Page 70 - Journal of Structural Heart Disease - Volume 1 Issue 2

99
Meeting Abstracts
experience of closing multiple ASD with more than one ASO devices, effectiveness and follow up in a South American Hospital (Guaya- quil-Ecuador).
Methods: From June 2013 to May 2015, four patients (median age 47,6 years, median weight 48,5 Kg) went to closure of multiple ASD with more than one ASO devices under transesophageal echography (TEE) guidance.
Results: The chosen devices were 1 to 2 mm more than the diameter of the balloon sizing using the “stop flow” technique. In four patients were used 8 devices. The mean diameter of the large and small de- fects were 19,75 mm and 12,75 mm. The device mean diameters used were 20,5 mm and 14 mm. After the procedure all 4 patients had no residual shunt, there were no complications. One patient had mild mitral regurgitation, described previously in a transthoracic echog- raphy, with no modification after the procedure. The mean follow up were 9,75 months (5 to 18 moths).
Conclusions: The closure of multiple ASD with more than one ASO devices is an effective procedure with no complication described in this experience. Follow up is very important to guarantee the suc- cessful long-term outcome of the procedure.
ABC
Figure 1. Fluoroscopy of the procedure in one patient. A. Defects crossed with two size balloons. B. The large and de small device were deployed. C. Devices released.
#0160
PERCUTANEOUS OCCLUSION OF PERIMEMBRANOUS VENTRICULAR SEPTAL DEFECT: MID- AND LATE-TERM FOLLOW-UP
Fabricio Pereira1, Raul Arrieta2, Cleusa Lapa1, Cristina Ventura1, Paulo Menge1, Renata Cassar2, Cristina Melo1, Luziene Bonates1, Lucia Salerno4, Luiz Piccinini1, Cesar Esteves3, Juliana Neves1
1Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Recife, Pernambuco, Brazil
2Instituto do Coração - INCOR, São Paulo, São Paulo, Brazil 3Instituto Dante Pazzanese de Cardiologia - IDPC, São Paulo, São Paulo, Brazil
4Hospital Esperança, Recife, Pernambuco, Brazil
Background: Percutaneous occlusion of perimembranous ventricular septal defect (pmVSD) has been an option to handle it, with good and safe early results. In other hand there is little data on long-term follow up (FU)
Objectives: To determine safe and effectiveness of pmVSD percuta- neous closure and its complications in mid- and late-term follow up.
Methods: Prospective, nonrandomized study including 60 patients (62,7% female) submitted to percutaneous occlusion of pmVSD from
June/09 to May/15. Mean age 9.9 ± 6,6 years and mean weight 32,4 ± 18,7 Kg. Most procedures were performed under sedation, guid- ed by transthoracic echocardiography (TTE). PmVSD was retrograde crossed. Electrocardiography was performed during the first two days, and then 1, 3, 6 and 12 months and every year thereafter. Echo- cardiography was performed looking for residual shunt and aortic insufficiency annually.
Results: Mean pmVSD diameter was 6.1 ± 2,2mm, which 40% was multi fenestrated VSD, Four different devices were used – Cera Lifetch (n=48), Shsma Lepu (n=9), Flipper (n=2) and Nit Occlud (n=1). 40% had residual shunt immediately after procedure, however during fol- low up there was only 13% of minimal or mild shunt (90% of multi fenestrated VSD). Coil devices showed high frequency of residual shunt (67%). There were 14 cases of FU loss (23%). Median FU time is 2,4 years (1 month - 5 years). Although 14% had some arrhythmia, only one pt was submitted to pacemaker implantation, and half of them were back to sinusal rhythmus before 6 months of FU. Three pts had aortic insufficiency, two mild insufficiency without worsening during follow up and one underwent to aortic valvuloplasty due to noncoronary leaflet perforation.
Conclusions: Double disk device occluders showed to be safe and efective, with low incidence of significant arrhythmya or aortic insuf- ficiencies in mid and long term follow up.
#0161
STENTING DUCTUS ARTERIOSUS AS INITIAL PALLIATION FOR DUCT-DEPENDENT CONGENITAL HEART DISEASE: EARLY OUTCOME AND FOLLOW-UP Juliana Neves1, Fabricio Pereira1, Raul Arrieta3, Cristina Ventura1, Adriana Quaresma1, Tereza Pinheiro1, Jessica Marinho1, Fabiana Aragão1, Catarina Cavalcanti2, Wyndira Andrade1, Cleusa Lapa1
1Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Pernambuco, Brazil
2Pronto-Socorro Cardiológico de Pernambuco, Recife, Pernambuco, Brazil
3Instituto do Coração, São Paulo, São Paulo, Brazil
Stenting the ductus arteriosus for congenital heart disease with duct-dependent pulmonary circulation is an alternative to surgical palliation due to its lower morbidity and risk of complications. This study aims to analyse the safety of stenting the ductus arteriosus, de- termine risk factors influencing its complications and the mid term follow-up until a surgical approach if necessary.
Method: Retrospective analysis of medical records in 80 (58,7% males) children in whom stenting of the ductus arteriosus (DA) as ini- tial palliation were performed from April 2007 to May 2015.
Results: The mean age was 91.4 days (SD 194.2) with a median of 19 days at the time of the procedure. 53.8% were neonates. The aver- age weight was 3.5 kg (SD 1.73). 20% of patients have some other underlying disease; prematurity being the most frequent (7.1%) and 74.6% were in ICU support. The following diagnoses were identified: transposition of the great arteries (6.4%), pulmonary atresia or crit- ical pulmonary stenosis (34.6%), pulmonary atresia with ventricular septal defect (VSD) (32,1%), univentricular heart (26.9%). Success was achieved in 92.4% of procedures with two (2,5%) deaths related
19th Annual PICS/AICS Meeting Abstracts