Page 36 - Journal of Structural Heart Disease Volume 2, Issue 6

263 Meeting Abstracts
AB
Post Interven on Post Interven on
Figure 1 (#0055). A 23 year old with bicuspid aortic valve and supra valvar aortic narrowing received a Palmaz-XL 3110 stent placed at 22mm.
Cases: A 23 year old with bicuspid aortic valve and supra valvar aortic narrowing received a Palmaz-XL 3110 stent placed at 22mm (Figure 1). A 35 year old with Tetralogy of Fallot with supra valvar nar- rowing due to bypass cannulation received a 26mm EV3 placed at 25mm. An 11 year old post-transplant (cardiomyopathy) received a 36mm EV3 at 24mm. There was resolution of gradient, angiographic improvement, and no complications in all cases.
Conclusion: Our experience suggests that transcatheter ascending aorta stenting is a safe and feasible alternative to surgery in selected cases. 3D Rotational Angiography provides an optimal roadmap for successful implantation.
#0056
COMPARISON OF PATIENTS UNDERGOING SURGICAL VERSUS TRANSCATHETER PULMONARY VALVE REPLACEMENT: CRITERIA FOR REFERRAL AND MID- TERM OUTCOME
Jenny E. Zablah2, Nilanjana Misra1, Dorota Gruber1, Dipak Kholwadwala1, Shilpi Epstein1
1Northwell Health, New Hyde Park, New York, USA
2Children’s Hospital of Colorado, Denver, Colorado, USA
Background: Pulmonary regurgitation (PR) and/or stenosis (PS) is challenging in patients with congenital heart defects. We compared baseline characteristics of patients undergoing surgical (SPVR) versus transcatheter (TPVR) pulmonary valve replacement and identi ed if criteria for referral di er.
Methods: Retrospective chart review of patients post-SPVR or TPVR at Cohen Children’s Medical center of New York from 2013-2015. Volumetric data obtained from cardiac magnetic resonance (CMR), one year prior and about one year after PVR. PS was de ned as peak-peak gradient ≥35mmHg by catheterization or peak gradient ≥50mmHg by echocardiography. Student’s t-test and Mann-Whitney test for group comparisons and chi-square and Fisher’s exact test for associations.
Results: 30 patients post-PVR: 15 surgical, 15 transcatheter (1 hybrid). At referral, the SPVR group had only PR; indications for SPVR were: 2+ CMR parameters in 12 patients; 3 had decreased left ventricular ejection fraction (LVEF) and hemodynamic ndings and/or abnormal exercise stress test. In the TPVR group, 8 patients had PR, 1 had PS and 6 with PR/PS; indications for TPVR were: 2 CMR parameters in 5 patients, 10 had symptoms±hemodynamic ndings. At baseline, SPVR group had signi cantly larger right ventricular (RV) volumes than TPVR group. Biventricular function was not signi cantly di erent. Post-PVR, both groups had signi cantly decreased RV volumes and increased LV diastolic volumes. The SPVR group improved LV cardiac output (CO) (4.9±1.1 to 5.9±0.8 L/min, p0.03) and biventricular function (RVEF 44.7±5.4% to 53.4±8.8%, p0.02, LVEF 54.2±5.4% to 60.2±3.8%, p0.04) whereas the TPVR group had no signi cant changes.
Conclusions: Most patients were referred for SPVR due to CMR vol- umetric criteria, whereas for TPVR due to exercise intolerance with mildly abnormal CMR criteria. One year after PVR, both groups had near-normal biventricular volumes and function irrespective of base- line characteristics at referral.
Hijazi, Z
20th Annual PICS/AICS Meeting Abstracts