Normal heart Pulmonary vascularization comes from the pulmonary arteries. Angiography of MAPCA Pulmonary vascularization comes from collaterals from the aorta. Embolization devices Coils: metal wires covered with PTFE (Teflon). The various closure devices composed of Nitinol and containing PTFE (Teflon). EMBOLIZATION OF AORTO-PULMONARY COLLATERALS What are collaterals? In cyanotic congenital heart disease, that is, heart defects that cause a mixture of oxygenated and non-oxygenated blood, it is very common to find vessels that have developed to bring more blood to the arteries of the lungs; these vessels are called Multiple AortoPulmonary Collaterals Arteries (MAPCA). Veno-venous collaterals can also be found after palliation surgery for a univentricular heart. These collaterals can be objectified by ultrasound, cardiac scan, but above all it is necessary to perform a right heart catheterization to identify them and see their path. Pulmonary atresia with ventricular septal defect is a congenital malformation in which the newborn does not have continuity between the right ventricle and the pulmonary artery. Blood therefore reaches the pulmonary arteries via collaterals from the aorta, the MAPCAs. Should the MAPCAs be closed? The condition for occluding a MAPCA is that the flow delivered by the anterograde pathway (from the RV to the PA) is deemed to be sufficient for adequate pulmonary circulation. In this case, MAPCAs may contribute to increased blood flow to the lungs, leading to pulmonary hypertension . MAPCAs can therefore be closed pre-operatively because they can complicate surgery, or post-operatively if it is considered that closing them beforehand risks increasing oxygen depletion in the blood. Should veno-venous collaterals be closed? Veno-venous collaterals develop postoperatively in palliative surgery of a univentricular heart. They are closed when they cause significant clinical desaturation. How is a MAPCA embolization procedure performed? The procedure can be performed under local anesthesia, but for children under 14 years of age, deep sedation or general anesthesia is preferred so that they do not move. A puncture is performed in the groin and a catheter is passed along the artery or vein to the branch that we want to block. To embolize the artery, either coils or closure devices will be used. At the end of the procedure, the groin is compressed for about ten minutes and then a pressure bandage is applied. The child is monitored in the recovery room until he or she is fully conscious and then returned to the parents. Feeding is only allowed two hours after the end of the procedure to avoid the risk of choking. Discharge is usually the next day after an ultrasound scan. What are the complications of a collateral embolization procedure? Despite the experience of the operators and the significant technical progress concerning catheters and devices, this is an invasive procedure involving risks: allergic complications most often linked to the use of anesthesia products. Vascular complications at the femoral puncture site: the most common is a hematoma which results in a bluish appearance usually without consequence and disappearing after a few days. Rarely (<1% of cases), a vascular injury may require surgical repair or transfusion. Thrombosis of the artery can also occur. cardiovascular complications during the hospital period : they are very rare (<0.5% of cases) of stroke, hemorrhagic effusion around the heart or displacement of the device, which may require additional intervention, sometimes surgical. Cardiac complications after hospital discharge : Hemoptysis (coughing up blood). complications leading to death : they are very exceptional (<0.1%). It is important to note that these complications are rare, and the benefits of collateral occlusion usually outweigh the risks. Aortopulmonary collateral embolization Vascular embolization Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Merci pour votre envoi ! Demande d'information map

La dilatation de la valve pulmonaire est une procédure de cardiologie interventionnelle qui consiste à lever le rétrécissement congénitale de la valve pulmonaire grâce à un ballonnet. Elle est réalisée sous anesthésie générale et permet d'éviter les risques de la chirurgie classique de commissurotomie pulmonaire. Pulmonary valve stenosis Pulmonary valve dilatation A. Waisting of the balloon used to dilate the pulmonary valve marks. B. Opening of the pulmonary valve with disappearance of the waist. PULMONARY VALVE DILATATION in pediatrics What is pulmonary valve dilatation? Pulmonary valve dilatation is a medical procedure that aims to treat pulmonary stenosis, a condition where the pulmonary valve is too narrow, restricting blood flow from the heart to the lungs. This procedure is performed by inserting a catheter with a balloon at its tip through the femoral vein and guided to the heart. Once inside the valve, the balloon is inflated and separates the valve cusps, allowing better blood flow . Pulmonary dilatation can be performed at birth, if the newborn's adaptation to extra-uterine life is difficult (cyanosis), or during childhood if pulmonary stenosis affects the child's growth or ability to exercise. Performing pulmonary valve dilatation: Pulmonary dilatation is performed in the catheterization room. The child is laid flat and given general anesthesia so as not to move during the procedure. The doctor performs a venipuncture in the groin and inserts a thin catheter. The catheter is guided to the heart. An inflatable balloon is positioned at the pulmonary valve. Then, the balloon is inflated to widen the valve and improve blood flow. At the end of the procedure, the groin is compressed for about ten minutes and then a pressure bandage is applied. The child is monitored in the recovery room until he or she is fully conscious and then returned to the parents. Feeding is only allowed two hours after the end of the procedure to avoid the risk of aspiration. Discharge is usually the next day after an ultrasound check. Are there any risks associated with pulmonary valve dilatation? Despite technical progress and the experience of doctors, cardiac catheterization to dilate the pulmonary valve carries, as with any invasive or surgical procedure, a risk of incidents or accidents: Allergic complications: Most often linked to the use of iodinated radiological products or local anesthetics. If you have already experienced allergic manifestations, it is imperative to inform your doctor. Complications at the puncture site of the vein: The most common complication is the formation of a bruise or hematoma at the puncture site which can persist for several days, but is usually without consequence. Also, thrombosis, i.e. occlusion of the vein, can be mentioned. Cardiac and vascular complications: During the examination, palpitations may occur due to a rhythm disorder. Serious complications include cardiac perforation and tricuspid valve tear. These are rare but not negligible in the context of the emergency and the low weight of the infant. Failure of valvular dilation: Quite rare, it generally redirects the diagnosis towards a supravalvular stenosis, that is, arterial, which in this case requires surgical management. What benefits can be expected from pulmonary valve dilatation? Dilation of the pulmonary valve offers several benefits for the child: Normal height and weight growth. Improved exercise capacity: The child will have no limitations when playing and running. Improved cognitive abilities: The child will have fewer difficulties in learning and performing. What is the follow-up after pulmonary valve dilatation? Dilatation of the pulmonary valve gives good results over many years. Follow-up with the cardiologist is annual and there are two possible developments: The valve has been dilated and over the years it will tighten. At that point, we can proceed to a new dilation of the pulmonary valve. We can perform this procedure as many times as necessary, because it represents the best alternative to valve surgery. The valve has been dilated and over the years it has become leaky. At this point, we will have the choice of performing pulmonary revalvulation either by catheterization or surgery. Pulmonary valve stenosis Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank your for your submission ! Demande d'information map

La fermeture du canal artériel est une procédure de cardiologie interventionnelle qui consiste à occlure le canal artériel qui est un vestige persistant entre l'aorte thoracique et les artères pulmonaires. c'est un geste très fréquent en cardiopathie congénitale. Elle permet d'éviter la chirurgie classique et ses risques. Patent ductus arteriosus The patent ductus arteriosus is a connection between the aorta and the pulmonary artery. PDA closure device Actual size of a patent ductus arteriosus closure device, a few millimeters. PDA closure The device is attached to the catheter which is positioned in the ductus arteriosus. It is deployed there to occlude it. CLOSURE OF THE PATENT DUCTUS ARTERIOSIUS in adults What is the patent ductus arteriosus? Patent ductus arteriosus is a birth defect that occurs when the ductus arteriosus, a normal connection between the aorta and pulmonary artery in the fetus, does not close properly after birth. Normally, this duct allows blood to bypass the lungs and go directly to the baby's system. However, after birth, blood must be oxygenated by the lungs, and the ductus arteriosus closes quickly, usually within a few days to two weeks . When the ductus arteriosus persists, some of the oxygenated blood, which should be redistributed to the rest of the body, returns to the lungs. This can lead to blood circulation problems and overload of the pulmonary system. So why is closure of the patent ductus arteriosus proposed? Restore normal circulation: Closing the ductus arteriosus restores normal blood circulation. Oxygenated blood can then be distributed efficiently throughout the body, without overloading the lungs. Preventing complications: Patent ductus arteriosus can lead to complications, such as lung infections, heart problems, and pulmonary hypertension . Closing the ductus arteriosus early reduces these risks. Improve quality of life: Closing the ductus arteriosus improves the patient's quality of life by avoiding the symptoms associated with this malformation. Depending on your medical assessment, you may be offered a prior right heart catheterization to determine the indication for closure of the ductus arteriosus. Procedure for closing the Arterial Duct: Your examination will take place in the interventional cardiology unit. Upon your admission to the cardiology department, you will be asked to wear a hospital gown. You will need to remove all your jewelry, underwear, and socks. A small area of your groin will be shaved, which will be the access point for the examination. A stretcher-bearer will take you to the catheterization room in your bed. You will be helped to lie down on a narrow, hard table. It might be a bit cold in the room. Around you, you will see X-ray analysis devices and screens. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring device. Your body will be covered with a large sterile drape. The procedure involves the implantation of a metal mesh device in the arterial duct. This flexible device is implanted by cardiac catheterization via a puncture of the femoral vein under local anesthesia. In the absence of complications, the patient returns to their room and is monitored for 4 to 6 hours. Discharge is possible afterward. What are the complications of a ductus arteriosus closure procedure? Despite the experience of the operators and the significant technical progress concerning catheters and devices, this is an invasive procedure involving risks: allergic complications most often linked to the use of anesthesia products. Vascular complications at the femoral puncture site: the most common is a hematoma which results in a bluish appearance usually without consequence and disappearing after a few days. Rarely (<1% of cases), a vascular injury may require surgical repair or transfusion. cardiovascular complications during the hospital period : they are very rare (<0.5% of cases) of stroke, hemorrhagic effusion around the heart or displacement of the device, which may require additional intervention, sometimes surgical. Cardiac complications after hospital discharge : Very rarely, displacement of the deviceor localized infection may occur. complications leading to death : they are very exceptional (<0.1%). It is important to note that these complications are rare, and the benefits of ductus arteriosus closure usually outweigh the risks. PDA closure Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank your for your submission ! Demande d'information map

Le cathétérisme droit est un examen diagnostique de cardiologie interventionnelle qui consiste par le biais d'une voie veineuse périphérique de mesurer les pressions intracardiaques et pulmonaires et d'imager les anomalies structurelles. Il permet de mieux orienter les investigations étiologiques en cas d'hypertension pulmonaire et de déterminer le traitement médicamenteux ou interventionnel adéquat dans le cas de cardiopathies congénitales ou acquises. Balloon catheter Multi-lumen catheter for performing right heart catheterization. Right heart catheterization The catheter is introduced into the different right heart chambers to take pressure and angiography measurements. RIGHT HEART CATHETERIZATION in adults What is right heart catheterization? Right heart catheterization, abbreviated as RHC, is a test that is performed to check how well your heart muscle is functioning. During this test, heart and blood pressure readings are taken and blood samples are taken to measure oxygen levels in the heart. This test is useful in finding the cause of pulmonary hypertension, determining its medication or interventional treatment, and deciding whether to have heart surgery in the case of congenital heart disease. Can I take my usual medications before the test? You can take most of your usual medications the night before your test and on the day of the test. Your doctor will review the medications you are taking with you. If you are unsure about any medication, you will need to let us know before you come. Can I eat and drink before this test? You can have a small snack on the day of the exam. Depending on the organization of the day, we try to respect the order and time of passage. However, depending on the emergencies of the day, the duration of the interventions of the day, it is possible to have a waiting time of several hours. How is right heart catheterization performed? Your test will take place in the interventional cardiology unit. When you are admitted to the cardiology department, you will be asked to put on a hospital gown. You will need to remove all jewelry, underwear and socks. You may wear your glasses, dentures, and hearing aids, if needed. A small area of your groin will be shaved in case it will be the entrance for the test. You will be asked to go to the bathroom to empty your bladder (urinate) just before your test. A stretcher-bearer will take you to the catheterization room in your bed. You will be helped onto a hard, narrow table. It will be a little cold in the room. Around you you will see X-ray machines and screens. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring machine. Your body will be covered with a large sterile drape. The doctor will administer an anesthetic subcutaneously into the vein of your right arm or right groin to reduce the sensation of pain. Small catheters (tubes) are inserted into a vein into the right side of your heart. You may be asked to take a deep breath to help move the catheter. The doctor will measure the pressure in your heart and take blood samples to measure oxygen levels. If your ambient air saturation is low, an artery will be punctured to measure blood pressure and a blood sample will be taken to measure oxygen concentrations. The puncture will be made either at the wrist or in the groin crease. We may also perform angiograms, i.e. injections of contrast products. At this time, you may feel a sensation of heat throughout your body for a few seconds. The test lasts approximately 60 minutes. Are there any risks with this test? This procedure is safe and usually well tolerated, but there are still some risks. There may be bleeding at the insertion site, as well as pain and bruising. Additional heartbeats or palpitations (rapid heartbeats) may occur when the catheter is placed in your heart. It is very rare for this to cause problems, but you may experience such palpitations during the test. The risk of serious complications is very rare (less than 1%), but the benefit of the examination far outweighs the risks. How long will I be in bed after the test? If the procedure was performed using a vein in your arm, you will be able to get up as soon as you return to your room. If the procedure was performed from a vein in the groin, you must remain in bed for about two hours without bending the leg used for the puncture too much. The head of the bed can be slightly raised. After 2 hours of bed rest, you will be able to get up. When can I be discharged from the hospital? If the test was performed from a vein in the arm and without artery puncture, you will be able to leave 1 hour after the end of the examination. If the test was performed from a vein in the groin, you will be discharged approximately three hours after the procedure is completed. You will need to walk around and check for bleeding before you can consider discharge. It is recommended that you be picked up and taken home. It is important that someone be with you for a few hours after discharge in case you have any bleeding and need assistance. Cardiac catheterization Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Demande d'information

La fermeture de la communication interauriculaire (CIA) chez l'enfant est une procédure de cardiologie interventionnelle qui consiste à fermer à l'aide d'une prothèse la communication entre les oreillettes. C'est une procédure sous anesthésie générale et permet d'éviter les risques d'une chirurgie classique. Atrial septal defect ASD is a hole between the atria. ASD closure device The device is an alloy of flexible metals (nickel and titanium). It contains a PTFE (Teflon) coating to make it waterproof. ASD closure The device is implanted between the two atria to close the ASD. ATRIAL SEPTAL DEFECT CLOSURE in adults Why are you being offered an ASD closure? An atrial septal defect (ASD) is a hole in the wall separating the two atria of the heart that is present during the embryonic stage and does not close after birth. Depending on the size of the ASD, it can cause exertional discomfort from a young age or may not present until adulthood, past the age of thirty. Additionally, it can lead to a stroke, a neurological complication that necessitates closure to prevent recurrence. Based on your medical evaluation, you may be offered a right heart catheterization beforehand to determine the indication for ASD closure. Can I eat and drink before this test? You must be more than 12 hours before the exam. We try to respect the order and time of passage according to the organization of the day. However, depending on the emergencies of the day, the duration of the interventions of the day, it is possible to have a waiting time of several hours. Performing the closing gesture: Your test will take place in the interventional cardiology unit. When you are admitted to the cardiology department, you will be asked to put on a hospital gown. You will need to remove all jewelry, underwear and socks. A small area of your groin will be shaved which will be the entrance route for the examination. A stretcher-bearer will take you to the catheterization room in your bed. You will be helped onto a narrow, hard table. It will be a little cold in the room. Around you, you will see X-ray machines and monitors. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring machine. Your body will be covered with a large sterile drape. General anesthesia will begin. The procedure involves implanting a device comprising two metal mesh discs connected by a small connector and positioned on either side of the septum between the two atria to make it watertight. This flexible device is implanted by cardiac catheterization via a puncture of the femoral vein. This procedure is performed with ultrasound guidance (usually via transthoracic or transesophageal route), requiring general anesthesia or simple sedation. You will be asked to lie down for a few hours after the procedure. You will generally be discharged the day after the procedure after a transthoracic ultrasound scan. What are the expected benefits? Closing the ASD will balance the volumes between the heart chambers and reduce the dilation of the heart and therefore eliminate discomfort during exercise. What are the risks involved? Despite the experience of the operators and the significant technical progress concerning catheters and devices, this is an invasive procedure involving risks: allergic complications most often linked to the use of anesthesia products. Vascular complications at the femoral puncture site: the most common is a hematoma which results in a bluish appearance usually without consequence and disappearing after a few days. Rarely (<1% of cases), a vascular injury may require surgical repair or transfusion. cardiovascular complications during the hospital period : they are very rare (<0.5% of cases) of stroke, hemorrhagic effusion around the heart or displacement of the device, which may require additional intervention, sometimes surgical. Cardiac complications after hospital discharge : the most common complication is the occurrence of palpitations linked to a rhythm disorder (<5% of cases): generally early (first weeks) and transient, this arrhythmia may require an action or additional treatment if it persists. Much more rarely (<0.5% of cases), the formation of clots on the device or a displacement of the device may occur. complications leading to death : they are very exceptional (<0.1%). What follow-up after the device implantation? The implantation of the device requires taking a double antiplatelet treatment for a period of three to six months. No special physical or professional precautions are necessary after implantation of the device. This device also does not contraindicate any future exploration or intervention. Antibacterial prophylaxis will be offered in the event of risky extracardiac procedures during the 6 months following implantation of the device. Atrial septal defect closure Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 666 727 129 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Demande d'information Contact us Thank your for your submission ! Demande d'information map

La perforation de la valve pulmonaire est une procédure de sauvetage de cardiologie invasive qui consiste à perforer la valve pulmonaire pour permettre un débit cardiaque viable. Elle est réalisée dès la naissance. Normal heart Blood from the right ventricle goes through the pulmonary valve into the pulmonary arteries. Pulmonary atresia with intact septum Blood from the right ventricle cannot go through the pulmonary valve, it comes out to find a passage between the atria. Dilatation of the pulmonary valve after perforation A. Waisting of the balloon used to dilate the pulmonary valve marks. B. Opening of the pulmonary valve with disappearance of the waist. NEONATAL PULMONARY VALVE PERFORATION What is pulmonary atresia with intact ventricular septum? Pulmonary atresia with intact ventricular septum (PA-IVS) is a rare congenital heart defect. In this condition, there is no passage between the right ventricle and the pulmonary artery. In other words, blood cannot flow normally to the lungs. The severity of this defect varies, but if the right ventricle is well developed, it becomes urgent at birth to open the pathway to the pulmonary arteries, in which case a puncture of the pulmonary valve is necessary. Procedure for Neonatal Pulmonary Valve Perforation: The perforation of the neonatal pulmonary valve is performed in the catheterization room. The newborn is placed under general anesthesia, lying on their back. The doctor performs a venous and arterial puncture in the groin area. From these access points, the doctor inserts thin catheters that are guided to the heart. The goal is to pass through the floor of the valve to position a balloon. The balloon is inflated to enlarge the valve and allow blood flow to the pulmonary arteries. At the end of the procedure, pressure is applied to the groin area for about ten minutes, and a compressive bandage is placed, which should be kept for a few hours. On the left, the angiography shows the absence of opacification of the pulmonary arteries. On the right, after perforation, the passage of the contrast agent to the pulmonary arteries can be seen. What are the risks of pulmonary valve perforation? Once again, pulmonary valve perforation addresses a non-viable cardiac malformation in its current state. Pulmonary valve perforation remains a life-saving procedure. What benefits can be expected from pulmonary valve perforation? After a perforation of the pulmonary valve, the following days guide us towards the continuation of the treatment: Either the lungs receive enough blood and the baby's growth is monitored without resorting to additional intervention. Either the lungs do not receive enough blood and we are forced to perform additional percutaneous or surgical intervention. Pulmonary atresia with intact septum Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank your for your submission ! Demande d'information map

contact par mail ou whatssap. Soumission des dossiers pour avis. Address Local University Hospital Les Ambassadeurs Contact : + 212 (0) 6 22 22 26 31 Appointment Mon.- Fri. 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Souissi, Rabat, Morocco. In case of emergency, go to LUH Les Ambassadeurs at any time. Request for information First name Last name E-mail Message Send Thank your for your submission !

L'angioplastie coronaire c'est la méthode interventionnelle de revascularisation des artères coronaires. Elle consiste à faire une dilatation au ballon sans/avec pose d'un stent au site du rétrécissement de l'artère coronaire. Coronary stent The coronary stent is deployed and shown at actual size. Coronary stent A coronary stent is a flexible, deformation-resistant metal alloy. It is mounted on a balloon. Coronary stent The coronary stent is deployed after inflation of the balloon. CORONARY ANGIOPLASTY Why are you being offered angioplasty or coronary dilation? You have abnormalities in the blood supply to the heart secondary to narrowing of the coronary arteries. A narrowing of these arteries can cause chest pain, while an obstruction can cause a heart attack. Your doctors have therefore decided that it is preferable to treat these abnormalities. Performing coronary dilatation: The procedure is performed by inserting a catheter into the femoral artery (in the groin crease) or radial artery (at the wrist) and consists of dilating the narrowing(s) with an inflatable balloon. In the majority of cases, a stent is placed at this level. This is a type of metal mesh tube that is left in place and keeps the artery open. This stent is generally made of so-called “active” metal because it is covered with a medication intended to reduce the risk of recurrence of the narrowing when this risk is particularly high. The narrowing or occlusion may sometimes be impossible to cross or dilate. The risk of failure depends essentially on the complexity of the lesion. It is generally of the order of 2 to 5%, higher when the artery to be treated has been blocked for a long time. As with coronary angiography, the patient is monitored with a minimum stay of one full day. Dilatation of a blocked coronary artery Are there any risks associated with coronary dilatation? Despite technical progress in catheters, balloons, stents and the experience of doctors, coronary angioplasty, like any invasive or surgical procedure, carries a risk of incidents or accidents. Complications such as heart attack, serious heart rhythm disorders, stroke or coronary perforation are very rare. Exceptionally, emergency heart surgery may be necessary. Death is very rare. Restenosis - Scarring will occur in the areas that have been dilated. There is a risk that the narrowing will recur (called restenosis). If it does recur, further dilation may be performed. In some cases, bypass surgery may be considered. Puncture site complications - These have become rare. The most common complication is a hematoma that can persist for several days, but is usually harmless. More rarely, an artery may become blocked or injured and require surgical repair and/or a blood transfusion. Allergic complications - These are exceptional. Most often linked to iodinated contrast products or anesthetic products. If you have already had allergic manifestations, it is absolutely necessary to inform the doctor. Risk of radiodermatitis - This risk of skin burns is exceptional and linked to prolonged use of X-rays. What benefits can be expected from coronary dilatation? By allowing a greater blood supply to the heart muscle at rest and during exercise, coronary dilation reduces or eliminates angina pain and improves long-term outcomes. Antiplatelet treatment after dilatation: To prevent the formation of clots, the placement of a stent requires the use of simultaneous treatment with two medications, the first being aspirin taken over the long term, the second being another more powerful medication given for 1 month to 1 year depending on your illness and the type of stent used. The taking of these medications and their prescription duration must be strictly respected unless otherwise advised by a doctor. If an operation is scheduled in the months following the dilatation, it is imperative that you discuss it with the doctor before the coronary dilatation. Balloon coronary angioplasty Coronary angioplasty with stent placement Our location Make an appointment LUH Ambassadors : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Demande d'information map Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank you for your submission

Le stenting de la coarctation de l'aorte est une procédure de cardiologie interventionnelle qui consiste à dilater le rétrécissement de l'aorte thoracique. C'est une procédure sous anesthésie locale. Elle permet d'éviter la chirurgie classique qui comporte plus de risque. Coarctation of the aorta The narrowed aorta obstructs the flow of blood to the body's organs. Vascular stents a and b: Uncovered stents c and d: Covered stents e: Dilatation balloon Stenting of coarctation of the aorta Angiography images of aortic coarctation before and after stenting AORTIC COARCTATION STENTING in adults What is coarctation of the aorta? Coarctation of the aorta is an abnormal narrowing of the aorta, the large blood vessel that carries blood from the heart to the rest of the body. This limits blood flow to organs and lower limbs. It is present from birth and may be discovered later in life. The heart has to work harder to push blood through the narrowed part of the aorta. Why are you being offered coarctation of the aorta stenting? Stenting helps reduce blood pressure in this area, relieving the heart and improving blood flow . It widens the narrowed area, allowing blood to flow more freely. This improves perfusion of the abdominal organs and lower limbs, reducing the risk of complications . Stenting aims to improve quality of life and reduce the risks of cardiac and vascular complications associated with coarctation of the aorta . Performing stenting of coarctation of the aorta: Your test will take place in the interventional cardiology unit. When you are admitted to the cardiology department, you will be asked to put on a hospital gown. You will need to remove all jewelry, underwear and socks. A small area of your groin will be shaved which will be the entrance route for the examination. A stretcher-bearer will take you to the catheterization room in your bed. You will be helped onto a narrow, hard table. It will be a little cold in the room. Around you, you will see X-ray machines and monitors. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring machine. Your body will be covered with a large sterile drape. General anesthesia will begin. The procedure involves dilating the narrowed area of the aorta and implanting a stent to prevent it from narrowing again. This procedure is performed under local anesthesia, but you will be sedated during dilation so as not to feel any pain. You will be asked to lie down for a few hours after the procedure. You will generally be discharged the day after the procedure. Are there any risks associated with coarctation of the aorta stenting? Despite technical progress and the experience of doctors, cardiac catheterization involves, as with any invasive or surgical procedure, a risk of incidents or accidents: Allergic complications: Most often linked to the use of iodinated radiological products or local anesthetics. If you have already experienced allergic manifestations, it is imperative to inform your doctor. Complications at the artery puncture site: This can range from a simple hematoma to a vascular injury requiring surgical repair and/or blood transfusion. Cardiac and vascular complications: During the examination, discomfort, chest pain, palpitations related to a rhythm disorder may occur. Serious complications are very rare. The risk of death is very low. What follow-up after stenting of coarctation of the aorta? Stenting requires taking antiplatelet treatment for a period of 6 months. No special physical or professional precautions are necessary after implantation of the prosthesis. This prosthesis also does not contraindicate any future exploration or intervention. Antibacterial prophylaxis will be offered in the event of risky extracardiac procedures during the 6 months following implantation of the prosthesis. A chest CT scan for monitoring will be offered to you at one year. Coarctation of the aorta Stenting of coarctation of the aorta Our location Make an appointment LUH les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank you for your submission ! Demande d'information map

La dilatation de la valve aortique est une procédure de cardiologie interventionnelle qui consiste à dilater au ballon la valve aortique. Elle est réalisé chez l'adulte rarement car actuellement l'implantation de la valve aortique peut se faire par voie percutanée TAVI. Aortic valve stenosis Narrowing of the aortic valve obstructs ejection from the left ventricle. Balloon dilatation of the aortic valve The balloon is inflated at the aortic valve to stretch it. Aortic valvuloplasty Angiographic image of aortic valve dilatation. AORTIC VALVE DILATATION in adults Why are you being offered aortic valve dilatation? The aortic valve is one of the four valves of the heart and separates the left ventricle (the heart's pump) from the aorta (the largest blood vessel in the body). It allows blood to pass from the heart to the rest of the body. Narrowing of the aortic valve prevents blood from flow normally and becomes responsible for symptoms such as shortness of breath, angina and heart failure. Aortic valve dilatation, also called aortic valvuloplasty, is proposed in case of aortic valve narrowing or stenosis. It is a procedure that can be considered in an emergency, because it is currently overtaken by the direct implantation of an artificial aortic valve percutaneously, commonly called TAVI for Transcatheter Aortic Valve Implantation. Performing Aortic Valve Dilatation: Your test will take place in the interventional cardiology unit. Upon your admission to the cardiology department, you will be asked to wear a hospital gown. You will need to remove all your jewelry, underwear, and socks. A small area of your groin will be shaved, which will be the access point for the procedure. A stretcher-bearer will take you to the catheterization room in your bed. You will be helped to lie down on a narrow, hard table. It might be a bit cold in the room. Around you, you will see X-ray analysis devices and screens. Small sticky patches will be placed on your chest. These will be connected to a heart monitoring device. Your body will be covered with a large sterile drape. The doctor will perform a puncture under local anesthesia of the right or left femoral arterial and venous pathways. They will then insert the balloon catheter to dilate the heart valve. At this point, you may feel your heart rate increase. The valve dilation does not cause any pain. At the end of the procedure, the access points will be closed as much as possible with a percutaneous closure device. You will generally be discharged the day after the procedure following a transthoracic echocardiographic check. What are the expected benefits? The expected benefits of this therapeutic procedure are a rapid improvement in your symptoms (shortness of breath, chest pain, discomfort), an improvement in the contractility and functioning of your heart and, more generally, an improvement in your quality of life. However, this benefit does not last because the valve closes slowly to return to its basic state of narrowing after a year. This is why this procedure is only indicated in emergency situations or when a TAVI cannot be considered in a short time. Risks and side effects: The risks of the procedure are those of cardiac catheterization, coronary angiography , to which are added the potential risks linked to the dilatation of the valve itself. The potential complications linked to these therapeutic procedures are: cardiac rhythm disorders, vascular complications at the catheter insertion site (hematoma, perforation or arterial obstruction that may require surgical repair), myocardial infarction, embolization of valvular material or clots, aortic dissection (tear of the aortic wall), perforation of a heart chamber, stroke, renal failure, bleeding requiring transfusion, need for emergency surgery for aortic valve replacement, death. Aortic valve stenosis Aortic valvuloplasty Our location Make an appointment LUH les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Request for information Contact us Thank you for your submission! Demande d'information map

Le stenting du canal artériel est une procédure néonatale d'urgence dans les cardiopathies cyanogènes. Elle consiste à mettre un stent dans le canal artériel pour le garder ouvert et ainsi maintenir un débit suffisant au développement des artères pulmonaires. Normal heart Pulmonary atresia with intact ventricular septum The communication between the right ventricle and the pulmonary artery is closed. Blood goes from the right heart to the left heart through the foramen ovale. The ductus arteriosus is the only source of vascularization of the pulmonary circulation. Coronary stent Actual size of a stent used to keep the ductus arteriosus open. DUCTUS ARTERIOSIS STENTING in the newborn What is the ductus arteriosus? The ductus arteriosus is a normal connection between the aorta and the pulmonary artery in the fetus, allowing blood to bypass the lungs and go directly to its organs. However, after birth, blood must be oxygenated by the lungs, and the ductus arteriosus closes quickly, usually within a few days to two weeks. In some congenital pathologies (such as the example on the right of pulmonary atresia with intact ventricular septum ) affecting the pulmonary circulation, the lungs do not receive enough blood flow which causes desaturation in the newborn with a risk of death in the very short term. The ductus arteriosus then allows to maintain a sufficient supply of blood flow to the pulmonary circulation. To keep it open, stenting of the ductus arteriosus can be proposed. So why is ductus arteriosus stenting proposed? There are three ways to maintain sufficient flow to the pulmonary circulation: drug method: prostaglandin infusion. The advantage is the absence of invasive procedures. The disadvantage is the countless side effects of the medication. It is not advisable to leave it for more than a week. Interventional method: stenting of the ductus arteriosus. The advantage is that it is an invasive procedure without surgery. The disadvantage is the complications of the femoral arterial route. Surgical method: Blalock surgery. The advantage is that it is the oldest method. The disadvantage is the complications of surgery. Stenting of the ductus arteriosus in surgically risky situations may be the best alternative. Procedure for Stenting the Arterial Duct: The examination takes place in the interventional cardiology unit. The child is laid flat and placed under general anesthesia to prevent movement during the procedure. The doctor performs an arterial puncture in the groin area and inserts a thin catheter. The catheter is guided to the heart. The stent is deployed in the arterial duct to keep it open. At the end of the procedure, pressure is applied to the groin area for about ten minutes, and a compressive bandage is placed. The child is monitored in the recovery room until they fully regain consciousness and are then returned to their parents. Feeding is only allowed two hours after the end of the procedure. What are the complications of a ductus arteriosus stenting procedure? Despite the experience of the operators and the significant technical progress concerning catheters and prostheses, this is an invasive procedure involving risks: allergic complications most often linked to the use of anesthesia products. Vascular complications at the femoral puncture site: the most common is a hematoma, which results in a bluish appearance that is usually harmless and disappears after a few days. Sometimes, a vascular injury may require surgical repair or transfusion. Thrombosis of the artery may also occur. Complications leading to death : They are not rare, but the natural evolution of these pathologies leads to death in the very short term in the absence of intervention. Stenting remains a life-saving procedure. What benefits can be expected after ductus arteriosus stenting? Stenting of the ductus arteriosus allows normal height and weight growth, to be expected for a few months, after the next surgical step of correction of the congenital heart disease. Our location Make an appointment LUH Les Ambassadeurs : +212 (0) 6 22 22 26 31 Appointment Monday - Friday: 8 a.m. - 3:30 p.m. info@jakamyheartcenter.com Visit us Insurance At Jakamy Heart Center, we understand the importance of easy and hassle-free insurance claim processing. Our team is here to help you verify your insurance coverage and answer any questions you may have. Feel free to contact us for personalized assistance. Our goal is to make your experience as pleasant as possible. We are committed to providing transparent and clear information about the insurance plans we accept. Contact us today to see if your insurance is accepted and to get the care you need. Check your insurance Demande d'information map