Browsing by Autor "Franz Freudenthal"

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A Consensus Approach to the Classification of Pediatric Pulmonary Hypertensive Vascular Disease: Report from the PVRI Pediatric Taskforce, Panama 2011
(SAGE Publishing, 2011) María Jesús del Cerro; Steven H. Abman; Gabriel Díaz; Alexandra Heath Freudenthal; Franz Freudenthal; S Harikrishnan; Sheila G. Haworth; D. Dunbar Ivy; Antônio Augusto Lopes; J. Usha Raj
Current classifications of pulmonary hypertension have contributed a great deal to our understanding of pulmonary vascular disease, facilitated drug trials, and improved our understanding of congenital heart disease in adult survivors. However, these classifications are not applicable readily to pediatric disease. The classification system that we propose is based firmly in clinical practice. The specific aims of this new system are to improve diagnostic strategies, to promote appropriate clinical investigation, to improve our understanding of disease pathogenesis, physiology and epidemiology, and to guide the development of human disease models in laboratory and animal studies. It should be also an educational resource. We emphasize the concepts of perinatal maladaptation, maldevelopment and pulmonary hypoplasia as causative factors in pediatric pulmonary hypertension. We highlight the importance of genetic, chromosomal and multiple congenital malformation syndromes in the presentation of pediatric pulmonary hypertension. We divide pediatric pulmonary hypertensive vascular disease into 10 broad categories.
ANGIOPLASTÍA PERCUTÁNEA EN COARTACIÓN AORTICA
(2010) Alexandra Heath; Jorge Villanueva; Franz Freudenthal; Janne Mendes; Edgar Pozo; A. Gómez Sánchez
Bacterial nanocellulose as a new patch material for closure of ventricular septal defects in a pig model
(Oxford University Press, 2014) Nora Lang; Elena Merkel; Franziska Fuchs; Dieter Schumann; Dieter Klemm; Friederike Krämer; Susanne Mayer‐Wagner; Christian Schroeder; Franz Freudenthal; Heinrich Netz
BNC patches can close VSDs with good mid-term results and its biocompatibility can be considered as satisfactory. Its elasticity increases in the presence of blood, which might be advantageous. Therefore, it has potential to be used as an alternative patch material in congenital heart disease.
Beating-heart patch closure of muscular ventricular septal defects under real-time three-dimensional echocardiographic guidance: A preclinical study
(Elsevier BV, 2008) Nikolay V. Vasilyev; Ivan Melnychenko; Kazuo Kitahori; Franz Freudenthal; Alistair Phillips; Rainer Kozlik‐Feldmann; Ivan S. Salgo; Pedro J. del Nido; Emile Bacha
Chronic hypobaric hypoxia, patent arterial duct and a new interventional technique to close it
(Cambridge University Press, 2011) Franz Freudenthal; Alexandra Heath; Jorge Villanueva; Janne Mendes; Ximena Vicente; Inge von Alvensleben; Gabriel Echazú; Joaquin Navarro; Nora Lang; Rainer Kozlik‐Feldmann
We conclude that the "Nit-Occlud® PDA-R" device is safe and effective in closing patent arterial duct up to a diameter of 8 millimetres.
Clasificación funcional de la hipertensión pulmonar en niños: Informe del task force pediátrico del Pulmonary Vascular Research Institute (PVRI), Panamá 2011
(Elsevier BV, 2012) Astrid E. Lammers; Ian Adatia; María Jesús del Cerro; Gabriel Díaz; Alexandra Heath Freudenthal; Franz Freudenthal; S Harikrishnan; D. Dunbar Ivy; Antônio Augusto Lopes; J. Usha Raj
Los miembros del Task Force pediátrico del Pulmonary Vascular Research Institute (PVRI, su sigla en Inglés) fueron conscientes de la necesidad de desarrollar una clasificación funcional de la hipertensión pulmonar en niños. La clasificación que se propone sigue el mismo patrón y utiliza los mismos criterios de la clasificación de la hipertensión pulmonar específica para adultos de Dana Point. Fue necesario incluir modificaciones para los niños, teniendo en cuenta que la edad, el crecimiento físico y la madurez influyen en la expresión funcional de la enfermedad. Es necesario definir el estado clínico del niño, pues ello facilita revisar la evolución del mismo en una forma consistente y objetiva a medida que él/ella crecen. Particularmente en los niños más jóvenes, se trató de incluir indicadores objetivos como el crecimiento, la necesidad de alimentos suplementarios y los registros de asistencia al colegio y a la guardería. Esto ayuda a monitorear la evolución clínica y la respuesta al tratamiento a través de los años y facilita el desarrollo de algoritmos de tratamiento en estos pacientes. Se presenta un artículo de consenso sobre una clasificación aplicable a los niños con hipertensión pulmonar que se discutió en la reunión anual del PVRI que se llevó a cabo en Panamá en febrero de 2011. The members of the Pediatric Task Force of the Pulmonary Vascular Research Institute (PVRI) were aware of the need to develop a functional classification of pulmonary hypertension in children. The proposed classification follows the same pattern and uses the same criteria as the Dana Point pulmonary hypertension specific classification for adults. Modifications were necessary for children, since age, physical growth and maturation influences the way in which the functional effects of a disease are expressed. It is essential to encapsulate a child's clinical status, to make it possible to review progress with time as he/she grows up, as consistently and as objectively as possible. Particularly in younger children we sought to include objective indicators such as thriving, need for supplemental feeds and the record of school or nursery attendance. This helps monitor the clinical course of events and response to treatment over the years. It also facilitates the development of treatment algorithms for children. We present a consensus paper on a functional classification system for children with pulmonary hypertension, discussed at the Annual Meeting of the PVRI in Panama City, February 2011.
Consenso sobre la clasificación de la enfermedad vascular pulmonar hipertensiva en niños: Reporte del task force pediátrico del Pulmonary Vascular Research Institute (PVRI) Panamá 2011
(Elsevier BV, 2012) María Jesús del Cerro; Steven H. Abman; Gabriel Díaz; Alexandra Heath Freudenthal; Franz Freudenthal; S Harikrishnan; Sheila G. Haworth; D. Dunbar Ivy; Antônio Augusto Lopes; J. Usha Raj
Las clasificaciones actuales de la hipertensión pulmonar han contribuido significativamente al conocimiento de la enfermedad vascular pulmonar, han facilitado ensayos farmacológicos y han mejorado nuestro conocimiento de las cardiopatías congénitas del adulto; sin embargo estas clasificaciones no son aplicables completamente a la enfermedad en el niño. La clasificación que aquí se propone se basa principalmente en la práctica clínica. Los objetivos específicos de esta nueva clasificación son mejorar las estrategias diagnósticas, promover la investigación clínica, mejorar nuestro conocimiento de la patogénesis, de la fisiología y de la epidemiología de la enfermedad y orientar el desarrollo de modelos de la enfermedad humana en el laboratorio y estudios en animales; también puede servir como un recurso docente. Se hace énfasis en los conceptos de maladaptación perinatal, alteraciones del desarrollo e hipoplasia pulmonar como factores causantes de la hipertensión pulmonar pediátrica; así mismo, en la importancia de los múltiples síndromes malformativos congénitos, genéticos y cromosómicos en la presentación de la hipertensión pulmonar pediátrica. La enfermedad vascular pulmonar hipertensiva en niños se divide en diez grandes categorías. Current classifications of pulmonary hypertension have contributed a great deal to our understanding of pulmonary vascular disease, facilitated drug trials, and improved our understanding of congenital heart disease in adult survivors. However, these classifications are not applicable readily to pediatric disease. The classification system that we propose is based firmly in clinical practice. The specific aims of this new system are to improve diagnostic strategies, to promote appropriate clinical investigation, to improve our understanding of disease pathogenesis, physiology and epidemiology, and to guide the development of human disease models in laboratory and animal studies. It should be also an educational resource. We emphasize the concepts of perinatal maladaptation, maldevelopment and pulmonary hypoplasia as causative factors in pediatric pulmonary hypertension. We highlight the importance of genetic, chromosomal and multiple congenital malformation syndromes in the presentation of pediatric pulmonary hypertension. We divide pediatric pulmonary hypertensive vascular disease into 10 broad categories.
Developing High Medical Technology, a Challenge for Developing Countries: The Percutaneous Closure of Atrial Septal Defects Using Nit-Occlud ASD-R: Early and Mid-term Results
(SAGE Publishing, 2019) Alexandra Heath; Inge von Alvensleben; Joaquin Navarro; Gabriel Echazú; Rainer Kozlik‐Feldmann; Franz Freudenthal
The Nit-Occlud ASD-R device is safe and effective with very good closure rates.
Evaluation of a new hybrid technique for closure of muscular ventricular septal defects in a long-term setting
(Elsevier BV, 2009) Rainer Kozlik‐Feldmann; Nora Lang; Anja Lehner; Matthias Sigler; Christoph Schmitz; Ralf Sodian; Franz Freudenthal; Robert Dalla‐Pozza; N. V. Vasilyev; Pedro J. del Nido
Evaluation of a self-centering patch system for closure of muscular ventricular septal defects in a pig model
(Georg Thieme Verlag, 2010) Nora Lang; A Mever; Elisabeth Merkel; R Thalmann; Anja Lehner; Franz Freudenthal; Nikolay V. Vasilyev; Pedro J. del Nido; Heinrich Netz; Rainer Kozlik‐Feldmann
Objective: Closure of muscular ventricular septal defects (mVSDs) beyond the moderator band is still challenging. Recently, we established a new hybrid technique for closure of mVSDs on the beating heart. Here, we evaluated a self-centering patch system for this technique.
Functional Classification of Pulmonary Hypertension in Children: Report from the PVRI Pediatric Taskforce, Panama 2011
(SAGE Publishing, 2011) Astrid E. Lammers; Ian Adatia; María Jesús del Cerro; Gabriel Díaz; Alexandra Heath Freudenthal; Franz Freudenthal; S Harikrishnan; D. Dunbar Ivy; Antônio Augusto Lopes; J. Usha Raj
The members of the Pediatric Task Force of the Pulmonary Vascular Research Institute (PVRI) were aware of the need to develop a functional classification of pulmonary hypertension in children. The proposed classification follows the same pattern and uses the same criteria as the Dana Point pulmonary hypertension specific classification for adults. Modifications were necessary for children, since age, physical growth and maturation influences the way in which the functional effects of a disease are expressed. It is essential to encapsulate a child's clinical status, to make it possible to review progress with time as he/she grows up, as consistently and as objectively as possible. Particularly in younger children we sought to include objective indicators such as thriving, need for supplemental feeds and the record of school or nursery attendance. This helps monitor the clinical course of events and response to treatment over the years. It also facilitates the development of treatment algorithms for children. We present a consensus paper on a functional classification system for children with pulmonary hypertension, discussed at the Annual Meeting of the PVRI in Panama City, February 2011.
High Altitude May Protect Against the Early Development of Irreversible Pulmonary Hypertension in Patients With Congenital Heart Disease
(SAGE Publishing, 2025) Inge von Alvensleben; Brian B. Graham; Gustavo Balanza; Carlos Brockmann; Ermindo Barrientos Pérez; Ximena Vicente; C. A. Rosal Arteaga; Claudia Scherer; Franz Freudenthal; Rubin M. Tuder
Congenital heart disease (CHD) occurs at increased prevalence at high altitude, but there may be a paradoxical later onset of the development of Eisenmenger syndrome. We hypothesized that congenital heart disease patients at high altitude are protected from an early onset of irreversible pulmonary hypertension. We present a ospective observational case series study, supported by a PVRI grant, of patients in La Paz, Bolivia, located at 3600 m, who underwent surgery for CHD. 10 consecutive patients aged 5 to 29 years (mean 12) with left-to-right shunts and pulmonary hypertension underwent diagnostic catheterization to assess pulmonary pressure pre-operatively and six to 9 months postoperatively, and had a lung biopsy performed at the time of the surgery. Control lung tissue was obtained from patients living at the same altitude who underwent pulmonary hydatid cyst resection. 10 CHD patients and 4 control patients were analyzed. Pre-operatively, the patients had a significant response to hyperoxia with a fall in mean pulmonary pressure (mPAP) from 59.6 mmHg (SD 7.74) to 46.3 mmHg (SD 11.1); (<i>p</i> < 0.05). Postoperatively, the patients had an excellent response to surgery, with a mPAP of 26.4 mmHg (SD 6.42) (<i>p</i> < 0.05 vs. preoperative pressures). Analysis of the lung histology did not show evidence of pulmonary vascular remodeling in the CHD patients compared to the control patients. During the follow-up in up to 11 years, pulmonary pressure assessed by echocardiography remained normal. In conclusion, chronic hypobaric hypoxemia at high altitude may delay the development of pulmonary vascular disease in CHD patients.
Preclinical evaluation of a new self‐expanding device for closure of muscular ventricular septal defects in a pig model
(Wiley, 2009) Nora Lang; Christoph Schmitz; Anja Lehner; Franziska Fuchs; Alexandra Heath; Franz Freudenthal; Bernd J. Wintersperger; Armin Huber; Eckart Thein; Heinrich Netz
Our preclinical study shows successful closure of iatrogenic created mVSDs without residual shunting. The device is characterized by a more controlled deployment, an independent deployment of disk and waist, and a good alignment of the left ventricular disk to the muscular septum.
Repair of posterior mitral valve prolapse with a novel leaflet plication clip in an animal model
(Elsevier BV, 2013) Eric N. Feins; Haruo Yamauchi; Gerald R. Marx; Franz Freudenthal; Hua Liu; Pedro J. del Nido; Nikolay V. Vasilyev
Three-Dimensional Echo and Videocardioscopy-Guided Atrial Septal Defect Closure
(Elsevier BV, 2006) Nikolay V. Vasilyev; Joseph F. Martinez; Franz Freudenthal; Yoshihiro Suematsu; Gerald R. Marx; Pedro J. del Nido
Transcatheter closure of large patent ductus arteriosus at high altitude with a novel nitinol device
(Wiley, 2011) Alexandra Heath; Nora Lang; Daniel S. Levi; Miguel Granja; Jorge Villanueva; Joaquin Navarro; Gabriel Echazú; Rainer Kozlik‐Feldmann; Pedro J. del Nido; Franz Freudenthal
The Nitocclud PDA-R device is safe and effective and can easily close very large PDAs. This device has a high rate of complete occlusion within 1 year and is easily retrieved if embolized.
Use of a ductal occluder device as a test and then permanent closure of a large ductus arteriosus with increased pulmonary vascular resistance: a case report
(Cambridge University Press, 2025) Nelly Rocío Fabiani Hurtado; Alexandra Heath‐Freudenthal; Inge von Alvensleben; Gabriel Echazú; Franz Freudenthal; Abraham Rothman
A 3-year-old girl with a large ductus arteriosus had increased pulmonary vascular resistance at cardiac catheterisation. Test occlusion of the ductus arteriosus with a Nit-Occlud PDA-R device and hyperoxia decreased the pulmonary arterial pressure to < 50% of systemic level. The ductus was closed with the same device. Two years later, an echocardiogram showed normal pulmonary arterial pressure.
Weaving Indigenous Textile Art Into Cardiac Devices
(American Medical Association, 2018) Alexandra Heath; Alexander J. Javois; Franz Freudenthal
This Arts and Medicine essay describes how indigenous Aymara women in La Paz, Bolivia, are using traditional weaving techniques and patterns to create cardiac devices for occlusion of large congenital heart defects in children.