Page 30 - Journal of Structural Heart Disease - Volume 1 Issue 2

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Meeting Abstracts
#0065
AMPLATZER SEPTAL OCCLUDER VERSUS FIGULLA ASD OCCLUDER: A COMPARATIVE STUDY FOR PERCUTANEOUS CLOSURE OF ATRIAL SEPTAL DEFECTS. SINGLE CENTER EXPERIENCE
Vakhtang khelashvili, Lilia Kapanadze, Ekaterine Kapanadze The Jo Ann Medical Center, Tbilisi, Georgia
Objectives: Occlutech Figulla ASD Occluder (FSO), a later-generation double-disk device, is an alternative device to Amplatzer Septal Oc- cluder (ASO) with some structural innovations including increased flexibility, minimizing the amount of material implanted, and ab- sence of the left atrial clamp. We report our experiences with FSO and compare the outcomes of this device versus ASO.
Interventions: Between December 2002 and February 2015, 161 patients diagnosed with secundum atrial septal defects underwent transcatheter closure. The FSO device was used in 32 patients, and the ASO was used in 129. A mean age of 23.4 ± 16.1 years (median age 17 years, range 4–74 years) underwent percutaneous closure of mod- erate-to-large secundum ASD. Implanted ASO devices were in range from 10 mm to 38mm; implanted FSO devices devices were in range from 10.5 mm to 36mm; The ASO devices were delivered through a 7 Fr to 13 Fr sheath; the FSO devices were delivered through a 7 Fr to 12 Fr sheath.
Results: Patient characteristics, stretch size of the defect, device left disc size, procedure, and fluoroscopy time were similar between the groups. However, the difference between device waist size and stretched diameter of the defect was significantly largerer, and device delivery sheath was significantly larger in FSO group and device left disc size was significantly lower in the FSO group. In all patients, the residual shunt was small to trivial during follow-up and the reduction in prevalence of residual shunt with time was similar in both groups. We found no differences in complication rate between the two devic- es. The success rate using either device was excellent (ASO 97.8 % and OFSO 98.4 %). There were no significant differences between the ma- jor and minor complications when comparing the two devices. There were no significant differences of a fluoroscopic time. Both devices were safe and effective for percutaneous ASD closures.
Conclusions: Both devices are clinically safe and effective in ASD clo- sure. ASO device has similar outcomes when compared to FSO de- vice.
#0066
VASCULAR ACCESS RELATED ADVERSE EVENTS IN A MULTICENTER COHORT: A REPORT FROM THE CONGENITAL CARDIAC CATHETERIZATION PROJECT ON OUTCOMES (C3PO)
Sara Trucco1, Jacqueline Kreutzer1, Lisa Bergersen2, Susan Foerster3
1Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA 2Boston Children's Hospital, Boston, MA, USA
3Children's Hospital of Wisconsin, Milwaukee, WI, USA
Objectives: To describe the prevalence of and identify risk factors for vascular access related adverse events (ARAE) in patients undergoing pediatric cardiac catheterization in a large multicenter cohort.
Background: ARAE are a known complication following pediatric cardiac catheterization. Prevalence and predictors of ARAE in a large multicenter cohort have not previously been described.
Methods: Patient and procedural characteristics during cardiac cath- eterization were collected prospectively from 8 centers using the Congenital Cardiac Catheterization Project on Outcomes (C3PO) web-based registry. All ARAE were independently reviewed and clas- sified by a 5 level severity scale.
Results: 14,461 cardiac catheterization procedures were performed, which included 33,058 access events. 351 ARAE were identified in 341 cases, with a procedural prevalence of 2.4%. High severity (level 3, 4 or 5) ARAE were reported in 57 (16.2%) cases, of which 6 (1.8%) were severity level 4. There were no access-related deaths. The most common ARAE included pulse loss (140, 39.9%), groin hematoma (63, 18%), and rebleed after bandages applied (70, 19.9%). Associated univariate patient risk factors included: younger age (p=0.002), lower weight (p<0.001), and single ventricle physiology (p<0.001). Addi- tionally, low mixed venous and low systemic oxygen saturations were associated with higher rates of ARAE in both the single ventricle and non-single ventricle subgroups. Procedural variables including need for an intervention, length of the procedure, and largest venous or arterial sheath/weight ratio were all associated with higher rate of ARAE (all P<0.001). Cardiac index, history of prior catheterization, and access site used were not statistically significant.
Conclusions: ARAE occurred in 2.4% of pediatric cardiac catheteriza- tions and were more likely in smaller children, SV physiology, and low- er mixed venous and systemic saturations. Procedurals risks included need for intervention, length of procedure, and use of larger venous or arterial sheaths. These data provide a valuable baseline for the de- velopment of future ARAE prevention and treatment strategies.
#0067
RESULTS OF COIL CLOSURE OF PATENT DUCTUS ARTERIOSUS USING A TAPERED TIP CATHETER FOR ENHANCED CONTROL
Rajiv Devanagondi1, Larry Latson2, Sharon Bradley-Skelton3, Lourdes Prieto3
1Golisano Children's Hospital, Rochester, NY, USA
2Joe DiMaggio Children's Hospital, Hollywood, FL, USA 3Cleveland Clinic Foundation, Cleveland, OH, USA
Background: Transcatheter coil occlusion has traditionally been used for small patent ductus arteriosus (PDA) closure. Various techniques have been devised to enhance coil control and prevent embolization. Since 1995, we have delivered coils via 5 Fr modified vertebral cathe- ters (MVC) tapered to a 0.033” distal tip for enhanced control during delivery and retrieval. We report embolization rates and efficacy with this technique.
Methods: Catheterization reports, angiograms, and echocardiograms were retrospectively reviewed for patients with PDA occlusion using the MVC from 2001 to 2014. Residual shunting was determined by angiography and echocardiogram within 24 hours post-procedure. Procedural success was defined as ≤ trivial angiographic and color Doppler echocardiographic shunt, no aortic or LPA obstruction, and absence of embolization.
19th Annual PICS/AICS Meeting Abstracts