Page 80 - Journal of Structural Heart Disease - Volume 1 Issue 2

109
Meeting Abstracts
Memopart excentric pmVSD devices succesfully. There was an embo- lization in a pt with multiple mVSD. 2nd degree AV block was present and retrograde 48hs after corticoid therapy. There was no onset of new AV block on follow up.
Transcatheter VSD closure using devices in relation to VSD anathomy are effective and safe with a low incidence of minor and major com- plications at inmediate and mid-term FU
#0186
LONG TERM FOLLOW-UP POST CATHETER INTERVENTION FOR CRITICAL PULMONARY VALVE STENOSIS AND ATRESIA WITH INTACT VENTRICULAR SEPTUM. A 25 YEAR SINGLE INSTITUTIONAL EXPERIENCE UTILIZING VARIOUS TECHNIQUES
Athira Nair, Sunil Patel, Howard Weber
Penn State Hershey Medical Center, Hershey, PA, USA
Background: Various catheter interventions (I) and procedural suc- cess have been described for critical pulmonary stenosis (PS) or valve atresia with intact ventricular septum (PA).
Methods: From 1990- 2015, 62 patients (pts) underwent catheter I for PS or PA.
Results: The mean age at I was 3.6 days (range 0-69 days) and mean weight was 3.3kg (range 1.8-5.4). 51 pts (82%) had PS and 11 pts (18%) had PA via angiography. Early catheter I experience included 5 PA pts requiring stiff guide wire perforation (4 required arterial snare assistance technique). More recent experience included excimer la- ser perforation (0.9mm) in 9 pts while the remaining 48 pts required only a JR4 catheter and floppy tipped coronary guide wire. 40% had bipartite RV (bRV) vs 60% tripartite RV (tRV). There was 1 procedur- al mortality (1.6%). 60 pts (97%) required PGE1 pre I and 25 pts (40 %) post I. 11 of these pts (44%) required surgical BT shunts. Out of these pts, 6 (55%) required univentricular palliation(UniV). Fluoro exposure trended lower in those patients undergoing laser perfora- tion. In a multivariate analysis, initial TV Z score was an independent predictor for BT shunt placement but not UniV (-3.1; CI: -2.2 to -3.9 vs -1.9; CI:-1.3 to -2.5, p=0.017). Reduced PV Z score was found to be an independent predictor for both BT shunt placement (-1.6; CI:-2.1 to -1.1 vs -0.4; CI: -0.6 to -0.2, p<0.001) and UniV (-1.4;CI:-2.2 to -0.67 vs -0.5;CI:-0.8to -0.3, p=0.029). Mean follow up duration is 99 months (range 1-301 mths) and overall survival is 93%. 25 yr freedom from reintervention (FrI) for non- BT shunt was similar to pts requiring a BT shunt and subsequent BiV repair. 4 pts (7%) required late surgical pulmonary valve replacement (PVR).
Conclusion: Smaller TV annulus was an independent variable predic- tive for BT shunt placement. Smaller PV annulus is an independent predictor for BT shunt placement and subsequent UniV. There was a trend toward reduced fluoro exposure in those patients undergoing laser perforation. Overall 25 year survival for the entire cohort is ex- cellent with a low incidence of PVR.
#0187
THE FEASIBILITY AND FUNCTIONALITY OF ELIXIR PEDIATRIC SCAFFOLD IN THE CENTRAL ARTERIES OF A PORCINE MODEL
Damien Kenny1, Luiza dLima1, Nagarajan Ramesh1, Clifford Kavinsky1, Ziyad M. Hijazi2
1RUSH University Medical Center, Chicago, USA
2Sidra Medical Center, Doha, Qatar
Background: Polymer-based bioabsorbable scaffolds (PBBS) have been assessed for coronary artery revascularization in pre-clinical and clinical trials with excellent outcomes. However a PBBS designed specifically for growing arteries in pediatric patients has yet to be evaluated. The objective of this pre-clinical study was to compare the performance of the Elixir Pediatric Scaffold, a low profile larger di- ameter bioresorbable scaffold system, to a standard low profile bare metal stent (BMS) in the descending aorta and branch pulmonary ar- teries of weaned piglets.
Methods: A total of 42 devices ((Elixir pediatric scaffold 6x18mm, Elixir Sunnyvale, CA) and control BMS (Cook Formula 418 6x20mm, Cook Medical, Bloomington, IN)) were implanted in the descending aorta and pulmonary arteries of 12 female Yucatan miniswine pig- lets weighing approximately 5-10 kg. The position of the BMS and the Elixir Pediatric Scaffold within the aorta and respective branch pulmonary arteries was randomly selected and documented for each animal. Immediately prior to device deployment, initial angiography was performed and quantitative angiographic measurements were collected of the implantation vessels (ANOVA two-way followed by Bonferroni post hoc test). Follow up angiography was performed at 30 and 90 days post-device implantation to compare device patency and integrity.
Results: Aortic angiography demonstrated that both late lumen loss (LL) and percent diameter stenosis (%DS) were greater for the
19th Annual PICS/AICS Meeting Abstracts