Page 75 - Journal of Structural Heart Disease Volume 2, Issue 6

Meeting Abstracts
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heart disease. The initial experience at three large centers with the SAPIENTM S3 valve in TCPVR is presented.
Methods: A retrospective review was performed of all patients with congenital heart disease who underwent valve replacements using a Sapien S3 valve. In addition to collecting data from the procedures, data from all pre- and post- procedural MRIs and echocardiograms was also obtained.
Results: A total of 46 patients received implantation of the S3 valve (UCLA=32, Cedar Sinai=9, Cincinnati Children’s=3,) with 34 in the pulmonary position and the remainder in the tricuspid n=6, mitral n=3 and aortic n=3. Of the transfemoral cases, there were none in which the valve could not be implanted after introduction and no embolizations. Immediately after TCPVR these patients uniformly had no signi cant obstruction or regurgitation through the S3 valves. The incidence of signi cant paravalvular leaks (PVL) was 11% (n=5), rein- tervention, 6% (n=3). In 24 (52%) cases, the S3 valve was over-dilated beyond its nomination recommended in ation volume ( g 1).
Conclusions: The SapienTM S3 offers an opportunity to perform TCPVR in patients with large diameter native landing zones. Patient selection, sizing of the right ventricular outflow track (RVOTs) in the cath lab and knowledge of delivery techniques are critical for success and continues to improve (fig 2). To date, this represents the largest study of the S3 valve in the congenital heart disease population.
Figure 1 (#0148).
Figure 2 (#0148).
Figure 1 (#0149).
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A NEW COVERED STENT FOR COMPLEX COARCTATION AND PULMONIC VALVE LANDING ZONES.
Gareth Morgan, Matteo Ciu reda, J DeGiovanni Children’s Hospital of Colorado, Denver, CO, USA
Introduction: Recent evidence is providing guidance on the need for covered stent use in lesions such as coarctation of the aorta and right ventricular out ow tract stenting. Currently the only FDA approved covered stent is the Cheatham-Platinum stent, but development in this area is urgently needed. Andratec have developed the Optimus covered stent as an alternative covered stent for similar clinical indi- cations. This is a laser cut cobalt chromium stent with a double layer of PTFE sandwiching the stent struts. It’s hybrid design o ers a wider range of expansion with less shortening and potentially more pre- dictable behaviour of the covering. We describe the rst human use of the covered Optimus stent in patients with coarctation of the aorta.
Methods and Results: We successfully implanted the Optimus covered stent in 7 consecutive cases in patients whose pre-procedural anatomy looked challenging for currently available covered stents (Fig 1A). Six of the patients had native coarctation with one recoarctation following surgical repair. Median age was 46yrs (range 33-69yrs). There were no signi cant complications with reduction in the median invasive gradi- ent from 23mmHg to 0mmHg. The length of stents used ranged from 33mm to 57mm with a median shortening after expansion of 13%. Post-procedural follow-up with magnetic resonance imaging or com- puted tomography has not shown evidence of fracture or migration or re-narrowing (Fig 1B). The median duration of follow-up is 8months.
Conclusions: Preliminary results show that the Optimus covered stent is safe and e cacious for use in patients with coarctation of challeng- ing morphology. A systemic trial will be required to evaluate this stent for more widespread practice.
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PERCUTANEOUS ACCESS TO ATRIAL MASS IN FOLLOWING TCPC SURGERY (MODIFIED FONTAN) FOR SINGLE VENTRICLE PHYSIOLOGY
Journal of Structural Heart Disease, December 2016
Volume 2, Issue 6:241-306