Page 64 - Journal of Structural Heart Disease Volume 2, Issue 6

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Meeting Abstracts
#0120
INDICATIONS, OUTCOME AND FUNDING SOURCES OF CARDIAC CATHETERIZATION IN REFUGEE CHILDREN: EXPERIENCE AT A LOW INCOME COUNTRY OF JORDAN
Iyad Al-Ammouri, Mohamad Ararawi
The University of Jordan, Amman, Jordan
Introduction: Since March 2011, hundreds of thousands of Syrian refu- gees crossed into Jordan. More than 650 thousand persons are registered with the United Nations Higher Commissioner for Refugees (UNHCR) in Jordan, 51% are under the age of 18 years. Demand for health care is overwhelming. Symptomatic children and young adults with suspicion of congenital heart disease were referred for evaluation at Jordan University hospital. In this study we report our experience with cardiac catheteriza- tion in refugee patients with congenital heart disease with emphasis on types of procedures performed, outcome and funding sources.
Methods: From August 2012 to September 2016, data on refugees referred to the pediatric cardiology department at Jordan University Hospital and were found to have structural heart disease needing cardiac catheterization was recorded. Data included diagnosis, indi- cation for catheterization, outcome, mortality and funding sources for the procedure.
Results: Of 310 refugees with heart disease evaluated in the pedi- atric cardiology department, cardiac catheterization was indicated in 133 patients. Funding was secured from various sources for 120 procedures in 113 patients with a median age of 4years (5days- 30 years). Of these, 80 procedures were interventional and 40 were diagnostic. Most common intervention was closure of patent ductus arteriosus in 22 patients, pulmonary valvuloplasty in 21, coarctation angioplasty in 10, closure of ventricular septal defect in 7, closure of atrial septal defect in 6, and other miscellaneous indications in 13 patients. Three of the interventional procedures were not successful (failed aortic valvuloplasty, failed pulmonary valvuloplasty, and failed atrial septostomy for intact atrial septum). There were 10 deaths, ve occurred following surgical interventions, and 5 occurred for patient waiting for surgical interventions. Mean cost of catheterization was 1050 dollars for diagnostic, and 2510 dollars for interventional pro- cedures. Funding sources for performed procedures were individual donations in 55 (46%), nongovernment organizations in 31 (25%), UNHCR fund in 27 (23%), and patient out-of-pocket pay in 7 (6%).
Conclusion: Refugee children with heart disease who needed cardiac catheterization are more likely to be funded by charity than by United nations fund. For patients requiring surgical interventions after either a diagnostic catheterization, or palliative or failed intervention, there is a relatively high mortality, where death may occur post-operatively or while patients are waiting for funding.
#0121
CONGENITAL MULTICENTER TRIAL OF PULMONIC VALVE REGURGITATION STUDYING THE SAPIEN TRANSCATHETER HEART VALVE (COMPASSION): ONE-YEAR FOLLOW-UP.
Damien Kenny1, Saibal Kar2, Evan Zahn3, Julie Vincent4, Girish Shirali5, Mark Fogel6, John Fahey7, Dennis Kim8, Aimee Armstrong9, Ziyad Hijazi10
1Our Lady’s Children’s Hospital, Dublin, Ireland
2Cedar Sinai Medical Center, Los Angeles, Los Angeles, CA, USA 3Miami Children’s Hospital, Miami, FL, USA
4Morgan Stanley Children’s Hospital, New York, USA
5Children’s Mercy, Kansas City, MO, USA
6Children’s Hospital of Philadelphia, Philadelphia, PA, USA
7Yale New Haven Hospital, New Haven, CT, USA
8Children’s Healthcare of Atlanta, Atlanta, GA, USA 9Nationwide Children’s Hospital, Columbus, OH, USA
10Sidra Cardiovascular Center of Excellence, Doha, Qatar
Background: Early safety and e cacy of the Edwards SAPIEN tran- scatheter heart valve (THV) in the pulmonary position has been established through a multicenter clinical trial. This study provides one-year follow-up results in an extended number of patients under- going SAPIEN THV implantation for moderate-to-severe pulmonary regurgitation with or without stenosis.
Methods: Eligible patients were screened if body weight was greater than 35kgs and in situ conduit diameter ≥ 16mm and ≤ 24mm. Standardized implantation and follow-up protocols were used.
Results: Sixty-seven patients completed 12-month follow-up from a total of 69 implants in 81 enrolled patients. Mean weight was 71.2 ± 22.3 kgs. Indication for THV implantation was mixed (79.7%), ste- nosis (7.6%) regurgitation (12.7%). Twenty-two patients (31.9%) underwent implantation of 26mm valve. Patients with class I NYHA symptoms increased from 21.7% pre-procedure to 83.6% at one-year follow-up. Mean peak conduit gradient decreased from 37.7±25.4mmHg to 17.1±11.7mmHg (p<0.001). Mean estimated RV pressure decreased from 59.6±17.7mmHg to 43.4±11.9mmHg (p< 0.001). Pulmonary regurgitation was mild or less in 96.7%. Freedom from device or procedure related death or reintervention was 97.1%. Two patients required early valve-in-valve reintervention, secondary to valve dysfunction. One of these developed further early valve ste- nosis and underwent surgical valve replacement. One patient who did not receive the SAPIEN died secondary to bacterial endocarditis involving the surgical valve. Overall freedom from endocarditis was 97.1% at one year. There were no stent fractures.
Conclusions: Transcatheter pulmonary valve replacement using the Edwards SAPIEN THV demonstrates excellent valve function and durability at one-year follow-up.
#0122
PULMONARY REPERFUSION INJURY FOLLOWING RIGHT VENTRICULAR OUTFLOW TRACT STENTING. Guillermo Aristizabal, Omar Garcia, Jose Garcia Montes, Carlos Zabal, Adrian Sanchez, Aldo Campos, Carlos Guerrero, Juan Pablo Sandoval
National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
Background: Pulmonary reperfusion injury (PRI) has been described in children with tetralogy of Fallot (ToF) or pulmonary atresia with mul- tiple aortopulmonary collateral arteries undergoing unifocalization procedures to reconstruct the central pulmonary arteries. Severity has
Hijazi, Z
20th Annual PICS/AICS Meeting Abstracts