Page 30 - Journal of Structural Heart Disease Volume 2, Issue 6

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Meeting Abstracts
e ect. Children have more radio sensitivity but the evaluation of this exposition is more di cult mainly due to the weight variability. Finally, radiation dosage is not yet well standardized in this population.
Methods: This was a multicenter observational study. Data was col- lected from a Brazilian Registry of cardiac catheterization on congenital heart disease from march/2013 to june/2014. Patients aged more than 18 years old were excluded from this study. Four hundred and ninety ve patients had dose-area product (DAP) measured and were included in this study. Median and interquartile intervals (25th and 75th) of age and weight were respectively 50 months (10 ; 103) and 15 Kg (7 ; 28).
Results: The median and interquartile intervals (25th and 75th) of DAP was 742,2 (288,8 ; 1791,5) uGy.m2. Interventional procedures had higher DAP than diagnostic procedures (25th, 50th, 75th percentiles: 230, 715, 1534 versus 315, 751, 2095 uGy.m2). DAP correlated with body weight (r = 0,56) but best correlated with weight- uoroscopic time product (R = 0,75). DAP/weight showed no di erence between diagnostic and interventional procedures ((25th, 50th, 75th percen- tiles: 23, 57, 110 versus 30, 57, 139).
Conclusions: DAP/weight has been considered in the last few years as the most reliable unit to evaluate radiation exposure in pediatric population. However, to date, there are only two reports in the litera- ture. This study reports similar doses when comparing to the bench- mark doses previously published by the CCISC. It is very useful to report these data in order to be continuously evaluating the impact of strategies to lower radiation exposure in this vulnerable popula- tion. Di erences between institutions can alert for increased radia- tion exposure in patients and sta and support a program of quality improvements for radiation safety.
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HYBRID BALLOON VALVULOPLASTY FOR PULMONARY ATRESIA AND INTACT VENTRICULAR SEPTUM: 10 YEAR EXPERIENCES
Shoujun Li, Kai Ma, Shengshou Hu, Zhongdong Hua, Keming Yang, Hao Zhang, Jun Yan, Changwei Zhang, Kunjing Pang
Fuwai Hospital, National center for cardiovascular disease, CAMS & PUMC, Beijing, China
Objective: Management of pulmonary atresia with intact ventricular septum (PA/IVS) remains challenging for the unfavourable outcomes after surgical or percutaneous interventional approaches. This study aimed to report outcomes of our hybrid balloon valvuloplasty via sternotomy for PA/IVS.
Methods: From 2005 to 2015, consecutive patients with PA/IVS who underwent hybrid balloon valvuloplasty in our institution were included into the current study. Ductal ligation, bidirectional Glenn shunt (BDG) and modi ed B-T shunt (mBT) were applied according to the post-valvuloplasty hemodynamics. Exclusion criteria included: right ventricular (RV) dependent coronary circulation and muscular atresia.
Results: A total of 77 consecutive patients were recruited. The median age at balloon valvuloplasty was 3 months (1 day to 24 months). Fifteen (19.4%) patients were neonate, 19 (24.7%) patients had mild or moderate RV hypoplasia, and more than moderate tricuspid
regurgitation presented in 65 (84.1%) patients. Procedures included 25 valvuloplasty alone, 27 valvuloplasty + ductal ligation, 20 valvu- loplasty + ductal ligation + mBT, and 5 valvuloplasty + ductal ligation + BDG. RV out ow tract continuity were established in all patients without early mortality and early reoperation. After valvuloplasty, SO2 increased from 73.5 ± 25.7% to 93.0 ± 3.4%. Four (5.2%) patients had a residual pressure gradient more than 30 mmHg. During 6.5 years (4 months-11 years) follow-up, there were 7 late deaths, 2 re-balloon dilatations, 2 ductal occlusions and 2 mBT occlusions. According to the hemodynamics, 2 patients underwent subsequent BDG and 2 patients underwent subsequent total cavopulmoanry connection. At the latest follow-up, 59 patients had biventricular cir- culation, 5 patients had one and a half ventricular circulation and 2 patients had univentricular palliation. In multi-variate analysis, tricus- pid z score was identi ed as independent protective factor for post- operative death (p=0.02, OR=0.21).
Conclusion: Outcomes of hybrid balloon valvuloplasty for PA/IVS is favorable with satisfactory potential to biventricular circulation.
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NOVEL TRANSCATHETER INTERVENTION IN COR TRIATRIATUM DEXTER
I.B Vijayalakshmi
BMC&RI Super Specialty Hospital (PMSSY), Bengaluru, India
Cor triatriatum Dexter is an extremely rare congenital anomaly (0.025%), in which the right atrium is divided into two chambers by a septum, diagnosed on autopsy in the past. We describe ante- mortem diagnosis, by 2D transthoracic echocardiography with agi- tated saline contrast echocardiography and inferior venacava or superior venacaval venography. To the best of our knowledge, for the rst time in world, we report a novel method of transcatheter balloon disruption of membrane in ve cases, along with the bal- loon dilatation of rheumatic mitral stenosis in two cases and device closure of atrial septal defect in one case, to prevent morbidity and mortality.
Objective: To describe the importance of transthoracic echocardiog- raphy with agitated saline contrast echocardiography and assess the feasibility and e cacy of transcatheter intervention in Cor triatriatum Dexter
Material and Results: Out of fteen consecutive patients of Cor tri- atriatum Dexter diagnosed with transthoracic echocardiography with agitated saline contrast echocardiography, ve patients who underwent transcatheter balloon disruption of membrane and other interventions formed the material for study. Three patients were boys and two were girls, age ranged between 3 to 17 years, median age was 10 years. Three patients presented with extertional dyspnea and two were asymptomatic. Two who had rheumatic heart disease with mitral stenosis underwent balloon mitral valvuloplasty and one case with atrial septal defect without pulmonary artery hypertension underwent device closure.
Conclusion: The Cor triatriatum Dexter is not benign as mortality occurs due to pulmonary embolism. Timely diagnosis with transtho- racic echocardiography with simple agitated saline contrast echo fol- lowed by balloon disruption can prevent cyanosis, pulmonary artery hypertension, morbidity and mortality.
Hijazi, Z
20th Annual PICS/AICS Meeting Abstracts