Page 9 - Journal of Structural Heart Disease - Volume 1 Issue 2

Meeting Abstracts
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usually is effective method of treatment. In our experience failure of redilatation was observed more often in pts with ReCoA.
#0005
TRANSCATHETER PFO CLOSURE IN CHILDREN AND TEENAGERS AFTER PARADOXICAL EMBOLISM EVENT. Jacek Bialkowski1, Malgorzata Szkutnik2, Roland Fiszer2
1 Medical University of Silesia, Zabrze, Poland
2 Silesian Center for Heart Diseaes, Zabrze, Poland
Introduction: In adults, studies have demonstrated a significantly higher prevalence of patent foramen ovale (PFO) in patients with unexplained, paradoxical embolism event. In contrast such data in children and teenagers are spare.
Aim: To analyse clinical data and follow-up of youngster with PFO who underwent transcatheter PFO closure.
Methods: Between October 2001 and October 2014 seventeen pa- tients (7 males), aged between 12 and 20 years (mean 17,1 years ), had closed percutaneously PFO (from the group of 260 treated pts). All were qualified by neurologist taking in consideration presence of right –left shunt through PFO documented during Valsalva ma- noeuvre in transesophageal echocardiography (TEE) and contrast transcranial Doppler (c-TCD). The indication were in 8 pts transient ischemic attack (TIA), in 7 cryptogenic stoke (CS), in 1 peripheral sys- temic embolic event and in another 1 prevention before professional diving. Moreover before procedures in 6 pts headache were present. In all pts, but two nitinol wire mesh PFO occluders were implanted. In 2 pts double umbrella system was applied.
Results: The procedures were successfully completed in all patients and no complications were observed during hospitalization. During follow-up 1 pt have episode of recurrent TIA and in another one small residual shunt in control c-TCD was observed (without clinical consequence). In one pt treated with Amplatzer device paroxysmal atrial fibrillation occurred treated pharamacologically and 2 others patients continued to have headache.
Conclusions: Cryptogenic embolic events are rare in young patients. Transcatheter PFO closure should be considered in this group, al- though more investigation regarding this subject should be per- formed. C-TCD is sensitive, noninvasive method for PFO detection, proved in our experience particularly suitable for children.
#0006
TRANSCATHETER CLOSURE OF RUPTURED SINUS OF VALSALVA ANEURYSM WITH NEW TYPES OF NITINOL WIRE MESH PDA OCCLUDERS – SHORT AND MIDTERM RESULTS
Malgorzata Szkutnik1, Roland Fiszer2, Jacek Bialkowski1 1Medical University of Silesia, Zabrze, Poland
2Silesian Center for Heart Diseaes, Zabrze, Poland
Introduction: Ruptured sinus of Valsalva aneurysm (RSOVA) is a rare shunt lesion frequently treated percutaneously. Lately for this pur- poses have been used also Chinese PDA nitinol wire mesh devices very similar to Amplatzer Duct Occluder type I (ADO). Experience with this occluders is scant.
Aim: To present results of transcatheter closure of RSOVA with Chi- nese PDA occluders taking in consideration short and midterm re- sults.
Methods: From September 2010 to August 2014, 8 patients (pts) from 17 to 72 years old (mean age 40 y) have closed their RSOVA with niti- nol wire mesh PDA occluders (produced by 3 different Chinese com- panies). All but two pts had congenital sinus of Valsalva aneurysm. Two pts had acquired RSOVA after previous cardiac surgery (one after aortic valve replacement, another after surgery of tight subaortic ste- nosis – LVOTO). In all pts arterio-venous loop was created and PDA devices were implanted transvenously. There were used devices 2-6 mm bigger than orifice of RSOVA. There were 7 connection between right coronary or noncoronary sinus with right atrium and 1 between noncoronary sinus and right ventricle.
Results: All PDA devices (sizes from 12/10 to 18/16) were successfully implanted in RSOVA. In one pt with iatrogenic RSOVA (after LVOT op- eration) device have been retrieved because of massive aortic regur- gitation after implantation provoked by the device. In 72 y old wom- an, after aortic valve replacement, Chinese duct occluder was applied in proximal entrance to the RSOVA. Because of the presence of im- portant residual leak on the edge of the implant the procedure had to be supplemented by closing of the distal RV orifice of RSOVA with 10 mm Muscular VSD Occluder. In one pt after embolization of ADO to pulmonary artery and its transcatheter retrieval, bigger device (Chinese one) were applied. In another pt after ADO implantation 2 y later (during pregnancy) recanalization of SOVA occurred treated suc- cessfully by Chinese PDA occluder after delivery. In follow-up (ranged from 0,5 till 4 years) no complications were observed in any pt.
#0008
OUTCOME OF PEDIATRIC PATIENTS WHO UNDERWENT TETRALOGY OF FALLOT CORRECTION IN CORRELATION WITH THE SURGICAL TECHNIQUE USED IN RELIEVING RIGHT VENTRICULAR OUTFLOW OBSTRUCTION
Lorielyn Mandigma, Ma. Bernadette Azcueta, Corazon Estevanez
Philippine Heart Center, Quezon City, The Philippines
Introduction and Objectives: Before the advent of surgical interven- tion, about 50% of patients with Tetralogy of Fallot died in the first few years of life. In the advent of surgical repair, which includes clo- sure of the VSD and relief of right ventricular outflow tract (RVOT) ob- struction has greatly improved the long-term survival of TOF patients. Potential complications have been reported in operated TOF patients if they remain asymptomatic. The objective of this study is to deter- mine the outcome of pediatric patients who underwent tetralogy of fallot correction in relation to the surgical technique used in relieving right ventricular outflow tract obstruction (RVOT).
Methods: In this prospective study, 63 patients who underwent te- tralogy of fallot correction were included. Postoperative complica- tions of residual pulmonary stenosis, pulmonary regurgitation, and right ventricle systolic and diastolic dysfunction were determined and analyzed in correlation to the surgical technique used to relieve right ventricular outflow tract obstruction.
Results: Residual pulmonary stenosis was observed on all patients for
Journal of Structural Heart Disease, August 2015
Volume 1, Issue 2: 36-111