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La dilatation de la valve mitrale est une procédure de cardiologie interventionnelle qui consiste à dilater la valve mitrale. Elle permet de retarder la chirurgie cardiaque de remplacement valvulaire. Rheumatic mitral stenosis Mitral dilatation Mitral valve balloon dilatation Mitral dilatation The image on the left shows the balloon used for mitral dilatation (on the right) in angiography. MITRAL DILATATION What is mitral dilatation? Mitral dilatation is a procedure aimed at relieving the blockage to the filling of your ventricle. Following rheumatic fever contracted in the past, the mitral valve located between the left atrium and the left ventricle has narrowed due to "fusions" of its commissures, causing difficulty during heart filling and clinically the shortness of breath you feel. How is mitral dilatation performed? 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. You may wear your glasses, dentures, and hearing aids if needed. A small area of your groin will be shaved in case it is the access point for the procedure. 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 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. This examination is performed under X-ray control, at doses as low as possible. The doctor will administer a subcutaneous anesthetic in the vein of the right groin to reduce the sensation of pain. In some cases, general anesthesia will be performed, the goal of which is to guide the procedure using transesophageal echocardiography. The dilatation is performed using an inflatable balloon catheter via the femoral vein. This balloon is placed at the level of the mitral valve by passing from the right atrium to the left atrium after making an opening through the wall that separates these two atria (trans-septal puncture). The valve is then dilated by inflating the balloon to progressively larger sizes under echocardiographic control to achieve the best possible result. 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 with you the medications you are taking. If you have any doubts about a medication, you should notify the doctor before your visit. Can I eat and drink before this test? You must fast for 12 hours before 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. Are there any risks associated with mitral dilatation? Despite technical progress in equipment and the experience of doctors, mitral dilatation, like any invasive or surgical procedure, carries a risk of incidents or accidents: Allergic complications - Most often linked to the use of iodinated contrast product or local anesthetic. If you have ever had allergic reactions, it is essential to inform the doctor before the examination. Complications at the puncture site - These are rare. The most common complication is a hematoma which results in a bluish appearance, which can persist for several days but is usually without consequence. Exceptionally, surgical repair and/or a blood transfusion may be necessary. Cardiac complications - Mobilization of a clot that can lead to a stroke is exceptional. Injury to the heart envelope secondary to the creation of the hole between the two atria is rare and usually treated effectively by immediate drainage in the catheterization room (about 1%). Surgery is rarely necessary. A valve tear may occur (about 3% of cases). It is unpredictable but the risk is reduced by the use of echocardiography during the procedure. It may require surgery which is exceptionally necessary in an emergency. Failure of dilatation: The narrowing may be impossible to cross or dilate. The failure rate of the procedure is around 5 to 10%. In this case, a classic surgical intervention can always be considered in a second stage. What benefits can be expected from mitral dilatation? By allowing normal passage of blood between the left atrium and the left ventricle, mitral dilatation improves long-term outcomes and in particular reduces your shortness of breath. The progression of the disease means that the narrowing can recur at a distance. The average delay is 7 to 12 years. This restenosis can be treated by a new dilatation or surgery depending on the appearance of the valve. How long will I be in bed after the test? 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 for eating. After 4 hours of bed rest, you will be able to get up. You will spend the night under observation. Mitral stenosis Mitral valve dilatation 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 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

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 générale chez l'enfant. 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 Aortic coarctation stenting Angiographic images of aortic coarctation before and after stenting. AORTIC COARCTATION STENTING in children 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 can be present from birth (congenital coarctation) or develop later in life. The heart has to work harder to push blood through the narrowed part of the aorta. How to treat coarctation of the aorta? The interventional solution for coarctation of the aorta is stenting. Stenting reduces blood pressure in this area, thus relieving the heart and improving blood circulation . 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 . However, to perform this procedure, one must be able to ensure the accessibility of the femoral approach. The stent is introduced through the femoral artery, which must be of a good caliber. Generally, the stent can be considered after 8 - 10 years. In younger children, surgery will be discussed. In the neonatal period, for a rescue procedure, balloon dilation alone can be performed. Performing stenting of coarctation of the aorta: The child must fast for 12 hours before the examination. Stenting of the coarctation of the aorta 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 arterial punctures in the groin and inserts a thin catheter. The catheter is guided to the narrowed area of the aorta. The stent is deployed there to dilate the aorta. At the end of the procedure, compression is applied for about ten minutes at the groin level 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. Food 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 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 or occlusion 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. Antibacterial prophylaxis will be proposed in the event of risky extracardiac procedures during the 6 months following stent implantation. The child will be able to have a normal school life. He must continue the follow-up with his cardiologist, have a chest scan at 1 year. Depending on the child's growth, it may be necessary to repeat the procedure to dilate the previous stent or add a new stent. 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 map Assurance 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

La manoeuvre de Rashkind est une procédure de cardiologie interventionnelle de sauvetage chez le nouveau-né qui consiste à créer une communication interauriculaire pour permettre la vie. C'est une procédure d'urgence et vitale. Transposition of the great arteries Atrioseptostomy balloon The balloon measures 1 - 1.5 cm in diameter. RASHKIND ATRIAL SEPTOSTOMY What is the Rashkind atrial septostomie? The Rashkind atrial septostomy, also called Rashkind manoeuvre, is an interventional cardiology procedure performed as soon as possible after birth in newborns with transposition of the great arteries. In transposition of the great vessels, the pulmonary ("small circulation") and systemic ("large circulation") blood circulations occur in parallel rather than in series. The Rashkind maneuver aims to artificially create a wide communication between the right atrium and the left atrium. Performing the Rashkind maneuver: The procedure is performed as an emergency on a sedated newborn or under general anesthesia. A catheter with an inflatable balloon is introduced through the femoral vein or umbilical vein and directed into the left atrium via the foramen ovale. The balloon is inflated to enlarge this communication. The increase in arterial oxygen saturation assesses the effectiveness of the maneuver. Does Rashkind 's maneuver carry risks? Coronary complications : They can occur and represent the main cause of secondary mortality . Bleeding: As with any procedure, there is a risk of bleeding associated with the manipulation of blood vessels. Vascular damage: The catheter may damage blood vessels during insertion. Allergic reaction: The use of radiological contrast agents can cause allergic reactions in some patients. What benefits can we expect from Rashkind's maneuver? Rashkind maneuver allows better oxygenation of blood for efficient perfusion of organs and tolerating life. It is followed by cardiac repair surgery. Transposition of the great arteries Rashkind atrial septostomy 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 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 permet d'éviter les risques de la chirurgie classique de commissurotomie pulmonaire. Pulmonary valve stenosis Pulmonary valve valvuloplasty 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 adults Why are you being offered pulmonary valve dilatation? Pulmonary valve dilatation is a medical procedure 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 the tip through a vein and guiding it into the heart. Once inside the valve, the balloon is inflated and separates the valve cusps, allowing better blood flow . In rare cases, if balloon dilatation is not possible or effective, the pulmonary valve may be replaced with a bioprosthetic valve . 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 pulmonary valve dilatation: Pulmonary dilatation is performed in the catheterization room. The patient is conscious and lying flat. The doctor performs a venipuncture under local anesthesia at the groin. It is from this route that the doctor inserts a thin catheter into a large vein in the groin. 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, a pressure bandage is put on you and you will be asked to keep your leg straight for 4 hours. You can get up afterwards. You are usually discharged the next day. Are there risks associated with pulmonary valve dilatation? Despite technical advances and the experience of doctors, cardiac catheterization to dilate the pulmonary valve, like any invasive or surgical procedure, carries a risk of incidents or accidents: Allergic complications: Most often related to the use of iodinated radiological contrast or local anesthetic. If you have had allergic reactions before, 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 inconsequential. Cardiac and vascular complications: During the examination, discomfort, chest pain, or palpitations related to a rhythm disorder may occur. Serious complications, however, are very rare. What benefits can be expected from pulmonary valve dilatation? Pulmonary valve dilatation offers several benefits for patients: Improved shortness of breath during exercise: After the procedure, you should feel less shortness of breath during physical activities and in your daily life. Your ability to tolerate exercise should improve, allowing you to participate in activities for longer periods of time. Improved quality of life: Pulmonary valve dilatation can reduce anxiety and depression, promoting a better quality of life. 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 dilatation 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 using a bioprosthesis or by surgery using a mechanical valve. 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 map Assurance 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

La fermeture de communication interventriculaire (CIV) est une procédure de cardiologie interventionnelle qui consiste à fermer grâce à des prothèses la communication acquise ou congénitale entre les ventricules. Elle permet d'éviter les risques d'une chirurgie classique de fermeture avec patch sous circulation extracorporelle. Ventricular septal defect A 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. CLOSURE OF VENTRICULAR SEPTAL DEFECT in adults What is a ventricular septal defect? In the normal heart, the wall that separates the right and left ventricles, called the " interventricular septum ", is completely hermetic. A ventricular septal defect (VSD) is the presence of a more or less large orifice in this wall, allowing blood to pass directly from one ventricle to the other. VSDs can be congenital (i.e. present at birth) or acquired following a myocardial infarction. The consequences of this malformation depend essentially on the size of the communication and the speed at which it develops. A VSD following a myocardial infarction is generally very serious and its closure can only be considered if the patient's condition remains stable for one month. Congenital VSDs that occur in adulthood will require an evaluation by a right heart catheterization before deciding to close them. So why is the closure of VSD is being proposed? 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 . Improve quality of life: By closing the VSD, the patient's quality of life is improved by avoiding the symptoms associated with this malformation (shortness of breath). Implementation of the CIV Closure: Your examination takes 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. The procedure involves implanting a metal mesh prosthesis into the VSD. This flexible prosthesis is implanted by cardiac catheterization via a puncture of the femoral vein and artery under local anesthesia. General anesthesia may be performed if a transesophageal ultrasound is deemed necessary. In the absence of complications, the patient returns to his room and is monitored for 4 to 6 hours. Discharge is possible the next day after an ultrasound check. What are the complications of a VSD closure 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 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 prosthesis, which may require additional intervention, sometimes surgical. Cardiac complications after hospital discharge : Very rarely, displacement of the prosthesis 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 Closure of ventricular septal defect 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

Dr Réda JAKAMY Cardiologue interventionnel structurel Cardiologie pédiatrique et adulte Dr. Réda JAKAMY Interventional structural cardiologist The Jakamy Heart Center aims to be at the forefront of innovative treatments and patient-centered services. The motto of the Jakamy Heart Center is “expertise at your service”. Expertise is the commitment to continuing education for excellence in cardiovascular care. Serving patients requires the dedication of a team of medical and paramedical staff who actively participate in guaranteeing our patients the highest quality care. You can ask your questions or make an appointment in the contact section. Education Diplomas Silver Medal, Faculty of Medicine Laureate Paris VI Interventional cardiology Paris V Pediatric and congenital cardiology Bordeaux Publications ORCID Affiliations Moroccan Association of Private Cardiologists European society of cardiology European association of percutaneous cardiovascular intervention Pediatric and adult interventional cardiac symposium

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 récupération au lasso est une procédure de cardiologie interventionnelle qui consiste à retrouver du matériel embolisé dans la circulation sanguine. C'est une procédure sous anesthésie locale et évite le risque d'une chirurgie cardiaque ou vasculaire. LASSO SNARING What is a snare and what can it be used for? The snare is a catheter with a loop at its end that is intended for the recovery of intravascular or intracardiac material. The snare is generally used to retrieve the ends of central catheters or implantable chambers that have become detached, as illustrated below. How does a snaring procedure work? The procedure is performed under local anesthesia with the puncture at the groin or jugular level. A catheter is introduced to the material to be extracted then the snare is used to catch it and remove it. The procedure lasts about an hour. Discharge is possible the same day after a monitoring time determined by the doctor. What are the risks of the procedure? The risks are very low and related to any catheterization procedure. One can cite the hematoma at the puncture site especially. That said, the risk of remaining with intravascular material exceeds that of the snaring procedure. 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

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

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 !