Page 21 - Journal of Structural Heart Disease Volume 2, Issue 6

Meeting Abstracts
248
#0017
TRANSCATHTER CLOSURE OF POSTINFARCTION VENTRICULAR SEPTAL DEFECT – IN-HOSPITAL OUTCOME AND FOLLOW-UP ANALYSIS
Sebastian Smerdzinski, Michal Galeczka, Roland Fiszer, Malgorzata Szkutnik, Jacek Bialkowski
Silesian Center for Heart Diseases, Congenital Heart Defects and Pediatric Cardiology Dept., Zabrze, Silesia, Poland
Introduction: Postinfarction Ventricular Septal Defect (PIVSD) is a rare and severe complication with poor prognosis. Transcatheter closure (TC) of such defect can be a good alternative to surgery in selected patients.
Materials and Methods: All of 26 consecutive patients (pts) (64,6±10y; 9 female) in whom TC of PIVSD was attempted in our department between 2000-2015 were retrospectively analyzed. All pts had cor- onary artery angiography before TC of PIVSD. Mean time between PIVSD occurrence and its TC was 11±5 weeks. All pts were admit- ted in III/IV NYHA class, 9 pts were on balloon counterpulsation; 3 pts were after previous PIVSD cardiac surgery with residual shunt. Mean PIVSD diameter was 11,4±3,8mm (5-19mm) in angiography. Implants used during TC: 19 Amplatzer Atrial Septal Occluders, 3 Amplatzer Postinfarction VSD Occluders, 2 Amplatzer Cribriform Septal Occluders, 1 Amplatzer Ventricular Septal Occluder and 1 Cardi-O-Fix ASD Occluder. All procedures were performed under uoroscopic (10-87min; mean time 39min) and echocardiographic guidance.
Results: 20 from 26 attempted PIVSD TCs were successful (74%) with immediate signi cant clinical improvement. In 6 pts procedure was abandoned because of unfavorable morphology, from whom 3 pts were referred for surgery. During the TC 4 pts needed de brillation because of VF. No peri-procedural deaths were observed. Hemolysis occurred 2 days after TC in 1 pt. 15 from 20 pts survived till the dis- charge; 5 pts died because of multiorgan failure. In observation 2 pts needed second percutaneous closure of another defect. Mean fol- low-up was 6±4,6y (11 pts).
Conclusions: PIVSD is one of the most severe complication of myo- cardial infarction with high risk of surgical or medical treatment. TC of such defect should only be limited to properly selected pts.
#0018
COMPARISON STUDY OF THREE-DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY AND
CT IN MEASURING THE SIZE OF AORTIC RING AND THE HEIGHT OF CORONARY
Cuizhen Pan, Xue Yang, Daxin Zhou, Wenzhi Pan,
Weipeng Zhao, Xianhong Shu, Junbo Ge
Department of Echocardiography, Zhongshan Hospital of Fudan University, Shanghai, China
To investigate the di erence between three-dimensional transesoph- ageal echocardiography (3DTEE) and CT in measuring the size of aor- tic ring and the height of coronary ostium.
Methods: 15 patients were recruited and were treated with the trans-catheter aortic valve implantation (TAVI). Routine transtho- racic echocardiography, two-dimensional and three-dimensional echocardiography (2DTEE, 3DTEE) and CT examinations were taken preoperatively.
Results: The minimal diameter, maximum diameter, perimeter, area of the aortic ring measured by 3DTTE showed strong correlation and consistency with those measured by CT [r=0.88, P<0.0001, ICC=0.928 (0.788-0.976); r=0.81, P=0.0003, ICC=0.890 (0.673-0.963), r=0.85, p=0.0001, ICC=0.914 (0.744-0.971); r=0.88, p<0.0001, ICC=0.932 (0.799-0.977)]. The height of the left and right coronary artery mea- sured by 3DTT also showed strong correlation and consistency with those measured by MDCT [r=0.87, P<0.0001, ICC=0.923 (0.777-0.975); r=0.82, P<0.0002, ICC=0.897 (0.693-0.965)]. Besides, inter-observer and intra-observer reproducibility for 3DTEE measurement data were very good.
Conclusions: 3DTEE has high repeatability in evaluating minimal diameter, maximum diameter, perimeter, area of the aortic ring and the height of coronary ostium, which also shows good correlation with those measured by CT. Thus, 3DTEE is expected to replace CT in the near future.
#0019
STENT PLACEMENT FOR TREATMENT OF AORTIC COARCTATION IN CHILDREN UNDER 30 KG:
ACUTE AND LONG-TERM OUTCOMES
Marcelo Ribeiro, Vinícius Destefani, Amanda
Vicente, Rodrigo Costa, Daniela Kreuzig,
Simone Pedra, Carlos Pedra
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil
Introduction: The use of stents for percutaneous treatment of aortic coarctation (CoAo) in children presents some challenges as possible limitations of vascular access and lack of published data regarding the need for reintervention. We sought to evaluate the feasibility, safety and e cacy of stent in children, with an emphasis on follow-up.
Methods: A retrospective analysis of a cohort of consecutive children (<30 kg) who had undergone stent placement for aortic coarctation between April/2009 and December/2015 was performed. The access route was the carotid in patients <10 kg. Stents that can be expanded to larger diameters have been used. Demographic, clinical, hemody- namic and follow-up data were collected. The endpoints evaluated included: immediate and mid-term severe adverse events (SAE), per- sistent high blood pressure and need for reintervention.
Results: Thirty-seven patients (25 male, 27 with native CoAo and 1 with associated hypoplasia of aortic arch), with mean age and weight of 5.4±3.4 years and 20.7±11.0 kg were enrolled respectively. Immediately, the peak-peak gradient decreased from 33.7±15.1 to 5.4±5.3 (p <0.01) and the ratio of aortic coarctation diameter/DAo increased from 0.40±0.16 to 0.95±0.20 (p <0.01). There were no deaths or immediate SAE. Thirty-four patients were followed during a mean period of 43.1 ± 19.4 months. Computed tomography of aorta was performed in 26 patients (23.1 ± 17.6 months after procedure) and showed stent integrity in all. Five patients still needed medication
Journal of Structural Heart Disease, December 2016
Volume 2, Issue 6:241-306