Page 37 - Journal of Structural Heart Disease Volume 3, Issue 3

Meeting Abstracts
90
Background: Untreated large ventricular septal defects (VSD) are an important cause of congestive heart failure in early infancy. This population usually fails to grow and surgical closure is challenging because of congestion in their lungs prone to respiratory infection and their bad nutritional status.
Objective: The aim of this study was to share our experience in percu- taneous VSD closure of children under 1 year of age.
Methods: We have performed VSD closure in 7 patients under 1 year of age between the September 2012 – May 2016 in Erciyes University Pediatric Cardiology Department.
Results: Age of patients ranged between 4–12 months. Weight of the patients during the procedure was between 5.3-9 kg. Mean VSD diameter was 3.19±0.47 mm. One defect was muscular, all others were perimembranous defects. All defects were closed with Amplatzer Ductal Occluder II(ADO-II). Mean uoroscopy duration and total radiation dosage were 78.5±94.6 min, 2069±1395 cGy/min respectively. We did not face any major complications except in one patient where complete AV block was seen one month after the pro- cedure. Pacemaker was implanted. No aortic regurgitation was seen in patients after device implantation.
Conclusion: The procedure of VSD closure, whether it is surgical or percutaneous, is very risky. The risks were higher when the children were smaller than 1 year of age and low body weight. Percutaneous VSD closure may be an alternative to surgery in early infancy that carry the similar risks but less invasive.
USING OF INTRACARDIAC ECHOGRAPHY DURING ASD CLOSURE
Dr. med. Irina Nikolaeva1, Dr. med. Vladimir Plechev1, PhD Igor Buzaev1, Dr. med. Eusthachio Onorato2, PhD Bogdan Oleinik1, Dr. med. Vladimir Surkov1, PhD Inna Iamanaeva1, PhD Elvira Nurtdinova1, PhD Gulchachak Khalikova1
1 Republican Cardiology Center, Ufa, Russian Federation
2 Cardiovascular Dept Humanitas Gavazzeni Clinic, Bergamo,
Italy
Background: Transcatheter device ASD closure is a good alternative to open heart surgery. Most often the ASD closure is performed under transthoracic and transesophageal echocardiography. Although TEE provides exceptional images, it requires general anaesthesia and can- not be used in case of esophagus abnormality. These reasons explain the need to develop new imaging tools.
Objective: The aim of this study is to compare views obtained by dif- ferent methods of intracardiac ultrasound (Ultra ICE, AcuNav).
Methods: 42 closure procedures were performed in the Philips Allura cathlab with a local or general anaesthesia, depending on age. To perform an intracadiac echocardiography (ICE) guidance we used the Ultra-ICE (iLab) by Boston Scienti c in 39 cases and AcuNav by Biosense Vebster in 3 cases.
Results: By Ultra ICE we can get two cross-sectional views of the fossa ovalis in a 360˚ radial plane. The Ultra ICE allows to evaluate the length of the septum, the oval fossa perimetry, the all muscular edges, the right and left atria, tricuspid and mitral valves.
AcuNavTM scans in the longitudinal monoplane, providing a 90˚ sec- tor image. By AcuNav we can get longitudinal and short-axis views of fossa ovalis. We can see right and left atrium, ascending aorta, inferior vena cava, superior and inferior muscular rims of fossa ovalis, and the diameter of the defect can be measured.
Conclusions: ICE provides clear visualization of heart structure, size and location of the defect and presence of rims. All device deploy- ment steps can be monitored using ICE. The advantage of using AcuNav system is the possibility of acquiring doppler and color ow imaging.
A SEGMENTAL FEMORAL ARTERY OCCLUSION: A LESSON TO IMPLEMENT THE COMPREHENSIVE CARDIAC-CATHETERIZATION SYSTEM IN A DEVELOPING INSTITUTE
Kachaporn Nimdet, Krongjit Lekpetch, Chor. Wittawas Phetpaisit
Suratthani hospital, Suratthani, Thailand
History and Physical Examination: A 3-year-old boy diagnosed as Tetralogy of Fallot underwent cardiac catheterization for diagnostic study. Physical examination revealed central cyanosis, systolic ejec- tion murmur at left upper parasternal border with clubbing of n- gers. Oxygen saturation in room air was 70 percent.
During procedure, the left femoral artery was punctured with one attempt. Heparin 50 units/kg was given after insertion of 5F arte- rial sheath. The procedural time from vascular puncture was twelve minutes.
One day after cardiac catheterization, the deminished pedal pulse with cold left leg was recognized. Heparin was given at once. Heavy gauzes with compressive bandage dimension 3x4x5 cm was found at left groin. Twelve hours after heparin infusion, the computed tomo- graphic angiography (CTA) revealed intraluminal thrombus (2.8 cm in length) causing complete occlusion of left common femoral artery with the reconstituted branches from left external iliac artery sup- plied to left popliteal and tibial artery.
The operative ndings revealed constriction of the common femo- ral and superior femoral artery diameter of two and four millimeters, respectively. Thromboembolectomy was performed by 3F Fogarty catheter, however, no intraluminal clots were detected. Both vessels dilated up to ve millimeters and pedal pulse was recovered at the end of operation. Enoxaparin was given following the heparin at one week. Two months after cardiac catheterization, the CTA demon- strated slight progression of common femoral-artery occlusion (3.6 cm in length) with the normal reconstructed ow to distal arteries (Figure 2). He has not received another vascular surgery, as he had not exhibited signs of claudication or limb ischemia.
Journal of Structural Heart Disease, June 2017
Volume 3, Issue 3:73-95