Page 41 - Journal of Structural Heart Disease Volume 3, Issue 3

Meeting Abstracts
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small size of the radial artery limits the size of the equipment that can be used via this approach.
Objective: In this study we sought to investigate whether pre-proce- dural manual heating of radial artery facilitates radial artery puncture or not.
Methods: Patients undergoing transradial cardiac catheterization were randomized in a double-blind fashion to a subcutaneous com- bination of nitroglycerin+diltiazem or manual heating. The study endpoint was puncture score (score 1: easiest puncture- rst try, score 2: puncture at second try, score 3: puncture at third try, score 4: punc- ture at forth or more try, score 5: radial puncture failed).
Results: 90 patients were enrolled (45 allocated to treatment group and 45 to heating group). Patients underwent ultrasound of the radial artery before the catheterization. Complications were rare: one hematoma (treatment group) and one radial artery occlusion (heat- ing group). Baseline demographic and clinical characteristics were similar. The baseline radial artery diameter was similar in both groups. (2.41 ± 0.46 mm in heating group and 2.30 ± 0.48 mm in treatment group. However, puncture score was 1.47 ± 0.9 in heating group and 2.22 ±1.2 in treatment group (p=0.002), respectively.
Conclusions: Pre-procedural manual heating of radial artery facil- itates radial artery puncture in patients undergoing transradial car- diac catheterization.
TRANSCATHETER CLOSURE OF PATENT DUCTUS ARTERIOSUS IN PREMATURE INFANTS WEIGHING LESS THAN 2,500 GRAMS
Jieh-Neng Wang, Yung-Chieh Lin, Min-Ling Hsieh, Yu-Jen wie, Jing-Ming Wu
Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Background: Transcatheter closure of patent ductus arteriosus (PDA) in preterm babies remains a highly challenging procedure.
Objective: The aim of this study was to describe our experience with transcatheter device closure of PDA in symptomatic low birth weight premature infants.
Methods: Hospital records and catheterization reports of all prema- ture babies who underwent transcatheter PDA closure since October 2014 in our hospital were reviewed. Basic demographics clinical infor- mation, echocardiographic, and angiographic data were recorded.
Results: Six premature infants (three boys and three girls) born at ges- tational ages ranging between 24 and 33 weeks (median, 28 weeks) were identi ed. All patients were symptomatic and received at least one course of indomethacin therapy. Median age and weight for pro- cedure was 32 days (17-102 days) and 1,500 g (1,032-2,350 g), respec- tively. The mean minimal ductal diameter was 3.7 + 0.7 mm. Device used in this study were Amplatzer Ductal Occluder II additional size (ADO II AS) (n=4), Amplatzer Vascular Plug I (n=1), and Vascular Plug
II (n=1). Complete closure was achieved in all patients with no major procedural complications.
Conclusions: It is currently feasible to undertake transcatheter PDA closure in carefully selected symptomatic premature infants.
SUCCESSFUL STENTING OF CHRONIC TOTAL OCCLUSION OF THE EPTFE GRAFT AFTER RIGHT PULMONARY ARTERY BYPASS SURGERY IN A GIRL WITH ABSENT PULMONARY ARTERY
Kenichiro Yamamura, Mitsuhiro Fukata, Naoki Kawaguchi, Mamoru Muraoka, Kiyoshi Uike, Yasutaka Nakashima, Eiko Terashi, Yuichiro Hirata, Hazumu Nagata, Eiji Morihana, Shouichi Ohga
Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
History and Physical: A 12-year-old girl was admitted to our hospi- tal for endovascular treatment of chronic total occlusion of the right pulmonary artery (RPA) bypass graft. She rst visited our hospital because of heart murmur when she was two years old. She was then diagnosed as having absent right pulmonary. She underwent RPA bypass surgery with 6mm ePTFE graft. The graft became stenotic eas- ily because it passed anterior of the ascending aorta and then had a tight curve before it went into RPA between ascending aorta and superior vena cava. After the surgery, she underwent balloon dilation of the graft stenosis every two or three years. Pulmonary perfusion scintigraphy at 12 years of age suggested total occlusion of the RPA graft (right 3%, left 97%). Prominent second heart sound and ejection systolic murmur at upper left sternal border were audible.
Imaging: Computed tomography con rmed the diagnosis of total occlusion of the RPA bypass graft.
Indication for Intervention: She showed mild shortness of breath on exertion. Cardiac catheterization revealed elevated main and left pul- monary artery pressure (57/21[39] mmHg).
Intervention: The procedure was performed under local and intrave- nous anesthesia. An 8 French (Fr) sheath introducer was placed in the right femoral vein. Right ventriculography demonstrated total occlu- sion of the proximal RPA bypass graft. 6Fr AL-1 catheter could be sta- bilized at the ori ce of the graft using 6Fr Brighttip sheath and4Fr Multipurpose catheter. A 0.018”
Treasure 12g guidewire was passed through the graft, and 0.035” Radifocus guide wire reached peripheral RPA. Intravascular ultra- sound revealed severe thrombotic stenosis of the graft. The graft was dilated with 3 x 20 mm Sterling balloon, 3.5 x 13 mm NSE balloon, and then 5mm x 30mm Sterling balloon. RPA angiography revealed 50% patency of the graft and we nished the procedure. Oral aspi- rin and heparin infusion were administrated and then switched to aspirin and warfarin. She discharged eight days later, after checking the patency of the graft with ultrasonography and computed tomog- raphy. However, two months later, ultrasonography and pulmonary perfusion scintigraphy suggested re-occlusion of the RPA graft. After con rming the diagnosis of the occlusion by pulmonary artery angiography, we decided to perform stent implantation. Using a 10
Journal of Structural Heart Disease, June 2017
Volume 3, Issue 3:73-95