Page 25 - Journal of Structural Heart Disease - Volume 1 Issue 2

Meeting Abstracts
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3DTEE dataset was added for superior visualization of the system- ic AV valve. The registration of the datasets resulted in an accurate model for enhanced visualization of the cardiac morphology. Our experience shows the feasibility and proof of concept of printing 3D cardiovascular models derived from multiple imaging modalities. This approach has the potential to provide detailed and anatomically accurate 3D printed models. Further research is required to evaluate the use of these 3D models in decision-making for transcatheter or surgical interventions.
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PERCUTANEOUS PDA CLOSURE IN PRETERMS LESS THAN 2 KG
Nazmi Narin1, Ali Baykan1, Ozge Pamukcu1, Mustafa Argun1, Abdullah Ozyurt1, Adnan Bayram2, Kazim Uzum1
1Erciyes University Pediatric Cardiology, Kayseri, Turkey
2Erciyes University Anesthesiology, Kayseri, Turkey
Background and Aim: Preterms and low birth weights are the group that PDA is most common and intervention is most risky. Main aim of our study is to emphasize the effectiveness and safety of percutane- ous PDA closure in the infants less than 2kg.
Material Method: Between the dates July 1997 to October 2014 in our center 382 PDA closures were done. 18 patients less than 2kg were included in this study. Demographic and angiographic data of the patients were reported (Table 1, Table 2 respectively).
Results: All the patients were symptomatic and PDA was decided to be contributor of this medical state. The median patient age 32days. The median weight of patients was 1603gr(910-2000gr). Mean PDA diameter was 3.2±1.3mm. Morphology of PDA: type A in 7patients, type C in 9patients, type E in1, type B in 1 patient. Types of the devices used were:Cook coil in 2patients, ADOI in 2, ADOII in 3, ADOII-AS in 11 patients. There were no major complications reported. Left pul- monary arterial stenosis was detected in 4 patients which were all resolved in 6 months duration.
Conclusion: Preterm complications like chronic lung disease, necro- tising enterocolitis etc. increase the mortality and morbidity. Inorder to decrease the complications early intervention is required but sur- gery could be too risky. Because of the risks of surgery in the recent years interventional catheterization procedures are more commonly used.
Up to our knowledge it is the only study that discuss safety and ef- fectiveness of percutaneous PDA closure in the infants less than 2 kg. Patient population less than 2 kg are preterms and most have addi- tional health problems that the surgery could be dangerous but cath- eterisation can be used safely.
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HYBRID REHABILITATION OF THE NATIVE RVOT: PULMONARY ARTERY PLICATION FOLLOWED BY TRANSFEMORAL PULMONARY VALVE REPLACEMENT – COMPARISON WITH SURGICAL PVR.
Cyndi Sosnowski1, Thomas Matella1, Michel Ilbawi2, Massimo Caputo1, Damien Kenny1
1Rush University Chicago, Chicago IL, USA 2Advocate Christ Hospital, Chicago IL, USA
Background and objective: Historically the sole option for patients with a dysfunctional native RVOT requiring re-establishment of pul- monary competence has been surgical valve replacement. The objec- tive of this study was to compare early outcomes from our initial ex- perience with hybrid pulmonary valve replacement in which surgical plication of the main pulmonary artery is performed prior to trans- femoral pulmonary valve replacement, with a contemporary cohort of surgical PVR patients.
Methods: Retrospective chart analysis of all patients with a dilated native RVOT eligible for surgical pulmonary valve replacement over the past 36 months. Pre-procedural, procedural and post-procedur- al data were collected. The cohorts included patients with previous tetralogy of Fallot repair (n=12), previous intervention for congenital abnormality of the pulmonary valve (n=6).
Results: Eighteen patients with a dysfunctional native RVOT met crite- ria for pulmonary valve replacement during the designated time peri- od; 5 using the hybrid procedure (group 1: age, 22.8 +/-13 years) and 13 with cardiopulmonary bypass (group 2: age, 31 +/- 18.4 years). BSA was comparable between the two groups (p-value 0.843). Valve im- plantation was successful in all cases, with slight proximal migration of the transcatheter valve in one patient from group 1 during removal of the delivery system, requiring conversion to surgical valve replace- ment. Mean cardiopulmonary bypass time in group 2 was 134 min- utes. There was a trend seen towards shorter hospital stay in group 1 (mean length of stay 4.6 days vs 6.5 days for group 2 (p=0.12)). There was a significantly higher requirement for blood products in group 2 respectively (p=0.007). None of those patients in group 1 required inotropic support post-operatively whereas 54% of patients in group 2 required inotropic support for at least 1 day. All patients were extu- bated by post-operative day 1 with the exception of 1 patient from group 2 remaining intubated for 8 days. On median follow up of 1.4 months for group 1 and 9.2 months for group 2, the average peak gradient across the RVOT was 22 and 14.2 mmHg for groups 1 and 2 respectively (p=0.131) and the PI grade was no greater than mild for all patients in both groups.
Conclusions: Transfemoral hybrid pulmonary valve implantation fol- lowing RVOT plication provides a reasonable alternative to surgical pulmonary valve replacement, reducing morbidity and possibility of longer-term consequences of repeated cardiotomy. . Care must be taken when performing simultaneous pulmonary artery interven- tions as this may impact upon transcatheter valve stability.
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NOVEL USE OF A DRUG-ELUTING BIOABSORBABLE VASCULAR SCAFFOLD IN CONGENITAL HEART DISEASE: EARLY EXPERIENCE
Brian McCrossan, Colin McMahon, Kevin Walsh
Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
Background: The aim of catheter intervention for vascular stenosis is the restoration of lumen area and optimization of distal blood flow. Bare metal stent (BMS) insertion, particularly in infants, limits the ves- sel diameter potential. Design modifications to bioresorbable stents, resulting in polymer-based, drug eluting, bioabsorbable vascular scaffolds (BVS) have reportedly overcome some of these faults. We
Journal of Structural Heart Disease, August 2015
Volume 1, Issue 2: 36-111