Page 17 - Journal of Structural Heart Disease Volume 2, Issue 6

Meeting Abstracts
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systemic ventricular systolic pressure (beta=0.4, p=0.004), aortic sys- tolic pressure (beta=0.3, p=0.007), aortic mean pressure (beta=0.3, p=0.02), and decreased ventricular shortening (p=0.03). Compared to those with pre-Fontan SVEDP ≤ 7 mmHg, patients with SVEDP > 7 mmHg had higher average ventricular systolic pressure (85.0 ± 7.5 mmHg vs. 78.7 ± 8.3 mmHg, p=0.003), higher average descend- ing aorta mean pressure (62.4 ± 4.9 mmHg vs. 58.6 ± 8.1 mmHg, p=0.03), and a higher incidence of decreased ventricular shortening (36% vs. 15%, p=0.07). The pre-Fontan SVEDP was similar between those with systemic RV (7.3 ± 2.0 mmHg) and systemic left ventri- cle (LV) (7.2 ± 1.8 mmHg) (p=NS). For those with a systemic RV, the SVEDP decreased signi cantly from pre-Stage 2 to pre-Fontan mea- surements (8.7 ± 2.6 mmHg vs. 7.3 ± 2.0 mmHg, p=0.02), but not for those with a systemic LV (7.8 ± 2.0 mmHg vs. 7.2 ± 1.8 mmHg, p=0.3).
Conclusions: In patients undergoing Fontan operation, pre-Fontan SVEDP was associated with decreased ventricular shortening and markers of systemic afterload. Systemic blood pressure may be an important determinant of SVEDP in this population. SVEDP decreased signi cantly after Stage 2 for those with systemic RV, but not for those with systemic LV; the systemic RV may be particularly vulnerable to pre-Stage 2 volume loading and bene t more than the LV from unloading at the stage 2 operation.
#0009
PERCUTANEOUS TRANSCATHETER CLOSURE OF PERIMEMBRANOUS VENTRICULAR SEPTAL DEFECTS IN ONE WORKING GROUP, LONGTERM FOLLOW UP Federico Borges1, Angelo Sparano1, Yudith Robles1,
Ernesto Urbano1, Manfred Hermanni1, Carlos Garcia1,
Rosa Zabala1, Guillermo Viloria2, Manuel Acuña1, Hugo Castro1, Roshec Bravo1, Ericson Ramirez1, Carlos Troconis3 1Hospital De Niños J.M. De Los Rios, Caracas, Venezuela
2Centro Medico Docente La Trinidad, Caracas, Venezuela 3Ucqne, Caracas, Venezuela
Our goal in this work was to evaluate the safety and e cacy of per- cutaneous transcatheter closure of ventricular septal defects (VSD), mostly perimembranous types (VSDpm) and long-term results. The VSD is the most common congenital heart disease. Transcatheter percutaneous closure have been a novel technique. Material and Methods: Between December 2004 and December 2013, 300 patients with medical record of VSD were admitted to our study, previously admitted to the cath lab at our center for percutaneous treatment of their VSD with various types of devices. All patients were followed until December 2013, 1 to 109 months. VSD type treated: perimem- branous (VSDpm) 93.85 % and muscular (VSDM) 6.14%. The VSD measures before the procedure by echocardiography or at cardiac cath ventriculography were 2 - 18 mm. Successful implantation of the device was 91.4 % in all attempted cases. The type of device used was Amplatzer 73.30 % and the Nit Occlud Coil 26.69 %. Complications were mostly minor, major complications were 2.49% including the late follow-up. They were complete AV block in 2 cases, 0.99 %; 2 cases need late surgery in the follow up secondary to the VSD closure procedure, 0.99 % and 1 case that required removal of the device in surgery because of Hemolysis 0.5 %. Conclusions: Percutaneous closure of VSD in experienced hands can be performed safely and
successfully with low morbidity and mortality. Long-term results are good; percutaneous closure of VSD is less invasive and could be taken as a reasonable proven alternative in the treatment of perimembra- nous ventricular septal defects as well.
#0010
USE OF SYMMETRICAL HYPERIOM PERI- MEMBRANOUS VSDO FOR PERVENTRICULAR CLOSURE OF MUSCULAR SEPTAL DEFECT
Justo Santiago, Sara Mendoza, Juan Gallego, Igor Donis, Javier Castro
Colombian Cardiovascular Foundation, Bucaramanga, Santander, Colombia
The per ventricular closure of the muscular interventricular septal defects it’s use in children with lightweight and it’s incrementing with more promising results everytime. The devices used have been occlusors designed for muscular septum, which possess a length of 7 mm. We described a case which is treated with this clo- sure mode through a new device designed for Perimembranous Ventricular Septal Defect in a 3 month old infant with 4,3 kg of weight and history of intrauterine growth retardation whom was diagnosed with the presence of muscular interventricular com- munication with length of 6 mm which is associated with the presence of aortic coarctation. It was taken to the surgery room and under general anesthesia a correction of aortic coarctation with terminal technical term extended by left lateral thoracotomy, sternotomy sequentially and interventricular communication approach per ventricular puncture was performed and a septal occluder device perimenbranous of 8 mm designed for interven- tricular communication was placed achieving a complete occlu- sion of the defect.
The device used constitutes a feasible alternative in this patients and we consider the smallest waist length an advantage. Offering a more apt configuration further adapting the diameters of the interventricular septum in this age, which exposes less of the device’s material towards the ventricular cavity.
Key words: Ventricular Septal defect • Perventricular closure • Hyperiom
#0011
EXPERIENCE IN MANAGEMENT OF AORTIC COARCTATION DIAGNOSED DURING PREGNANCY Bogdan Cherpak1, Nataliia Yashchuk1, Igor Dytkivskyy1, Julia Davydova2, Sergey Siromakha1, Vasyliy Lazoryshynets1 1Amosov National Institute of Cardiovascular Surgery, Kiev, Ukraine 2Institute of Pediatrics, Obstetrics and Gynecology, Kiev, Ukraine
Introduction: Native severe coarctation is a condition in which preg- nancy is at risk – WHO IV, which means pregnancy is contraindicated. Diagnosis of aortic coarctation is quite poor in developing countries. Pregnancy is not rare in patients with coarctation and possibility of existence of this abnormality should be considered in every case of hypertension occurring during pregnancy, especially in cases of drug resistance. Treatment of the arterial hypertension is mandatory when the blood pressure is higher than 160/90 mmHg.
Journal of Structural Heart Disease, December 2016
Volume 2, Issue 6:241-306