Page 81 - Journal of Structural Heart Disease - Volume 1 Issue 2

Meeting Abstracts
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bioresorbable scaffold as compared with BMS at 30 days post device implantation (LL: 1.083±1.072 vs 0.1220±0.388; %DS: 17.89±19.14 vs 1.688±6.588, respectively; p<0.05). However, the late loss and percent diameter stenosis were comparable between groups at 90 days follow-up time point (LL: scaffold= -0.4325±0.4975 vs stent= 0.0325±0.1936; %DS: scaffold= -8.895±10.59 vs stent= 0.3600±3.456; p>0.05). There was no difference between bioresorbable scaffold and BMS in the pulmonary arteries at 30 day (LL: 0.4650±0.7654 vs 0.3160±0.3613; %DS: 7.884±12.45 vs 5.114±5.711, respective- ly; p>0.05) and 90 day (LL: -0.6075±1.344 vs 0.3675±0.1008; %DS: -11.50±25.32 vs 5.958±1.819, respectively; p>0.05) follow-up time points.
Conclusion: The Elixir pediatric bioresorbable scaffold maintains ves- sel patency in the descending aorta and branch pulmonary arteries comparable to a low profile BMS control at 90 days. It is hoped that further follow-up intravascular ultrasound and histopathological findings from this pre-clinical trial will provide the platform for clini- cal testing of the Elixir pediatric scaffold in infants and children with vessel stenosis in the setting of congenital heart disease.
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TRANSCATHETER CLOSURE OF PERIMEMBRANOUS VENTRICULAR SEPTAL DEFECTS USING AMPLATZER DUCTAL OCCLUDER TYPE -1
Hussein A. Abdullah, Zayir H. Khalid
Ibn Albitar Cardiac Center, Baghdad, Iraq
Objectives: To evaluate efficacy and safety of Amplatzer Ductal Oc- cluder type I in transcatheter closure of perimembranous ventricular septal defects (PM VSD) in different locations.
Patients and Methods: Between September 2013 and May 2015, 134 non-selected patients with PM VSDs were enrolled for transcatheter closure using ADO type I. Only patients with malalignment type VSD were excluded from this study. The mean age of patients was 9.5yrs (1 – 44yrs) and the mean weight was 19 kg (7 – 95kg).The peak and mean PA pressure were ranged from 20-75 mmgh and 10- 55 mmgh respectively. Anatomical locations were PM – Outlet in 14 patients , PM – Muscular in 78 patients and PM - Inlet in 42 patients. Of these defects, 3 patients had significant post- surgery residual shunt and one patient had dextrocardia with situs inversus. Fourteen patients found to have RVOTO and 6 patients had subaortic ridge which has been captured by the device. The procedures were done under deep sedation and TTE guidance. . Aortogram and LV angiogram were done before and after device deployment. Each patient was followed at 1 day , 1, 6 and 12 months post-closure.The mean period of follow up was 11 months(3 – 20 months).
Results: Aneurysmal septal tissue was found in 38% and prolapsed cusps in 35.8 % of patients( RCC in 20, NCC in 16 and both cusps in 12 patients) . Multiple defects were observed in 12 patients ; in 4 of them the defects closed by 2 occluders . Successful closure was achieved in 129/ 134 patients ( 96.2%) and complete closure was found to be 92.2% at 24 hrs. post closure & 95.5% & 97.7% at one month and 6 months respectively. The mean procedure time was 58 min (23 – 120 min) and the mean fluoroscopic time was 22 min (9 – 50 min ). Failure of closure was occurred in 5 cases ; 2 PM- outlet , 2 PM- inlet and 1 PM- muscular due to large defect with insufficient rims in 2 cases and aortic valve contact with new onset of AR in 3 cases. No major compli-
cations were reported at follow up including aortic valve insufficiency or complete heart block.
Conclusion: The ADO type I is suitable, effective and safe in closure of perimembranous VSD in different locations with or without aneu- rysm or prolapsed aortic cusps and has high rate of successful closure with no significant adverse events.
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TRANSCATHETER PATENT FORAMEN OVALE CLOSURE Sahar Elshedoudy
Tanta University, Tanta, Egypt
Introduction: Patent foramen ovale (PFO) is considered a risk factor for serious clinical syndromes, the most important of which is cryp- togenic stroke in the setting of paradoxic embolism. Optimal man- agement of patients with PFO and cryptogenic stroke is still debated; Moreover, data from long-term studies on large patient populations are lacking. Aim of the study is to assess The safety and feasibility of transcatheter PFO closure, its immediate and long-term clinical out- come.
Methods: We enrolled 20 patients (13 female, 7 male, mean age 43.0 ± 3.7 years) referred to our department over a 2 year period, all had PFO-related stoke, except one had severe, disabling, medication-re- fractory migraine eura, Criteria for intervention after routine investi- gations included: basal shunt and shower/curtain shunt pattern on transcranial Doppler (TCD) and transoesophageal echocardiography (TEE), Primary endpoints were death, recurrent stroke or TIA. Residual right-to left shunt (RLS) was monitored by TEE and TCD at 3 months and 6 monthes'follow-up.
Results: 20 consecutive patients underwent percutaneous PFO clo- sure for secondary prevention of stroke. Device malalignement was observed in one patient during the procedure and was realigned successfully. No peri-procedural or in-hospital complications, no re- current embolic events were observed within the first 12 months of follow-up. Of the 20 patients only one (0.05%) submitted to TEE or TCD at 3 months' follow-up, presented a residual small RLS.
Conclusion: Transcatheter PFO closure is associated with low inci- dence of in-hospital complications and low frequency of recurrent sroke at follow-up.
References: Percutaneous closure of patent foramen ovale in cry- togenic embolism. Meier B, Kalesan B, Mattle HP, et al. N Engl Med 2013;368:1083-91
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TRANSCATHETER
ATRIAL SEPTAL DEFECTS: RESULTS OF THE FIRST RANDOMIZED CLINICAL TRIAL BETWEEN THE OCCLUTECH FIGULLA FLEX-II AND THE AMPLATZER SEPTAL OCCLUDER
Ziyad M. Hijazi, Andreas Eicken, Ingo Dahnert, Younes Boudjemline, Horst Sievert, Martin BE Schneider, Tommaso Gori, Damien Kenny, John P. Cheatham, Jana Steinmetz
Transcatheter closure of secundum atrial septal defect (ASD) has be-
CLOSURE OF
SECUNDUM
Journal of Structural Heart Disease, August 2015
Volume 1, Issue 2: 36-111