Page 8 - Journal of Structural Heart Disease - Volume 1 Issue 2

37
Meeting Abstracts
Background: Elevated factor VII (FVII) level is a risk factor for throm- boembolic disorders. FVII R353Q polymorphism is associated with variation in plasma FVII levels with Lower levels are associated with the 353Q genotype compared with the 353R genotype .
Aim: The aim of the study was to investigate whether factor VII R353Q gene polymorphism is associated with the risk of development of ar- terial and venous thrombotic disorders.
Methods: A case control study was conducted on 97 subjects; 33 pa- tients with acute myocardial infarction (AMI), 34 patients with deep venous thrombosis(DVT) and 30 healthy controls. FVII R353Q gen- otypes were identified using restriction fragment length polymor- phism analysis.
Results: The homozygous FVII 353QQ genotype was present only in 3% of AMI, and the heterozygous 353RQ genotype was present in 12.1% and 20.6% of AMI and DVT patients respectively in comparison to 13.3% controls (odds ratio of AMI = 1.16, 95% confidence inter- val =0.2-5.9, p =1.0; odds ratio of DVT = 1.6, 95% confidence interval =0.4- 6.4, P =0.4).
Conclusions: Our findings suggest that the FVII R353Q polymorphism is not associated with increased risk of arterial or venous thrombosis.
Keywords: FVII R353Q polymorphism , AMI, DVT.
#0003 TRANSCATHETERPULMONARYVALVEIMPLANTATION IN NOT TYPICAL PATIENTS.
Roland Fiszer1, Malgorzata Szkutnik2, Jacek Bialkowski2
1 Silesian Center for Heart Diseaes, Zabrze, Poland
2 Medical University of Silesia, Zabrze, Poland
Introduction: Transcatheter pulmonary valve implantation become recently a modern treatment of postsurgical patients with right ven- tricular outflow tract (RVOT) pathology. Several standard require- ments should be completed as presence of circumferncial coduit/ho- mograft, favorable right ventricle outflow tract (RVOT) morphology with clinical indication for procedure .
Aim: To present our experience with implantation of Melody valve ( Medtronic Comp) in pulmonary position in not typical patients.
Material and methods: In selected 6 patient pulmonary valve implan- tations were performed from 08.2012 to 07.2014. All of them were after surgical correction of Tetralogy of Fallot (TOF) with increasing stenosis and/ or insufficiency of RVOT. Their age ranged from 12 to 40 (mean 24,5) years. Two of them had native RVOT with transannu- lar patch – 3 months before procedure prestenting of RVOT was per- formed as a landing zone creation (in one of them telescopic method in previously stented LPA ). Two another patients with homograft had primary absent pulmonary valve with huge MPA (one with LPA agen- esis). Another patient also with homograft had absent LPA . One 12 years old child had implanted surgically stentless biological valve in pulmonary position (Freestyle) and shortly after surgery severe pul- monary stenosis developed. Five procedures were performed from femoral access and one from jugular approach.
Results: In all cases Melody valve were implanted successfully with standard prestenting before procedures. Gradient RV-PA dropped
from 1-46 (mean 25,2) to 1-25 (mean 11,3) mmHg. There was one complication- stent migration of second prestenting stent to MPA in patient with TOF and absent pulmonary valve. Stent was secured and deployed in RPA with double balloon method. Fluoroscopy time ranged from 11-61 mean 32,3 minutes. During follow up good func- tion of implanted pulmonary valves was confirmed in echo in all pa- tients.
Conclusion: Melody valve implantation is demanding, but feasible procedure also in patients beyond classical indications.
#0004
RESULTS OF REDILATATION OF STENTS IN THE TREATMENT OF COARCTATION OF THE AORTA – SINGLE CENTER EXPERIENCE.
Jacek Bialkowski1, Malgorzata Szkutnik1, Roland Fiszer2
1 Medical University of Silesia, Zabrze, Poland
2 Silesian Center for Heart Diseases, Zabrze, Poland
Introduction: Nowadays stent implantation is the treatment of choice in selected patients (pts) with native coarctation of the aorta (CoA) or recoarctation after previous surgery (ReCoA). In certain situation (growth of the patient, neointima proliferation or planned stage stent dilatation) redilatation of previously implanted stent can be required.
Aim: To present results of stent redilatation in the patients with CoA and ReCoA.
Material and methods: Between VII 2003 and XI 2014 50 pts under- went stent redilatation: 40 with CoA and 10 with ReCoA. The proce- dures were performed using high pressure balloons.
Data of pts are presented in the table Stent implantation (SI)
CoA 40 pts
ReCoA 10 pts
Age (years)
Gradient before SI (mmHg)
Gradient after SI (mmHg)
Stent redilatation (SR)
Time from SI to SR (months)
Gradient before SR (mmHg)
Gradient after SR (mmHg)
24,7 (6,5-53) 50,5 (20-94)
17,1 (0-63)
13,5 (4-36) 22,2 (9-59) 8,5 (0-38)
33,8 (10-65) 50,3 (30-111)
22,1 (0-36)
29,7 (6-108) 39,8 (10-65) 23,5 (0-52)
Results: The procedure of SR was ineffective (residual pressure gradi- ent > 20 mmHg) in 3 from 40 pts (7,5%) with CoA and in 4 from 10 pts (40%) with ReCoA, because of stiff lesion (p=0,023 ). No significant complication (stent fracture, aneurysm formation etc) were observed in any patients during follow-up.
Conclusion: Stage treatment of CoA and ReCoA with SI and than SR
19th Annual PICS/AICS Meeting Abstracts