Page 18 - Journal of Structural Heart Disease - Volume 1 Issue 2

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Meeting Abstracts
absence of vascular injuries demonstrated that the venous approach chosen was adequate and allowed to conclude the PDA closure suc- cessfully. 3) The learnig curve will give more conclusions.
#0033
EXPERIENCE IN THE CLOSURE OF PATENT DUCTUS ARTERIOSUS WITH NEW OCCLUTECH DEVICE. WHAT IS THE CORRECT POSITION OF THE DEVICE?
Veronica Vasquez, Juan Pablo Molina, Paul Escalante, Ximena Bermeo, Vladimiro Neira
Hospital Vicente Corral Moscoso, Cuenca, Ecuador
Patent ductus arteriosus (PDA) is one of the most frequent congenital cardiopathies associated with or without different clinical syndromes. Close the PDA using catheterization techniques with modern devices like “Occlutech” it is motive of controversy, since nowadays there isn’t consent about the best way to avoid it’s displacement and to achieve PDA’s complete occlusion. We share the following lab results.
Methods: Since July 2014 to April 2015 we have closed 10 PDA, by percutaneous approach with “Occlutech” device, in patients with clin- ical and echocardiography diagnosis of arterial duct. Mean age was 8 years (11 months to 21 years), and median weight was 17kg (6-40kg). In six patients with Down’s Syndrome, the pulmonary border of the arterial duct ranging from 2 to 11mm (median 5). We have classified the functional class according to the NYHA. The pulmonary arterial hypertension was classified: mild, pulmonary systolic pressure was 1/3 of the systemic blood pressure; moderate, when pulmonary sys- tolic pressure rose to 2/3 of the systemic pressure and severe, with more than 2/3. Krichenko’s classification was used. The selection de- vice size was calculated by the diameter of the ductus arteriosus pul- monary and pulmonary arterial hypertension. Patients were followed clinic, radiological and echocardiographic at 24 hours, 48 hours and a week after the procedure. The immediate residual shunt was classi- fied as mild; if contrast get the pulmonary ductal extreme, moderate; if rise to the pulmonary artery without delineating its valve, severe, if the whole valvular was delimited. The residual shunt was moderate in 80% of patients, with complete occlusion within 1 to 7 days (median 4 days). Placement device at the PDA aortic extreme in a convex way decrease the residual shunt and it is more likely complete occlusion. Complications were embolization of a device into the abdominal aor- ta, a patient who had a small arterial duct, in which convexity of the retention disc could not be achieved. Statistical analysis was done with SPSS 12 software.
Conclusion: It is our experience, the Occlutech device was useful for small and large PDA closing. Residual immediate shunt were mod- erate. Deformation of the device retention disc, in a convex way at the PDA, it is safe, in contrast with other devices. Research with larger number of cases are required in order to more effectively answer our clinical question.
#0034
REGRESSION OF TRICUSPID REGURGITATION AFTER PERCUTANEOUS PULMONARY VALVE IMPLANTATION Wenzhi Pan1, Daxin Zhou1, Cuizhen Pan1, Junbo Ge1, Qiling Cao2
1Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University,, Shanghai, China
2Sidra Cardiovascular Center of Excellence, Doha, Qatar
Introduction: Chronic severe pulmonary regurgitation (PR) can cause right ventricular enlargement and then functional tricuspid regur- gitation (TR). However, whether correction of PR by percutaneous pulmonary valve implantation (PPVI) can reduce TR is unknown. The objective of present study was to investigate the effect of PPVI on TR in chronic PR patients.
Methods: Patients with severe PR following surgical right ventricular outflow tract (RVOT) reconstruction were selected and implanted with a Venus-P Valve, which is consisted of a self-expanding, “double trumpet” shaped nitinol support frame and a trileaflet porcine peri- cardial tissue valve. The patients were evaluated with echocardiogra- phy at baseline and one, three months after procedure.
Results: Ten patients (aging 35.7± 8.3 years, seven females) were successfuly implanted with a Venus-P Valve. All patients had chron- ic severe PR because of previously surgical repair with RVOT recon- struction. Four patients had grade 2 and four had grade1 functional TR, while the other two didn’t have TR. The degrees of PR were all decreased to grade 0 at one month or three month follow-up, from grade 3 (N=5) or 4(N=5) at baseline (P<0.01). The trans-pulmo- nary-valve gradient at baseline, one month and three month fol- low-up was 20.1 ±14.0, 17.0± 6.0, and 17.5± 6.3 mmHg, respectively. The right ventricular end-diastolic area (RVEDA) was decreased from 34.2± 3.2 cm2 at baseline to 27.5± 6.6 cm2 (P=0.03) at one month fol- low-up and to 26.2± 5.2 cm2 (versus baseline, P=0.01) at three month follow-up. However, the right ventricular end-systolic area (RVESA) was not different among baseline (20.8 ±3.1 cm2), one month (18.3± 6.0 cm2) and three month (17.3 ±4.9 cm2) follow-up (P=0.35). The grade of functional TR was reduced from 1.2 ±0.9 at baseline to 0.8 ±0.9 (P=0.045) at one month follow-up, and to 0.5 ±0.9 (versus base- line, P<0.01) at three month follow-up.
Conclusions: PPVI could reverse right ventricular enlargement and then regress TR in severe chronic PR patients with functional TR.
#0035
CLOSURE OF SECUNDUM ATRIAL SEPTAL DEFECT WITH THE AMPLATZERTM ASO: RESULTS OF A 1000 PATIENT STUDY
Scott Lim1, Carl Owada2, Muhammad Khan3, Charlie Sang4, Dan Turner5
1University of Virginia, Charlottesville, VA, USA
2Valley Children's Hospital, Madera, CA, USA
3Driscoll Children's Hospital, Corpus Cristi, TX, USA
4East Carolina University, Greenville, NC, USA
5Wayne State University, Detroit, MI, USA
Objectives: To evaluate the safety and efficacy of the St. Jude Medi- calTM AMPLATZERTM Septal Occluder (ASO) for percutaneous closure of secundum atrial septal defects (ASD).
Background: The ASO is a self-expanding, double-disc nitinol wire mesh occluder for percutaneous closure of ASD. Concern has been raised about the potential for cardiac injury with the ASO, although the reported incidence is rare. This prospective study was developed as the first of a two-part study to evaluate safety and efficacy.
Methods: Subjects prospectively enrolled in a 1000 patient single
19th Annual PICS/AICS Meeting Abstracts