Page 8 - Journal of Structural Heart Disease Volume 1, Issue 4

153
Meeting Abstracts
SURGICAL MANAGEMENT OF TRICUSPID ENDOCAR- DITIS IN DRUG ABUSERS: 10 CASES
Ben Youssef Atef1, Zairi Sarra2, Ghariani Zied2, Bousnina Mouna2, Gaied Dorsaf2, Ouerghi Sonia2, Kilani Tarek2
1 Department of Cardiothoracic and Vascular Surgery, Al Ahli Hospital, Doha, Qatar
2 Department of Thoracic and Cardio-vascular Surgery, Abderrahmen Mami Hospital, Ariana, Tunisia
Background: Tricuspid valve endocarditis is a common disease and represents 5 to 10% of cases of infective endocarditis. Invasive pro- cedures and intravenous drug abuse are the main causes. In recent years, we have noticed an increase in the number of patients man- aged for severe tricuspid valve endocarditis secondary to intravenous drug abuse.
Objective: To assess the management of tricuspid valve endocarditis secondary to intravenous drug abuse, in a surgical department.
Methods: We report 10 cases of tricuspid valve endocarditis in intra- venous drug-abuse patients, managed from January 2009 to Decem- ber 2013 in the Department of Thoracic and Cardiovascular Surgery in Abderrahmen Mami Hospital Ariana, Tunisia.
Results: The mean age of the patients was 31.24 years. Valve replace- ment with a bioprosthesis was performed in 7 cases and vegetation removal with tricuspid valvoplasty in 3 cases. The postoperative course was uneventful in 9 cases. During follow-up, re- current bio- prosthetic valve endocarditis and complete atrio-ventricular block occurred in 1 patient, requiring pacemaker implantation. One patient died with septic shock secondary to aspiration pneumonia.
Conclusion: Tricuspid valve endocarditis is an underestimated pathol- ogy and is often worsened by immune suppression. These patients should be systematically included in a postoperative rehabilitation program, in order to prevent recurrence.
TRANSCATHETER CLOSURE OF PATENT DUCTUS AR- TERIOSUS WITH THE AMPLATZER DUCT OCCLUDER IN SUB-SAHARAN AFRICA
Jean Claude Ambassa1, Kongnyuy Alfred1, Jacques Cabral Tantchou1, Mve Charles Mvondo1, Gianfranco Butera2, Alessandro Giamberti2
1 St. Elizabeth Catholic General Hospital Shisong Cardiac Centre, Cameroon
2 Department of Pediatric Cariology and Cardiac Surgery, San Donato, Italy
Background: During an 8 year period, a Cardiac Centre has been de- signed and developed in Sub-Saharan Africa. Three partners have worked towards the realization of this project: two Italian charities (Associazione Bambini Cardiopatici nel mondo and Cuore Fratello) and a local general hospital run by the Tertiary Franciscan Sisters of Bressanone. Two cardiologists, one anaesthesiologist, one cardiac surgeon and 18 nurses have been trained. A fully equipped centre for cardiac care (2 operating theatres, 12 ICU beds, one at panel Siemens catheterization laboratory, 38 beds in the ward, 6 neonatal beds and two outpatient clinics) have been developed by this Eu- ro-African collaboration.
Objective: The aim of this study was to analyse the safety and e cacy of percutaneous closure of patent ductus arteriosus (PDA) in symp- tomatic pediatric and adult patients in a Sub-Saharan African centre.
Methods: We conducted a retrospective study on 40 patients with clinically signi cant PDA. 29 were children aged between 2 and 17 years and 11 were adults aged between18 and 29 years. The proce- dure was carried out under deep sedation or general anesthesia with uoroscopic control. The Amplatzer Duct Occluder (ADO I) and Mus- cular ventricular septal defect devices were used. Physical examina- tions, 12 lead ECG, echocardiogram, and chest X-ray were performed prior to the procedure.
Results: In 2 patients, there were restrictive PDAs, whilst 17 patients had moderate PDAs with increased pulmonary ow and 21 patients had large PDAs. Pulmonary arterial pressures in these patients were between 75 and 100% of the systemic pressure, and 3 patients had Eisenmenger syndrome. Two patients had complications with device embolization, in one of whom the device was retrieved and was suc- cessfully closed with a muscular VSD device. In 1 patient, the embo- lised device needed surgical retrieval. In all patients, the ADO I and muscular ventricular septal defect were used. No problems occurred during long term follow-up.
Conclusion: Successful and safe percutaneous treatment of PDA can be performed in a centre in Sub-Saharan Africa. Collaboration be- tween developed countries and local developing institutions is man- datory to succeed and have long lasting results.
RAPID, RELIABLE RESOLUTION OF DUCTAL SPASM DURING PERCUTANEOUS DEVICE OCCLUSION OF PAT- ENT DUCTUS ARTERIOSUS BY A NOVEL PROTOCOL Rik De Decker1, Jenny Thomas2, Elmarie van der Merwe3, John Lawrenson4
1 Red Cross Children’s Hospital; Interventional and General; Child Cardiology
2 Red Cross War Memorial Children’s Hospital; Anaesthetist; Child Anaesthesia
3 Red Cross War Memorial Children’s Hospital; Surgery; Child Surgery
4 Tygerberg Children’s Hospital/Red Cross Children’s Hospital; Interventional; Pediatric Cardiology
Background: Ductal spasm is a rare, but important complication of device occlusion of patent ductus arteriosus (PDA). We describe a novel protocol that rapidly and completely reversed the spasm in 8 ex-preterm infants, who had ductal spasm during cath- eterizations for PDA occlusion.
Object and Purpose: Our objective was to develop a protocol for the recognition and safe management of ductal spasm during percuta- neous PDA occlusion.
Methods: Eight infants born with gestational ages between 25 and 34 weeks presented for transcatheter PDA occlusion between 13 and 67 months of age. All 8 had ductal spasm immediately before, during or soon after induction of anaesthesia, or only after entering the PDA with a catheter. After detection of the spasm, the anaesthetist, in each case: 1) changed the mode of anaesthesia from inhaled sevo urane
CSI Africa 2015 Meeting Abstracts