Page 40 - Journal of Structural Heart Disease Volume 3, Issue 3

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Meeting Abstracts
PERFORATION BY CATHETER INTERVENTION FOR THE CALCIFIED OBSTRUCTION OR ARTIFICIAL CONDUIT- PLANNING BY MULTI-PLANAR RECONSTRUCTION IMAGE ON CARDIAC CT
Hisashi Sugiyama, Tetsuko Ishii, Hitomi Park
Pediatric Cardiology, Tokyo Women’s Medical University, Tokyo, Japan
Background: Perforation is an essential technique to reopen the chronic occluded vessels. However, penetration of calci ed obstruc- tion or arti cial conduit is still challenging.
Objective: To establish safety procedures to perforate calci ed obstructions or ePTFE conduits.
Methods and Results: Before the catheter procedure, multi-planar reconstruction (MPR) image was performed for the planning of cath- eter intervention.
Case 1: 18 y/o male, SRV, post extracardiac (ePTFE)- TCPC, protein loos- ing enteropathy (PLE). Creation of Fontan fenestration was planned for reduction of CV pressure. While xing Brockenbrough (BB) nee- dle by snare catheter (snare assistant technique), sti side of 0.014 inch guide wire advanced through tip of BB needle. Subsequently, perforation was dilated by 10mm balloon and then Palmaz stent was implanted. PLE improved.
Case 2: 41 y/o male. TGA, post Mustard procedure, SVC syndrome (cal- ci ed complete obstruction from SVC to RA). Steerable sheath was placed to t occlusion as vertical. Then sharpened 0.014 inch guide wire advanced toward SVC. The perforation was dilated in stages by balloon catheter up to 18mm diameter.
Case 3: 41 y/o male, Right isomerism, SRV, po TCPC (lateral tunnel using ePTFE), Atrial tachycardia. To access common atria, perforation of the Fontan rout was planned. While xing BB needle by snare assis- tant technique, BB needle gently advanced to common atria. The per- foration was dilated by 5 mm balloon.
Catheter ablation was successful without complication. In all cases, MPR image could provide us with useful information to make a pre- cise plan.
Conclusion: Snare assistant technique and steerable sheath is useful for back-up support. Sti side of thin wire or sharpened wire could penetrate even the tough calci ed lesions. MPR image on cardiac CT is a useful tool to make a feasible plan.
THE RISK OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION AFTER PERCUTANEOUS DEVICE CLOSURE OF PATENT DUCTUS ARTERIOSUS IN ADULTS
Tasalak Thonghong, MD1, Srun Kuanprasert, MD2,
Arintaya Phrommintikul, MD2, Suphot Srimahachota, MD3, Pornthep Lertsapcharoen, MD4
1 Northern region heart center, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
2 Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
3 Division of Cardiology, Department of Internal Medicine Department, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
4 Division of Pediatric Cardiology, Department of Pediatrics, Faculty of medicine, Chulalongkorn University, Bangkok, Thailand
Background: It has been reported that transcatheter closure of patent ductus arteriosus (PDA) is associated with deterioration of left ven- tricular ejection fraction (LVEF). However, the data remains sparse.
Objectives: To investigate the changes of LVEF after transcatheter clo- sure of PDA in adult patients and explore the risk factors related to deterioration of LVEF after device closure.
Methods: The study was retrospectively analyzed in patients with iso- lated PDA and treated with transcatheter PDA closure by CocoonTM device between January 2010 to March 2014. Determination of the risk factors of left ventricular systolic dysfunction has been explored by two-dimensional (2D) echocardiographic parameters pre-procedure.
Results: Thirty-three patients had successful device closure by CocoonTM Ductal Occluder. The mean age was 38.5+12.0 years and 81.8% were female. The mean PDA diameter at its narrowest segment was 6.9 mm. According to the PDA classi cation, 51.6% of patients had type A, 35.5% had type B, 3.2% had type C and 9.7% had type E. The device size 10/12 were predominantly used in 45%. The 2D- echocardiography showed that the shunt occlusions were completed in 90% of patient at one month and 100% at 1 year. Post-procedure, the left ventricular ejection fraction (LVEF) decreased more than 5% in 74.2% of patients. However, left ventricular dysfunction after device closure was transient, LVEF has recovered mostly in 3-6 months.
Conclusion: Transcatheter device closure of PDA is associated with left ventricular systolic dysfunction post-procedure but it is transient with recovery at short-term follow-up.
MANUAL HEATING OF RADIAL ARTERY
(BALBAY MANEUVER) TO FACILITATE RADIAL PUNCTURE PRIOR TO TRANSRADIAL CORONARY CATHETERIZATION
Sefa Ünal, Burak Açar, Çağrı Yayla, Ahmet Göktuğ Ertem, Yücel Balbay
Türkiye Yüksek İhtisas Education and Research Hospital, Cardiology Department, Ankara, Turkey
Background: Transradial access (TRA) is increasingly being used for both diagnostic and interventional cardiac procedures. The use of TRA o ers many advantages: decreased bleeding, vascular complica- tions, reduced length of hospital stay, and reduced cost. However, the
Hijazi, Z
20th Annual PICS/AICS Meeting Abstracts