Page 36 - Journal of Structural Heart Disease Volume 3, Issue 3

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Meeting Abstracts
Indication For Intervention: The decision was made to implant the Melody valve in per-ventricular way in a hybrid room setting.
Intervention: Mild hypothermia was induced (34.5 C) for brain pro- tection for potential periods of systemic hypotension. Through the limited, lower sternotomy the purse-string sutures were placed a little to the right from the subxyphoid area. This was also done to keep them away from the tricuspid valve apparatus and make all the maneuvers more applicable with a relatively sti delivery system and limit any tension to the dysfunctional right ventricle. The RV wall was punctured, a wire was introduced to RPA. Positioning of the valve was preceded by angiography. The Melody valve (Medtronic Inc, Santa Ana, CA) hand-crimped onto a 22-mm Ensemble delivery system was then delivered over the wire into the right ventricular out ow and placed at the Contegra graft level using the overlapping of images. After con rmation of the positioning, the balloon in the balloon system was distended to 22 mm, withdrawn, and the RV was xed. The valve was perfectly competent on repeated transthoracic echo- cardiograms. The patient was discharged home with bosentan and sildena l therapy with no oxygen, 10-15% di erence between the upper and lower body saturation.
Figure 1. Echocardiography showing reverse remodeling of the both ventricle (on the left) 2 years after Potts shunt and Melody valve im- plantation into pulmonary position in 12 kg baby with PAH.
Figure 2. Angio CT scan demonstrating 8 mm Potts shunt in 12 kg baby with repaired common arterial trunk and PAH.
Learning Points of the Procedure: The 2-year follow-up showed not only the 4 kg body weight increase, spectacular improvement in the quality of life, fully competent Melody valve, no rhythm disturbances in Holter monitoring, but also no signi cant di erence between the upper and lower body saturation and unsuspected reverse remodel- ing of the right ventricle. In conclusion, per- ventricular pulmonary Melody valve implantation is possible in a low-body-weight patient, when a surgical solution or femoral vessels are unsuitable, even if the patient presents with a signi cant right ventricular dysfunction. Potts shunt may be the treatment option in patients with iso or even infra- systemic RV pressure and signi cant RV dysfunction or distension to promote RV reverse remodeling.
PERCUTANEOUS PDA CLOSURE IN EXTREMELY LOW BIRTH WEIGHT BABIES
Nazmi Narin1, Ozge Pamukcu1, Ali Baykan1, Suleyman Sunkak1, Ayse Ulgey2, Kazim Uzum1
1 Erciyes University, Pediatric Cardiology, Kayseri, Turkey 2 Erciyes University,Anesthesiology, Kayseri,Turkey
Background: Patent Ductus Arteriosus (PDA) is an important cause of morbidity and mortality in preterms. As birthweight decreases, risks increase.
Objective: Main aim of our study is to emphasize the e ectiveness and safety of percutaneous PDA closure even in extremely low birth infants.
Methods: In our center between the dates June 2014 – December 2015, PDA of eight patients less than 1 kg were closed percutaneously. To our knowledge this study includes the largest cohort of infants less than 1 kg in the literature, whose PDA were closed percutaneously.
Results: Symptomatic patients weighing less than 1 kg with PDA were included in the study. The mean patient age and weight was 16±5.9 days and 923±75.9 gr respectively. Mean PDA diameter was 2.48±0.5 mm. In all patients ADOII-AS device were used for PDA closure. There were no major complications reported. Left pulmonary arterial steno- sis was detected in 2 patients which resolved spontaneously.
Conclusion: Interventional catheterization procedures are more com- monly used in recent years. The advantages of percutaneous PDA closure include a high success rate, shorter length of hospital stay, reduced blood loss, low morbidity rate, and no traumatic scars. Since the length of hospital stay decreases with catheterization, it is much more cost-e ective than surgery. We want to emphasize that in expe- rienced centers percutaneous closure of PDA can be an alternative to surgery even in the extremely low birth weight babies.
PERCUTANEOUS VSD CLOSURE UNDER 1 YEAR OF AGE
Nazmi Narin1, Ozge Pamukcu1, Ali Baykan1, Suleyman Sunkak1, Aydin Tuncay2, Kazim Uzum1
1 Erciyes University, Pediatric Cardiology, Kayseri, Turkey
2 Erciyes University,Cardiovascular Surgery, Kayseri,Turkey
Hijazi, Z
20th Annual PICS/AICS Meeting Abstracts