Page 69 - Journal of Structural Heart Disease - Volume 1 Issue 2

Meeting Abstracts
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major complications. In group 4(n=11) improved oxygen saturation or RA decompression was achieved in all and there were no major complications.
Conclusions: Transcatheter atrial septal interventions to create or en- large an atrial communication is an effective procedure and can be performed safely.
ostium secundum atrial septal defects (ASD) because it is highly successful and has low morbidity and mortality rates. However, this method is challenging to perform in young children (<20kg) due to a higher risk of complication.
Aim: To present our unit’s experience in ostium secundum atrial sep- tal defect closure in children.
Method: Between March 2010 and October 2013, 36 children weigh- ing up to 20kg each underwent percutaneous closures of atrial sep- tal defects. In each case, the reason for performing ASD closure was significant hemodynamic repercussion. All patients underwent gen- eral anesthesia and were administered 3-5 mg/kg/day acetylsalicylic acid starting one week before the intervention and continuing for 6 months after the procedure. A single dose of cefazolin was given as prophylaxis against endocarditis. The recommended prophylaxis for endocarditis was maintained for 6 months. A transesophageal echo- cardiogram using a pediatric probe was performed in all patients.
Result: The procedure was successful in 100% of the patients. The smallest and the largest devices were sizes 14 and 28, respectively (mean=18). The device/weight ratio was less than in in 15 of the pa- tients (13.9%) and over 1 in 31 of the patients (86.1%). Supraventriu- clar tachycardia developed in two of the patients (9.6%); conversion with adenosine was used in one patient, and venous amiodarone was administered over a course of 24 hours in the other patient. Head- aches presented in four of the patients (11%), lasting from 7 to 25 days. No residual shunt was observed in 34 of the patients (94.4%), and there was a trivial residual shunt in two of the patients (5.6%). Fol- lowing the procedure, the right heart chambers of all of the patients became normal, and all patients clinically improved without further complications.
Discussion/Conclusions: Percutaneous closure of ostium secundum atrial septal defect in children weighing less than 20kg is indicated in cases where there are significant hemodynamic repercussions or when a septal defect gradually becomes enlarged. Generally, in such circumstances, the atrial septal defect is considered to be large rela- tive to the child’s weight; therefore, the risk of complication is high- er. In our series, the procedure was successful in 100% of cases and produced no major complications. Percutaneous closure of ostium secundum atrial septal defects may be performed safely in children weighting less than 20kg. In our opinion, it is the method of choice for the treatment of this condition.
#0159
CLOSURE OF MULTIPLE ATRIAL SEPTAL DEFECT WITH MORE THAN ONE AMPLATZER SEPTAL OCCLUDER DEVICES, EXPERIENCE IN A SOUTH AMERICAN HOSPITAL
Boris Barreno1, Simon Duque1, Jhon German1, David Maldonado1
1Pediatric Hospital "Dr. Roberto Gilbert", Guayaquil, Ecuador 2Catholic University Of "Santiago de Guayaquil", Guayaquil, Ecuador
Background: The closure of multiple atrial septal defect (ASD) with more than one Amplatzer Septal Occluder (ASO) devices have been described, but there is a few publications relating the experience of this procedure in a South American Hospital. Objectives: Describe the
#0157
PERCUTANEOUS
DEFECTS (ASD/PFO) GUIDED BY INTRACARDIAC ECHOCARDIOGRAPHY (ICE)
Edmundo Oliveira, Marco Antonio Moura, Jose Augusto Barbosa
Hospital das Clinicas UFMG, Belo Horizonte - MG, Brazil
Background: The transesophageal echocardiography (TEE), has been the most used method to guide percutaneous closure of ASD/PFO. The necessity of a professional other than the one performing the intervention, who is not always available; the intolerance of the en- doesophageal probe in longer procedures and the necessity of seda- tion or general anesthesia and disadvantages of using ECTE. On the other hand, ICE makes possible both procedures been done by only one professional, under mild sedation or local anesthesia.
Objective: Shoing the experience of the service with occlusion of ASD/PFO guided by ICE.
Method: Between 04/2011 and 1/2015 201 procedures were done un- der ICE control. The probe was introduced through the femoral vein until right atrium, followed by delicate maneuver to get the wanted images. After that, the procedures followed the same steps used wh- jen they were guided by TEE. Finally, the sheaths were removed and manual compression waqs done for 5 to 20 minutes.
Results: The procedures were done with success in 201 (100%) pa- tients: 129 (64%) female, age of 7 to 78 years old (mean=36,6+19,3); weight 28 to 92 kg (mean+62,5+13);fluoroscopy time (mean=5.7+2,4 mi), procedure time (mean=21,5+6,4mi). Complications: Four pa- tient5s (2,0%) had transient arrhythmias and two (1,0%) had small arterio-venous fistula in the local of the punction, with spontaneous resolution in one month.
Conclusion: The images’ quality is fundamental to getting good re- sults and making the procedure safe. ICE provides this quality, asso- ciated with freedom of schedule. It has been an excellent option to guide these procedures.
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PERCUTANEOUS CLOSURE OF OSTIUM SECUNDUM ATRIAL SEPTAL DEFECT USING AN AMPLATZER DEVICE IN CHILDREN WEIGHING LESS THAN 20 KILOGRAMS
Edmundo Oliveira1, Marco Antonio Moura1, Jose Augusto Barbosa2, Zilda Maria Meira1
1Hospital Das Clinicas Ufmg, Belo Horizonte - Mg, Brazil
2Hospital Vila Da Serra, Belo Horizonte - Mg, Brazil
Percutaneous closure is the method of choice for the treatment of
CLOSURE OF
ATRIAL SEPTAL
Journal of Structural Heart Disease, August 2015
Volume 1, Issue 2: 36-111