Page 37 - Journal of Structural Heart Disease Volume 2, Issue 6

Meeting Abstracts
264
#0057
COMPARISON OF THE LIFETECH CERA AND AMPLATZER VENTRICULAR SEPTAL OCCLUDERS FOR VENTRICULAR SEPTAL DEFECTS CLOSURE IN 147 CHILDREN
Osman Baspinar1, Ayse Sulu1, Derya Aydin Sahin1, Huseyin Yildiz1, Orhan Ozer2, Mehmet Kervancioglu1, Metin Kilinc1, Gokhan Gokaslan3
1Gaziantep University Medical Faculty, Pediatrid Cardiology, Gaziantep, Turkey
2Gaziantep University Medical Faculty, Adult Cardiology, Gaziantep, Turkey
3Gaziantep University Medical Faculty, Cardiovascular Surgery, Gaziantep, Turkey
Objective: The Amplatzer and modi ed double-disc Lifetech Cera ventricular septal defect (VSD) occluders allow the transcatheter clo- sure of the VSDs. The Amplatzer membraneous devices are not used anymore because of increased complete atrioventricular block risk. Therefore, a comparison of these devices will show us the exact risk of the di erences of the devices.
Methods: From May 2009 to July 2016, 147 consecutive patients (mean age 8.5±4.2, range 1.4-26 year) underwent transcatheter closure of VSD. Used devices were Amplatzer membranous in 35 patients (23.8%), Amplatzer muscular in 32 (21.8%), Cera symmetric in 42 (28.4%), Cera muscular in 23 (15.6%), Cera asymetric in 4 (2.7%) patients. And also 9 patients took Amplatzer ductal occluder I or II and 2 patients Occlutech muscular VSD occluders.
Results: There were no di erences in age, sex, defect type and shunt ratio between groups. Membranous defect ratio was 71%. Amplatzer device sizes (7.22±2.11, range 4-16 mm) were bigger than Cera devices (6.22±1.83, range 4-10 mm) (p=0.009). Pacemaker implantation was performed temporary in 3 and permanently in 1 patient at Amplatzer group and none in Cera group. The follow-up period was statistically longer at the Amplatzer group (22.15±16.56 vs 4.76±5.52 months, p<0.001). The other complication and residual ow and success rate were similar at both devices (p>0.05). Membranous Amplatzer devices used in 72.9% of membranous defect but Cera symmetric and asym- metric devices used 94.5% of membranous defects (p<0.001), because of increased block risk of Amplatzer devices.
Conclusion: Although success rate was similar, Cera devices compare favorably with lower complete block risk. And they make more alter- native with choosing symmetric, asymmetric and eccentric types.
#0058
INTERVENTIONAL TREATMENT IN ADULTS WITH FONTAN PHYSIOLOGY
So ick jang, Sang yun lee, Su jin park, Eun young choi, Hye won kwon, Seong ho kim
Sejong General Hospital, Bucheon-Si, Gyeonggi-do, Republic of Korea
Introduction: The Fontan procedure made increasing survival rate in patients with single ventricle. And early outcomes were reported as good. However, recently the long-term complications have reported by many authors and they need to be regularly followed up with/ without catheterization. So, we studied the when and how to do interventional treatment in adults Fontan physiology.
Method: From Jan 2010 to Sep 2015, total 217 patients underwent catheterization in our hospital. Male was 110, and median age of patients was16.7 years old. Median duration from Fontan procedure was 11.8 years. We reviewed their record retrospectively.
Results: Of them, 118 patients underwent interventional procedure; 15 patients underwent the closure of fenestration in Fontan tract, 58 patients underwent the occlusion of venous collaterals, 34 patients underwent occlusion of arterial collaterals, 31 patients underwent balloon angioplasty, 11 patients underwent stent implantation. There was no intervention- associated mortality. Transient severe headache developed in 1 patient but disappeared in 1 week. It might be due to air emboli or thrombi. Mild hemoptysis occurred in 1 patients but disappeared after 1 day.
Discussion: In spite of good early results of Fontan operation, the long-term complication is not rare and the close follow-up and appropriate intervention is needed. There are many alternative imag- ing and treatment modalities. However, the well-prepared transcath- eter intervention is not risky and good alternative to surgery
#0059
IMMEDIATE AND SHORT TERM OUTCOME POST VSD CLOSURE USING NITOCCLUD PFM COIL – COMPLICATIONS ARE NOT UNCOMMON
Dina Adel, Amr Mansour, Alaa Roushdy, Heba Attya, Azza El ky, Maiy Elsayed
Cardiolog Department Ain Shams University, Cairo, Egypt
Objective: We sought to study the immediate and short term out- come post VSD closure using nitocclud PFM coil to document the safety and e cacy of the procedure.
Patients and Methods: The study included 16 patients with perimem- branous subaortic VSD who were scheduled for elective trans cathe- ter VSD closure using nitocclud PFM coil in the period from May 2014 to July 2016. All patients underwent full clinical examination, ECG and full echocardiographic study immediately before trans catheter clo- sure as well as 24 hour, 1 month and every 6 month after the proce- dure. Any intra or post procedural complications and their respective management were recorded.
Results: The mean age of the study subjects was 6.3 ± 3.3 years. The distance between the defect and the aortic valve was an average of 5.4 ± 1.8 mm, and the left ventricular opening averaged 10.6 ± 3.7 mm. Immediate closure of the VSD was acheived in 25% of the cases this percentage increased to 75% after 1 month. Intravascular hemo- lysis developed 3 days after the procedure in one patient with residual shunt and was successfully managed by PDA amplatzer occluder device implanted in the residual shunt. One patient reported syncope 1 week after discharge and was admitted with complete heart block for which he received transient pacemaker and steroid therapy for 2 weeks after which he regained normal sinus rhythm. The same patient had 2 more attacks of loss of consciousness 2 years after device implantation and complete heart block was documented by ECG and a VVIR pacemaker was eventually implanted for this child. 2 more children had transient self limiting bradycardia and junctional rhythm during the procedure.
Journal of Structural Heart Disease, December 2016
Volume 2, Issue 6:241-306