Page 30 - Journal of Structural Heart Disease Volume 3, Issue 3

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Meeting Abstracts
A NOVEL THREE DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHIC COMPREHENSIVE MODEL OF AORTIC ROOT : PRELIMINARY EXPERIENCE IN AORTIC ANNULUS SIZING IN TAVR
Domenico Galzerano1, Sara Di Michele2, Valeria Pergola3, Mohammed Admawi1, Giovanni Di Salvo4, Bahaa Fadel1 1 King Faisal Specialist Hospital, Riyadh , Saudi Arabia
2 Dipartimento Cuore e Grossi Vasi, Universita’ la Sapienza,
Roma,Italy
3 Croydon University Hospital, London, United Kingdom 4 Royal Brompton Hospital, London, United Kingdom
Background: A common use of 3D transesophageal echocardiogra- phy (TEE) is during TAVR procedures. The sizing of an aortic annulus (AA) is an important step in ensuring a successful TAVR procedure. A novel software, the eSie Valves package, relies on advanced machine learning technology to e ciently estimate a comprehensive model of aortic valve and aortic root from 3D TEE.
Objective: To test the accuracy of the eSie Valves package and True Volume TEE, these studies compared automated measurements using the eSie Valves package with MDCT to determine whether using 3D TEE data selects the same valve size as MDCT.
Method: In the pilot study in patients with aortic stenosis we are performing both 3D TEE and contrast MDCT prior to TAVR. 3D TEE (Acuson sc 2000)images were acquired with a one beat RES imaging to achieve high volume rates. The minimum and maximum AA diam- eter, AA area, perimeter, and other parameters were measured using the eSie Valves package and the standard MDCT method.
Results: In our preliminary study all 3D volumes that were acquired and analyzed showed that 3D TEE measurements are feasible and had excellent correlation with MDCT and excellent agreement between the two methods in selecting the prosthetic aortic valve size accord- ing to the standard sizing guidelines.
Conclusion: 3D echocardiographic imaging by the eSie Valves pack- age is a novel technique having the potential to provide accurate and reproducible automated aortic annular measurements in echo and have good agreement in selecting the same valve size as MDCT.
MID-TERM FOLLOW-UP OF TRANSCATHETER CLOSURE OF PERIMEMBRANOUS VENTRICULAR SEPTAL DEFECT IN CHILDREN USING AMPLATZER Mahdi Ghaderian
Emamhosein Children Hospital. Esfahan University of Medical Science, Esfahan, Iran
Background: Ventricular septal defect (VSD) is the most common form of congenital heart defects.
Objective: The purpose of this study was to evaluate the results of the early complications and mid-term follow-up of the transcatheter closure of the VSD using the Amplatzer VSD Occluder.
Methods: Between April 2012 and October 2013, 110 patients under- went percutaneous closure of perimembranous VSD. During the procedure, the size and type of the VSD were obtained from the ventriculogram. A device at least 2 mm larger than the measured VSD diameter by ventriculogram was deployed. Size of VSD, size of Amplatzer and device size to VSD size ratio were calculated. After con rmation of good device position by echocardiography and left ventriculography, the device was released. Follow-up evaluations were done at discharge as well as at 1, 6, and 12 months and yearly thereafter for VSD occlusion and complete heart block.
Results: We had 62 female and 48 male patients in our study. The mean age and weight of the patients at procedure were 4.3 ± 5.6 years (range 2 to 14) and 14.9 ± 10.8 kg (range = 10 to 43). The aver- age device size was 7.0 ± 2.5 mm (range 4 to 14). The VSD occlusion rate was 72.8% at the completion of the procedure, rising up to 99.0% during the follow-up. The most serious signi cant complication was complete atrioventricular block which occurred in two patients. The average follow-up duration was 10.9 ± 3.6 months.
Conclusions: Transcatheter closure of the perimembranous VSD is a safe and e ective treatment with excellent closure rates. This proce- dure had neither mortality nor serious complications.
Keywords: Perimembranous ventricular septal defect; Congenital heart defects; Amplatzer
A REVERSIBLE CAUSE OF CYANOSIS
Pravin K Goel, Roopali Reddy
Sanjay Gandhi Postgraduate Institute of Medical Sciences
A 20-year-old male was referred to our institute for evaluation of easy fatigability and breathlessness. On physical examination, he had central cyanosis with 78% SPaO2 and clubbing. There were bilat- eral symmetrical pulses and cardiac examination was normal. Chest x-ray revealed homogenous tubular opacity in the left upper zone. Electrocardiogram (ECG) and two-dimensional echocardiographic study were normal. Contrast echocardiography was done by injecting agitated saline in the upper limb peripheral vein. Immediate (within 3 cardiac cycles) appearance of microbubbles in the LA con rmed the provisional diagnosis of pulmonary arteriovenous stula (PAVF). Computed tomography of pulmonary angiography revealed a large PAVF arising from left pulmonary artery (Figure 1). There were no other features suggestive of hereditary hemorrhagic telangiectasia. Since patient was symptomatic with desaturation, he was taken for cardiac catheterization with intent to closure of the stula. Selective left pulmonary artery (LPA) angiography with 6 Fr Pigtail revealed a large PAVF, draining into the LA via large vertical tubular vessel. A 6 Fr Judkins right (JR) catheter was advanced over the guidewire into the sac through the largest arterial feeder. The targeted arterial feeder measuring 15 mm was occluded by deploying a 18 x 20 mm duct occluder (Cocoon duct occluder, Vascular Innovations Co. Ltd.) using 10 Fr duct occluder delivery sheath (Cocoon Vascular Innovations Co. Ltd.) After device deployment, an additional PAVF was appar- ent on LPA angiography, in addition to mild foaming through the device. As oxygen saturation improved from 78% to 93%, the proce- dure was termed successful and the patient was discharged without procedural complication. 7 days post procedure patient presented with breathlessness and 3 episodes of hemoptysis for 3 days. On
Hijazi, Z
20th Annual PICS/AICS Meeting Abstracts