Page 59 - Journal of Structural Heart Disease - Volume 1 Issue 2

Meeting Abstracts
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interventions can be performed safely with excellent results. We be- lieve that performing procedures in such an arrangement is safe, fea- sible, and has a positive economic impact on the patients' families and their state.
place the deployment of TAVRs as high as 50,000 worldwide. Differ- ences in size and morphology of the aortic root and surrounding anatomy are important considerations in determining which TAVR to deploy. 3D printing based off of patient images can be leveraged to create models for patient-specific surgical planning purposes.
An 82 year old female was diagnosed with severe aortic stenosis. Traditional measurements based on CT were inconclusive on size of TAVR for deployment. The decision was made to print an aortic model in a compliant medium with calcifications in a non-compliant medi- um. TAVR devices were deployed in the model to assist with device determination.
The multi-material, 3D print of the patient’s diseased aortic anato- my allowed physicians to perform two mock interventions on the patient-specific model with different TAVR specifications. From the results of the patient-specific, simulated TAVR deployment and in- formation traditionally available through conventional imaging, the clinicians selected the larger available TAVR device for future deploy- ment in the patient.
This case study and modelling process yield compelling results for pre-interventional planning in regards to TAVR deployment. Specifi- cally, representing the two tissue types, lumen and sclerosis, was an achievement through new 3D printing techniques. Integration of this rapidly developing technology within cardiovascular centers is rec- ommended for further study and validation
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INITIAL EXPERIENCE WITH NEW VIEWFLEX XTRA ICE CATHETER FOR MANAGEMENT OF STRUCTURAL CARDIAC LESIONS
Supawat Ratanapo, Paul Pommipanit, Zahid Amin
Children's Hospital of Georgia; georgia Regents University, Augusta, GA, USA
Objective: ICE catheter has proven to be a valuable tool to close atrial septal defects (ASD) and patent foramen ovale (PFO), left atrial ap- pendage and valvular lesions. We have started using Viewflex Xtra ICE (VICE) catheter to close ASD/PFO and placement of Melody valve. The objective of this study was to review our experience with this cathe- ter, its advantages and drawbacks compared to the Acunav ICE (AICE) catheter.
Methods: VICE) catheter can be introduced through an 11 F sheath. It has Agilis Sheath handle and large curvature radius that provides control over viewing angles and positioning. It has a single-handed, no lock control for full maneuverability, with excellent torsional and tip response. We reviewed our experience with this catheter for ASD/ PFO closure and its feasibility during Melody valve placement in the pulmonary position.
Results: There was learning curve in VICE maneuverability and opti- mal image acquisition. The imaging and color quality were excellent. Its large curvature radius hindered image acquisition during initial experience but overall was an excellent feature. Twelve patients un- derwent successful percutaneous ASD/PFO closure and two pts. had Melody valve placement. One patient had two devices placed. All cas- es were successful; there were no acute or late device related compli- cations. Mean age ranged 1.5 years to 64 years (mean, 34.03 ±25.02 and median, 30). Weight ranged from 11.96 kg to 152.1 kg (mean,
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TECHNICAL FACTORS
ANGIOPLASTY OF COARCTATION OF THE AORTA AND THE RISK OF RECURRENCE
Matthew Lisi1, Sung In Kim2, Scott Gillespie1, Robert Vincent1, Dennis Kim1, Christopher Petit1
1Emory University School of Medicine, Atlanta, GA, USA
2Emory University Rollins School of Public Health, Atlanta, GA, USA
Background: Balloon angioplasty (BA) is a common treatment for coarctation of the aorta (CoA), but is associated with recurrence (reCoA). Technical factors during initial BA of CoA may play a role in incidence of reCoA. We sought to identify procedural and patient fea- tures associated with freedom from re-intervention following BA.
Methods: All BAs for CoA from 2003 to 2014 were reviewed to obtain the minimum CoA diameter (MinCD), reference aortic diameter (Re- fAD), length of CoA, pressure gradient, balloon inflation pressure(BIP), maximal balloon diameter, balloon waist diameter, and presence of intimal disruption. The primary endpoint was reCoA. Variables were examined for association with re-intervention using Cox regression.
Results: We identified 175 pts who underwent BA (14 native, 161 post-surgical CoA) performed at a median age of 4.4 months (IQR 3.2, 8.3). Interventions were performed using median BIP of 10 atm (6, 12), balloon max: MinCD ratio of 2.1 (1.7, 2.5), balloon max: RefAD ratio of 1.1 (0.9, 1.2), and balloon waist: RefAD ratio (BWR) of 1.0 (0.9, 1.1). Following BA, 57 (32.6%) cases required re-intervention. Patient age ≤ 3 months was strongly associated with re-intervention (p < 0.001). Prior surgical repair, length of CoA, % stenosis, pressure gra- dient, and severe intimal disruption were not significantly associated with reCoA. BWR > 1 [HR =0.58 (95% CI 0.34, 0.99)] was also associ- ated with higher likelihood of re-intervention, independent of prior surgery, or length of CoA. Interestingly, native CoA and surgical CoA had equivalent rates of reCoA (p=0.52).
Conclusion: The diameter of the balloon waist at maximal inflation pressure is associated with risk of reCoA. In addition, infants ≤ 3 months of age at BA are at higher risk of reCoA. Native and post-sur- gical CoA seem to respond similarly to BA.
DURING BALLOON
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MULTI-MATERIAL 3D
INTERVENTIONAL TAVR PLANNING
Justin Ryan1, Randy Richardson3, Christopher Taylor3, Hursh Naik3, Kevin Brady3, Mitchell Ross3, David Frakes2, Stephen Pophal1
1Phoenix Children's Hospital, Phoenix, AZ, USA
2Arizona State University, Tempe, AZ, USA
3St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
Transcatheter Aortic Valve Replacement (TAVR) is widely becoming an accepted therapy for aortic stenosis. In the last 10 years, estimates
PRINTING
FOR PRE-
Journal of Structural Heart Disease, August 2015
Volume 1, Issue 2: 36-111