Page 73 - Journal of Structural Heart Disease - Volume 1 Issue 2

Meeting Abstracts
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intervention. 97% of all families surveyed felt they were more at EASE with the use of this application and found it superior to traditional ways of updating them during invasive procedures. Overall, the app was rated 9.9/10 for overall experience with the EASE application.
Conclusion: Families found that use of the EASE application during cardiac interventions is an effective and superior supplement to the use of traditional methods of communicating with families during in- vasive cardiac catheterizations.
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PREVENTING ARTERIAL OCCLUSION AFTER CARDIAC CATHETERIZATION
Asra Khan, Dhaval Parekh, Linda Drake
Baylor College of Medicine, Houston, TX, USA
Background: Arterial occlusion is a relatively common complication seen in smaller patients. Arterial spasm and local injury can predis- pose to thrombosis and loss of arterial patency. Reported occurrence ranges from 4.3-5.4%, with low weight considered as a risk factor. Intra-arterial nitroglycerin reduces risk of radial arterial occlusion in adults. We reviewed the incidence of arterial occlusion after adminis- tration of femoral arterial nitrolglycerin (FAN) in patients weighing < 10 kg after cardiac catheterization.
Objective: Outcomes of patients weighing <10 kg who received FAN were reviewed. A retrospective review of the demographic, procedur- al data and outcomes was performed.
Results: Five patients underwent 6 procedures where they received FAN from November 2014-May 2015. Weight ranged from 2.3 kg – 9.1 kg, age ranges 20 days – 16 months. Procedures preformed were patent ductus arteriosus occlusion in 3 and hemodynamics in 2 pa- tients, with 3 or 4 Fr arterial sheaths. All patients received FAN before removal of arterial sheaths. Angiogram showed improvement in arte- rial spasm after FAN. Clinical follow-up revealed equal pedal pulses in the immediate post-procedural and follow-up period.
Outcomes: Administration of FAN reduced clinical loss of pulse in our cohort of patients < 10 kg. Although our population size was limited, FAN may be considered in patients at risk for arterial occlusion. A larg- er study is needed.
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BALLOON-EXPANDABLE COVERED STENT IMPLANTATION FOR TREATMENT OF TRAUMATIC AORTIC PSEUDOANEURYSM IN A PEDIATRIC PATIENT Martha E. Heal, Shahryar M. Chowdhury, Varsha M Bandisode Medical University of South Carolina, Charleston, SC, USA
Traumatic aortic injuries occur rarely in the pediatric population. Adult vascular interventionalists more frequently encounter aortic injury, and endovascular graft placement is a commonly used man- agement approach. The standard of care in pediatric traumatic aortic injury is an open surgical repair, although it is not always the optimal approach. Endovascular graft placement has been trialed in pediatric patients, but its use has technical limitations. We describe the case of an 8-year-old female passenger in a motor vehicle collision, resulting in formation of a traumatic aortic pseudoaneurysm. Due to her co- morbidities, she was a high-risk surgical candidate, and therefore, un-
derwent successful percutaneous implantation of an investigational balloon-expandable covered Cheatham platinum (CP) stent (NuMed, Inc., Hopkinton, New York). This case demonstrates the utility of bal- loon-expandable covered stents for treatment of pediatric traumatic aortic injury (TIA) as an alternative to open surgical repair or percuta- neous endograft implantation.
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ANDRASTENTS IN CONGENITAL HEART DISEASE: EXPERIENCE IN 36 PATIENTS
Ahmet Celebi, Ilker Kemal Yucel, Orhan Bulut, Sevket Balli, Neslihan Kiplapinar, Mehmet Kucuk
Dr Siyami Ersek Hospital for Cardiology and Cardiovascular Surgery; Pediatric Cardiology, Istanbul, Turkey, Istanbul, Turkey
Introduction: AndraStents are cobalt–chromium balloon expandable and hand mounted stents recently developed for large vessels. XL Andrastents can be expanded from 8 to 25 mm and XXL up to 32 mm. Our experience on AndraStents implantation for congenital and postoperative cardiovascular lesions will be presented.
Methods: Between 2012 and 2015, AndraStent XL and XXL were used in 36 patients for large vessel stenosis and prestenting of native RVOT before transcatheter pulmonary valve (TPV) by hand crimping on BIB or ZMed balloons.
Results: The mean patient age was 14.9 years (5–50 years), and the mean weight was 44 kg (15–84 kg). 40 stents were used in 36 patients; For aortic coarctation (AC) in 19, right ventricular outflow tract (RVOT) dysfunction in 19 and branch pulmonary artery stenosis in two. XXL was usually used for large RVOT and XL for AC. Of the 18 patients with RVOT dysfunction 14 of them were native, others were conduits. In coarctation patients two of them weighed less than 20 kg (15 kg and 17 kg). The mean diameter of the balloons used for implantation was 19.2 mm (8-30), and 10 of them were larger than 24 mm. The fore- shortening percentages were found to be similar to those claimed by the manufacturer on fluoroscopic images. The vessel diameter was increased from a median 4.5 mm to a median of 12.5 mm, and the pressure gradient was decreased from a mean 40 mmHg to a mean of 3 mmHg in patients with coarctation. Stent slipping on the bal- loon has occurred in one and fracture in one. A bare and a covered Cheatham-Platinum (CP) stent were implanted on the fractured stent, and then PPVI was performed.
Conclusion: AndraStents have several advantages over Cheatham platinum stents: Its material and design allow better tissue penetra- tion and better curve, and a lower crimping profile. Furthermore, XXL can be used with large aneurysmatic RVOTs since dilation up to 32 mm is possible. Sometimes can be used one Fr larger than the bal- loon shaft in lesions straight ways to reach such as AC, so it can be used in AC patients less than 20 kg in weight. A relatively low radial force, tendency to slipping of the balloon during the advancing in tortuous way and absence of a covered form are disadvantages when compared with CP stents.
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TRANSCATHETER CLOSURE OF SECUNDUM ASD WITH COCCOON SEPTAL OCCLUDER IN CHILDREN; EARLY AND INTERMEDIATE TERM RESULTS
Journal of Structural Heart Disease, August 2015
Volume 1, Issue 2: 36-111