Page 15 - Journal of Structural Heart Disease Volume 2, Issue 6

Meeting Abstracts
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there was growth of the left heart with successful uncomplicated 2nd stage procedure at 6 months and 10 months of age. One child had residual pulmonary artery stenosis post 2nd stage operation that required balloon pulmonary angioplasty. At 6 months follow up, both cases were doing well clinically and had normal function in echocardiogram. Both had mild sub-aortic stenosis with no obstruction or regurgitation.
Conclusion: The 2 patients in this series had successful initial pal- liation with a hybrid approach to the Norwood operation with no signi cant procedural complications or pleural e usions. Both sustained adequate growth of the left heart that subsequently allowed biventricular repair. Hybrid approach to the Norwood pro- cedure carries the advantage of avoiding cardiopulmonary bypass and early aortic arch reconstruction and should be considered for palliation of high-risk patients with HLHS, especially with Turner syndrome.
#0003
INITIAL EXPERIENCE OF ATRIAL SEPTAL DEFECT CLOSURE USING THE NEW GENERATION CARDIA ULTRASEPT IITM DEVICE IN MEXICO.
Roberto Mijangos
Pediatric Hospital, Tuxtla Gutiérrez, Chiapas, Mexico
We present the initial experience in Mexico of atrial septal defect closure using the new Cardia Ultrasept IITM device. We present a series of 5 patients with ASD previously selected as candidates with favourable anatomy (less than 38mm defect, rims greater tan 5mm) to be subjected for closure of the defect through interventionism treated in the period April-August 2016. Prospective, observational, transverse and descriptive study. The group included 3 female patients (60%) with a mean age of 10 ±2.12 years. The haemody- namic and anatomical data were as follows: pulmonary artery sys- tolic pressure 25.2 ±3.5 mmHg, pulmonary to systemic ow ratio 2.78 ±0.52, septal defect diameter 17.78 ±6.18 mm, expanded defect diameter 20.7 ±6.56 mm. All septal occluder were delivered successfully. No residual shunt evidenced by angiography and int- racardiac echocardiography. At follow-up to one month, all patients showed complete closure of the defect and continuous decreased of right ventricular diastolic diameter (38.6 ±2.33 mm (Z-score 2.97 ±0.22) vs 34.26 ±3.13 mm (Z-score 2.46 ±0.33)) p=0.78. No compli- cations at follow-up have been reported. The new generation of the Cardia Ultrasept IITM device is a good alternative to percutaneously treat atrial septal defect.
#0004
RECONSTRUCTIVE SURGERY OF HYPOPLASIA OF THE AORTIC ARCH
Elnur Hasanov, Faig Mirzazada, Elnur Imanov, Shahmardan Danyalov, Nigar Suleymanzada, Samira Karimova, Vusala Kazimova
Pediatric Cardiac Surgery Centre, Baku, Azerbaijan
Objective: to evaluate the function of baroreceptors in patients after di erent types of surgical correction of hypoplastic aortic arch.
Materials and Methods: In this prospective cohort study evaluated the results of surgical treatment of 54 patients who underwent sur- gical treatment for aortic coarctation. The patients were divided into two groups according to the method of correction of the defect: reconstruction with the use of a modi ed reverse plasty of LPA (group I, n=27) and reconstruction using the “extended” anastomosis (group II, n=27 patients).
Results: the Postoperative period of observation was 25 (21-30) months. Spontaneous sensitivity of the baroreceptors differed between groups and was significantly higher in group II is 11.6 (10,5; 12,6) vs 9,1 (8,2;10,1) in group I, p -0,04. The velocity of pulse blood flow was also higher in group II 7,7 (5,8;9) (m/s) -1 compared to 6.5 (5,4;7,1) (m/s) -1 in group I and differed between groups P – 0,04.
Conclusions: Reduced sensitivity of baroreceptors in patients after a modi ed reverse plastic of the left subclavian artery may be regarded as the method of choice in patients with coarctation and hypoplasia of the arch as a method of reducing the frequency of arterial hyper- tension in the late postoperative period.
#0005
RECANNULATION OF LEFT PULMONARY ARTERY WITH RADIO-FREQUENCY PERFORATION AND STENT ANGIOPLASTY AFTER FAILED HYBRID STENT ANGIOPLASTY
Matthew Brown, John Breinholt
The University of Texas Health Science Center at Houston, Houston, TX, USA
An infant with pulmonary atresia and ventricular septal defect (VSD), s/p right-sided modified Blalock-Taussig shunt as a neo- nate, underwent VSD closure and placement of a 13 mm homo- graft right ventricle-to-pulmonary artery (RV-PA) conduit with augmentation of proximal branch pulmonary arteries at 9 months of age. After hospital discharge, there were concerns about flow into the left pulmonary artery (LPA), and he was referred for cath- eterization at 11 months of age, where he was found to have discontinuity of the left pulmonary artery (LPA). Transcatheter attempts at entering the LPA were unsuccessful, although he required stent angioplasty of right pulmonary artery branches. He was taken to the operating room (non-hybrid suite), where, after blind dissection and progressive dilation with Hegar dila- tors up to 3.5 mm, the surgeon positioned, and we deployed, a 16 mm long EV3 Intrastent Max LD stent mounted on an 8x20 mm Z-Med II balloon. A poor-quality C-arm angiogram, without the ability to record, demonstrated contrast to the end of the stent without flow in the LPA, indicating that the stent was extravas- cular. The patient was taken to cardiac catheterization lab, where simultaneous angiograms in the LPA stent and left pulmonary vein wedge injection demonstrated overlapping of the stent and the LPA. The Baylis Radio-Frequency system was used to perfo- rate from the blind end of stent into the LPA, allowing for pas- sage of the microcatheter into the LPA, followed by angiography in the LPA to confirm position. We then deployed a Palmaz Blue 7x15 mm stent over a V-18 wire, overlapping with the existing stent, resulting in patency of the LPA from the RV-PA conduit, and no extravasation of contrast. Follow-up echocardiograms, and
Journal of Structural Heart Disease, December 2016
Volume 2, Issue 6:241-306