Page 34 - Journal of Structural Heart Disease - Volume 1 Issue 2

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Meeting Abstracts
derwent cIMT measurement, of which 5 (71%) were abnormal. Eight pts underwent FMV, only 7 with interpretable data, of which 3 (42%) were abnormal. Eight patients underwent ABPM, only 4 with ade- quate data for interpretation. Three pts (75%) met criteria for ambula- tory hypertension, with 2 pts (50%) meeting criteria for severe ambu- latory hypertension. There was no significant association among CoA type or repair type with abnormal EST, cIMT, ABPM or FMV.
Conclusion: Pts with CoA demonstrate persistent arterial abnormal- ities despite adequate repair. CIMT is a validated predictor of future cardiovascular events in adults and was abnormal in 67% of pts. This is consistent with our hypothesis that these pts have abnormalities in their arterial endothelium which will place them at increased risk for future cardiac events at an early age. Further study is warranted in a larger population to better define this risk profile and reduce late morbidity and mortality.
#0075
RIGHT HEART FUNCTIONS IN ADULTS AFTER PERCUTANEOUS PULMONARY VALVE IMPLANTATION Cuizhen Pan
Zhongshen Hospital of Fudan University, Shanghai, China
Objective: Percutaneous pulmonary valve implantation (PPVI) is an efficient therapy for patients with severe pulmonary valve regurgita- tion who underwent cardiac surgery for Tetralogy of Fallot (TOF). In this study, we aimed to investigate the variation of right heart func- tion in PPVI patients in order to reveal the impact of PPVI on right heart.
Methods: Eight patients who underwent cardiac surgery for TOF in youth and had severe pulmonary valve regurgitation were enrolled. Patients accepted two-dimensional and three-dimensional echocar- diography examination before PPVI, 1 month, 3 months, 6 month, and 1 year after PPVI. Global right ventricle end diastolic/systolic volume (RVEDV/RVESV), body compartment of right ventricle end di- astolic/systolic volume, outflow compartment of right ventricle end diastolic/systolic volume, and inflow compartment of right ventricle end diastolic/systolic volumewere analyzed by three-dimensional echocardiography. The diameters of right atrium, and degree of tri- cuspid regurgitation were analyzed by two-dimensional echocardi- ography and color flow imaging.
Results:The right ventricle end diastolic area was significantly reduced at 1 month after PPVI, while right ventricle end systolic area reduced at 3 months after PPVI (p<0.05). Both RVEDV and RVESV showed sig- nificantly reduced at 6months after PPVI. The body compartment of right ventricle reduced significantly at 3 months after PPVI, while sim- ilar improvements of inflow and outflow compartment were found at 6 months after PPVI. The degree of tricuspid regurgitation was con- secutively reduced for 6 month after PPVI. Meanwhile, the diameters of right atrium showed consecutively improvement as well.
Conclusions: PPVI was efficient in improving right heart function in patients with severe pulmonary valve regurgitation after TOF surgery. The improvement of body compartment of right ventricle was earlier than that of inflow and outflow compartment after PPVI. The degree of tricuspid regurgitation and the diameters of right atrium were con- secutively improved after PPVI.
#0076
NOVEL HYBRID LARGE STENT IMPLANTATION THROUGH THE ASCENDING AORTA VIA RIGHT AXILLARY THORACOTOMY IN AN INFANT WITH AORTIC COARCTATION
Grace Bichara, Gustavo Dutra, Paulo Vasconcelos Silva, Jose Pedro Silva, Luciana Fonseca, Armando Mangione, Salvador Cristóvão
Beneficência Portuguesa de SP, São Paulo, Brazil
Objectives: To report a novel hybrid procedure for aortic recoarcta- tion in a low-weight infant performed via right axillary thoracotomy.
Case report: A 9 kg 6-month-old infant with aortic coarctation had had surgery at the age of 15-days and 45-days but he remained with 60mmHg transaortic gradient postoperatively. He has had a balloon aortoplasty but had not achieved a sufficient decrease in the tran- saortic pressure gradient (60 to 35mmHg). He was brought to the car- diac catheterization laboratory where a novel hybrid procedure was performed under general anesthesia.
The right axillary thoracotomy was performed and a 7F sheath was placed into the ascending aorta. He received 100UI per kilogram of heparin.
Stent implantation was performed using a Palmaz Genesis 1910 stent mounted on a 7x20mm powerflex balloon. During high-pres- sure-dilatation the stenosis-waist in the stent resolved at 6 atm and the pressure-gradient dropped from 60 to 0 mm Hg. Good immediate angiographic, clinical, and hemodynamic results were obtained .The final transaortic gradient was 0 mm Hg. There were no procedural complications. The patient was doing well at the 30-day and 6-month follow-up. The transaortic pressure gradient remained low (15 mmHg by echo). Reintervention has not been required so far.
Conclusion: Hybrid large stent implantation through the ascending aorta via right axillary thoracotomy is a safe and effective procedure as its performing in this 9 Kg infant has exemplified.
#0077
TRANSCATHETER NATIVE PULMONARY VALVE AND TRICUSPID VALVE REPLACEMENT WITH THE SAPIEN XT: INITIAL EXPERIENCE AND DEVELOPMENT OF A NEW DELIVERY PLATFORM
Sanjay Sinha, Daniel Levi, Morris Salem, Brian Reemtsen, William Suh, Jamil Aboulhosn
UCLA Mattel Children's Hospital, Los Angeles, CA, USA
Background: While the Melody valve is unable to be used for replace- ment of large pulmonary outflow tracts, the 29mm Sapien XT tran- scatheter valve, designed specifically for aortic valve replacement, can potentially be used in these large native outflow tracts. Tech- niques to enable off-label use of the Sapien XT valve for large diame- ter pulmonary and tricuspid valve replacement are described.
Methods: Use of the Sapien valve for transcatheter pulmonary and tricuspid valve replacement using both the commercially available Novaflex+ system and using a novel flexible delivery system (Fig 1) was reviewed. This customized flexible delivery platform was con-
19th Annual PICS/AICS Meeting Abstracts