Page 26 - Journal of Structural Heart Disease - Volume 1 Issue 2

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Meeting Abstracts
describe the first reported use of a drug eluting BVS in three patients.
Methods: Retrospective review of consecutive patients undergoing insertion of BVS. Outcome measures included procedural success, need for re-intervention and complications.
Results: Three patients were eligible for inclusion: (1) A newborn (3.0kg) with severe RPA stensosis, due to compression from an aneu- rysmal RV-PA conduit, post repair of type two common arterial trunk, (2) An 8 year old boy with pulmonary atresia/VSD and MAPCAs, and (3) An infant (4.1kg) with severe LPA stenosis in the setting of an LPA sling. In all three cases the procedure was technically successful with excellent relief of stenosis and no procedural complications. In Case 1 there was early restenosis due to either external pressure or early reabsorption of the stent. This responded to further BMS insertion. In Cases 2 and 3 the BVS has continued to perform well.
Discussion: BVS offers short-term relief of stenosis, radial support of the healing lesion and crucially, in children, the potential for long- term growth. This small case series suggest some variation in per- formance of BVS and greater experience is required to judge clinical utility.
#0054
FONTAN FENESTRATION CLOSURE WITH AMPLATZER DUCT OCCLUDER II DEVICE
Brian McCrossan, Kevin Walsh
Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
Background: Device closure of the Fontan fenestration is a well es- tablished catheter intervention. Most of the devices commonly used, and especially the Amplazer Septal Occluder, are relatively bulky. The ADO2 is a low profile, flexible, and inexpensive device that seems well suited to the Fontan fenestration. We report our experience of this novel technique.
Methods: A retrospective review of patients undergoing Fontan fen- estration closure with an ADO2 device. Outcome measures included procedural success, pre- and post- procedural differences in oxygen saturation and mean pulmonary artery pressure and complications.
Results: Over 34 month study period, 13 patients were eligible for inclusion. All procedures were technically successful. There was a sig- nificant increase in oxygen saturations (Mean= +12%, P<0.01) after fenestration closure but no significant change in mean pulmonary artery pressure (Mean= +0.5 mm Hg, p = 0.08). There were no proce- dural complications.
Conclusion: Fontan fenestration closure with the ADO2 device is a simple, short, and cost-effective procedure. Although there are no commercially available devices specifically designed for fenestration closure, the ADO2 characteristics recommend it to occlusion of vary- ing sizes and morphologies of Fontan fenestration.
#0055
MIDTERM RESULTS OF TRANS CATHETER CORONARY ARTERY FISTULA CLOSURE, IMPROVEMENT OF DILATED CORONARY ARTERY ORIGIN AFTER COMPLETE CLOSURE OF FISTULA
Hojjat Mortezaeian Langeroudi
Rajaie Cardiovascular,Medical and Research Center, Tehran, Iran
Background: The coronary artery fistula identifies a bypass pathway that connect the coronary artery to a chamber of the heart so called coronary-cameral fistula or any segment of the systemic or pulmo- nary circulation that called coronary arterio-venous fistula. Fistula enlarges over time, and induces complications such as steal from the adjacent myocardium, thrombosis and embolism, congestive heart failure, myocardial infarction, arrhythmias, and infective endocarditic, aneurysm formation, rupture, and sudden death, especially in older patients. The therapeutic goal is complete closure of the fistula with- out compromising the normal coronary blood flow and regression of dilated coronary artery origin to normal size.
Methods: 25 patients with age range of 2 months to 15 years old un- derwent percutaneous trans catheter closure between October 2007 and April 2015. Exclusion criteria were: fistulae with multiple connec- tions, and acute angulations that make catheter positioning difficult or impossible. Sites of origin of these fistulas were: RCA in 9 patients, LCA in 16 patients. Drainage sites of these fistulas were: right atrium in 6 patients, coronary sinus in 2 patient, right ventricle in 17 patients.
Results: Performed coils were included: cook coils in 6 patients, pfm coils in 14 patients, ev3 coils in 2 patients, ADO II in 3 patients. All pa- tients were considered to have successful procedure. Just in 1 patient procedure failed due to complete heart block so that, procedure was done in another time successfully. Follow-up studies by ECG, TTE and CT angiography and selective angiography showed complete occlu- sion in all patients with no evidence of recanalization and residual shunt and Improvement of dilated coronary artery origin, regression of dilated coronary artery origin to normal size. We administered low- dose aspirin (3 to 5 mg/kg/day) at least 6 months with clopidogrel (0.5-1 mg/kg/day) for at least 1month, In patients with persistent coronary artery dilatation (>8 mm) we continued low dose aspirin therapy until coronary artery diameter decreased to near normal size, although there is little available information concerning the risk of coronary thrombosis in this group.
Conclusions: In recent years increasing numbers of devices for thera- py of CAVF are available. Selection of device and technique for every patient varies based on many factors especially the anatomic char- acteristics of the fistula. We present our experience in occlusion of CAF in small pediatric patients with different and difficult anatomy of fistula and usage of different devices with both antegrade and retro- grade approaches. The midterm follow up of patients indicates that Trans catheter therapy is a safe and effective method of occlusion CAVF. Coronary CT angiography and selective coronary angiography are helpful in the assessment of complete fistula occlusion and im- provement of dilated coronary artery origin.
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ADO II IN PERCUTANEOUS VSD CLOSURE IN PEDIATRIC PATIENTS
Nazmi Narin1, Ali Baykan1, Ozge Pamukcu1, Mustafa Argun1, Abdullah Ozyurt1, Timur Mese2, Murat Yilmazer2, Isin Gunes3, Kazim Uzum1
1Erciyes University Pediatric Cardiology, Kayseri, Turkey
2Behcet Uz Children Hospital, İzmir, Turkey
3Erciyes University Anesthesiology, Kayseri, Turkey
19th Annual PICS/AICS Meeting Abstracts