Page 65 - Journal of Structural Heart Disease Volume 2, Issue 6

Meeting Abstracts
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been related to the degree of stenosis with di use and/or localized lung opaci cations (pulmonary edema) becoming apparent on chest x-ray lms within hours of having restored previously restricted pulmonary ow. We sought to determine if PRI was present following right ventricu- lar out ow tract (RVOT) stenting. We hypothesized PRI would be related to the severity of RVOT obstruction prior stenting and would re ect on longer days of ventilation and hospital stay.
Methods: Prospective study including 12 consecutive children with ToF (25% female) that underwent RVOT stenting between January and July of 2016. Clinical and procedural data were reviewed. A pedi- atric radiologist evaluated chest x-ray lms before and after interven- tion to determine presence and severity of PRI, as well as its impact on days of ventilation and length of hospital stay.
Results: Median age and weight were 32 months (range 1-139) and 10.8kg (1.8-22) respectively. SaO2 increased from a mean of 71± 9.8 % to 97±6 % post RVOT stenting (p<0.0001); PaO2 was 43±7.4mmHg and 126±94mmHg pre and post stenting respectively (p<0.001). Pre-stent RVOT diameter (mm) and PaO2 were negatively correlated (r -0.9, p 0.037). Median time of ventilation was 5 days (range 2-8). A positive correlation was found between diameter of the pre-stent RVOT and days of ventilation (r 0.851, p 0.032) and length of hospital stay (r 0.87 p 0.024) respectively. Similarly, positive correlation was found between post-stent RVOT diame- ter (mm) and days of hospital stay (r 0.683 p 0.014). Regarding radiological analysis results were as follows: Out of the 12 patients, di use lung opaci- cations were classi ed as severe in n=5(41%); moderate n=1(8%); mild n=3(25%); none n=3(25%) within 24hs post RVOT-stenting. Pulmonary in ltrates a ected the right lung in 8 (66.7%) patients. Seventy-two hours post RVOT-stent, 8(67%) of patients had complete resolution of previous abnormal ndings on chest X-ray.
Conclusion: Transient PRI is present after RVOT stenting. Degree of pre-stent RVOT stenosis re ected on longer duration of ventilation and length of hospital stay.
#0123
PERCUTANEOUS PULMONARY ARTERIES REHABILITATION IN UNIVENTRICULAR PATIENTS WITH GLENN AND CRITICAL STENOSIS OR PULMONARY ARTERY BANDING
Liliana Ferrin, Juan Manuel Lange, Teresa Escudero, Alejandro Romero, Leticia Matta
Corrientes Cardiovascular Institute, Corrientes, Argentina
Patients with univentricular physiology usually undergo bidirectional cavopulmonary anasthomosis previous to Total Cavopulmonary Bypass. When there is high right or left pulmonary arteries pressure the Genn univentricular physiology does not work and some times the banding of them is performed with unsuccessfully result.
Objetives: The aim of this work is to present the results of Ballon expandable Stent implantation in critical stenosis and adquired deconnected pulmonary arteries in univentricular patients with Pulmonary artery banding and/or AoP Shunt.
Material and Methods: We report our experience in treatment of 4 patients with univentricular physiology ( DIUV –LTGA with AP in 2,
Ebstein Anomaly with PA and DIUV with PA with Bidirectional GLENN and LPA Banding) with severe Sytemic desturation (69%), high PA pressure and defuncionalizated Glenn because of critical left pul- monary artery stenosis after pulmonary banding, that underwent Percutaneous Pulmonary Rehabilitation with Stent angioplasty.
There were 3 adults and one child with severe systemic dessaturation even with AoP Shunt. We have performed Pulmonary angioplasty with 5 CP stent implanted in 4 patients, 2 of them covered in order to occlude the AoP Shunt, and the other nude stent. The mean diameter of stenosis was 1,8 mm for a Mean Pulmonary arteries diameter of 9 mm. After Stent implantation the mean diameter was of 7,8 mm and the systemic saturation rised from 68% to 89% in all of 4 patients. The LPA MP was fram 17 mmHg to 13 mmHg.
All of patients are doing well and waiting the second stage.
Concusion: Ballon expandable stent are useful and safe in pulmo- nary artery rehabilitation after BTShunt or PAB . Follow up of these patients is need to know the medium term evolution and resolution of the third stage.
#0124
COMPLETE LEFT PULMONARY ARTERY OBSTRUCTION FOLLOWING LARGE PDA DEVICE CLOSURE: SUCCESSFUL IMMEDIATE LPA STENTING TO RESTORE PULMONARY BLOOD FLOW
Aldo Campos, José García Montes, Carlos Zabal,
Adrian Sánchez, Guillermo Aristizabal, Carlos Guerrero, Juan Pablo Sandoval1
National Institute of Cardiology “Ignacio Chavez”, Mexico, City, Mexico
Introduction: Over the last two decades, transcatheter therapy has become the rst line of treatment for closure of patent ductus arteriosus (PDA). Both safety and e cacy have been established in many series and currently the procedure can be considered relatively straightforward. However, rare complications have been reported such as device embolization or device obstruction to aortic or pul- monary blood ow, particularly in small children. We present our nightmare case involving complete PDA device obstruction of the left pulmonary artery (LPA) with subsequent LPA stenting to restore left pulmonary blood ow.
Our case involves a 3 year-old, 10 kg girl with failure to thrive (< 5th percentile). Physical exam and echocardiographic ndings con rmed the presence of a large PDA and the patient was brought to the cath lab to attempt closure. Baseline hemodynamic measurements included a mean pulmonary artery pressure of 45mmHg, systolic pulmonary artery pressure was 60% systemic, Qp:Qs was >3:1 and normal PVRi (2 WU). Aortography revealed a large, type A (Krichenko) PDA, pulmonary end diameter was 9mm.
A 22/24 mm CeraTM Occluder (Lifetech Scienti c) was used to close the defect. The device was deployed within the duct using standard ante- grade approach. Prior release, control aortography demonstrated the device sitting within the duct without signi cant aortic or LPA obstruction. However, upon release, immediate proximal retraction
Journal of Structural Heart Disease, December 2016
Volume 2, Issue 6:241-306