Congenital structural heart defects are more frequent at higher altitudes possibly because of effects of low oxygen tension on pulmonary vascular resistance.1 As pediatric cardiologists living in La Paz, Bolivia (altitude, 12 000 feet [4000 m]), we frequently encounter children with large functionally limiting defects—primarily patent ductus arteriosus with left atrial and ventricular dilation as large as the postductal aorta and atrial septal defects lacking appropriate borders for percutaneous occlusive therapy—that cannot easily be managed with commercially available devices. Because open corrective heart surgery is unimaginable for all but the most extreme cases in La Paz, Bolivia, we sought to develop an alternative percutaneous solution, a biocompatible occlusive device that would be durable across a lifetime of cardiac cycles.
Heath A, Javois A, Freudenthal F. Weaving Indigenous Textile Art Into Cardiac Devices. JAMA. 2018;319(10):966–967. doi:10.1001/jama.2018.0387
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