Page 48 - Journal of Structural Heart Disease Volume 2, Issue 6

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Meeting Abstracts
resolution on follow up imaging within 72 hours. Late CA imaging was available in 33 patients (80%) at a median of 105 days (range 7-1121) after index CA procedure with 9130 patient-days total of fol- low up. Among these 33 patients, there were 51 total cases of late CA follow-up imaging – all demonstrating a widely patent CA. There was no CA stenosis nor lumen irregularity noted in 33 cases (65%) with 18 cases (35%, 14 patients) demonstrating a median of 4.7% (range 2.3-12.5%) stenosis. No patient underwent intervention on the CA for vessel stenosis. No risk factors for mild CA stenosis were identi ed when evaluating vessel stenosis and sheath size at index procedure, interval from index procedure, weight at index procedure, or duration of CA access during index procedure.
Conclusion: Use of the CA for interventional catheterization is associated with excellent late patency with no appreciable CA stenosis noted late after the procedure. In patients with CA stenosis after cath- eterization, the stenosis is mild. This data supports the utilization of percutaneous carotid access during pediatric catheterization.
#0083
NOVEL APPROACH TO THE DIAGNOSIS AND TREATMENT OF HEMOPTYSIS IN CHILDREN
Syed Javed Hasan Zaidi, Dhaval R. Patel, Alexander J. Javois, Javeed Akhter
Advocate Children’s Hospital, Oak Lawn, Illinois, USA
Rationale: Hemoptysis in children is an uncommon presenting symp- tom but can be life-threatening if massive. Cardiac catheterization and coil embolization of aorto-pulmonary collateral vessels (APCs) is uncommon in patients with hemoptysis and without congenital heart disease. We present a series of 16 children with hemoptysis, all of whom underwent cardiac catheterization to look for and intervene upon aorto-pulmonary vessels if found.
Objective: To determine the presence and size of APCs in children with hemoptysis and assess resolution of symptoms after coil embo- lization of these vessels.
Methods: A detailed chart abstraction and review of bronchoscopy and cardiac catheterization images and reports was performed in this retrospective cohort study of children presenting with hemoptysis in a tertiary center from January 1995 to January 2015.
Main Results: A total of 16 patients were identi ed who presented with hemoptysis and underwent cardiac catheterization after bron- choscopy at our institution. The mean age was 12.6 years. Structural cardiovascular anomalies were present in 4 (25%). 13 (81%) had evi- dence of bleeding on bronchoscopy. Cardiac catheterization showed signi cant APCs (>2mm) in 9 (56%) all of which were coil embolized. 8 (89%) had complete resolution with no recurrences. 7 patients had no signi cant APCs. Of the 4 patients with structural cardiac anoma- lies, 2 had signi cant APCs that needed coil embolization.
Conclusions: Aorto-pulmonary collateral vessels should be high on the di erential diagnosis for pulmonary hemorrhage in an infant and besides early consultation with pediatric pulmonology, a con- sultation with pediatric cardiology is also warranted. Following a bronchoscopy, other imaging modalities may be helpful but cardiac
catheterization would have the advantage of being able to perform interventions, speci cally embolization of APCs.
Key words: aorto-pulmonary • collateral vessels • coil embolization • cardiac catheterization
#0084
EFFICIENCY OF TRANSCATHETER PATENT FORAMEN OVALE (PFO) CLOSURE WITH HYPERION PFO OCCLUDER*.
Malgorzata Szkutnik1, Jacek Bialkowski1, Roland Fiszer1, Blandyna Karwot1, Sebastian Smerdzinski1, Maciej Wawrzynczyk2
1Silesian Center for Heart Diseases, Congenital Heart Defects and Pediatric Cardiology Dept., Zabrze, Silesia, Poland
2Department of Neurology, Public Clinical Hospital No. 1, Medical University of Silesia, Zabrze, Silesia, Poland
Introduction: Patent Foramen Ovale (PFO) may result in paradoxical embolism event (EE). Transcatheter closure of PFO still remains an alternative and interesting treatment for selected patients. Experience with application of Hyperion PFO Occluders (similar to Amplatzer PFO Occluders) in such circumstances has been not evaluated yet.
Materials and Methods: 67 patients (pts) with cryptogenic EE in whom in years 2014-2016 PFO was closed percutaneously with Hyperion PFO occluder in our institution were retrospectively analyzed. There were 36 woman with mean age 41 (21-62) and 31 man with mean age 41 (19-68) years. The indications for the procedure were estab- lished by neurologist and included Transient Ischemic Attack (TIA) in 16 pts (among them 2 pts were divers), ischemic stroke in 49 pts and migraine with aura in 3 pts. Transcranial Doppler (TCD) was per- formed in all pts (with MES ≥2nd degree in all pts). Mean PFO tunnel length was 8 (4-16) mm. Follow up was performed 3, 6 and 12 months after the procedure and thereafter yearly. Control TCD examination was performed 6 months after the procedure and in case of residual shunt presence – 3 months afterwards again.
Results: The procedure was successfully completed in all patients and no procedure-related complications were observed during hospital- ization. Following devices were used (accordingly to the anatomy of PFO) – PFO Hyperion Occluder 18 mm in 6 pts, 24 mm in 49 pts, 30 mm in 8 pts and 34 mm in 4 pts. Fluoroscopy time was 2,4 (0,9-22) min. During follow-up no new neurological events were observed in any pt. Control TCD results were available in 54 pts (4 pts were lost from follow-up): 48 pts had complete PFO closure and 6 pts had a residual shunt. In 1 pt paroxysmal atrial brillation was observed.
Conclusions: Transcatheter PFO closure with Hyperion devices is safe and e ective procedure, however, long-term follow-up and random- ized study with other devices are necessary.
*Device produced as Hyperion PFOO, Comed BV, Netherlands / SHSMA, Shanghai, China
Hijazi, Z
20th Annual PICS/AICS Meeting Abstracts