Page 46 - Journal of Structural Heart Disease Volume 4, Issue 2

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Meeting Abstracts
SHORT AND INTERMEDIATE TERM SAFETY AND EFFICACY OF PERCUTANEOUS DEVICE CLOSURE FOR SECUNDUM ATRIAL SEPTAL DEFECTS USING OCCLUTECH FIGULLA OCCLUDER N
Khaled R Abd El Meguid MD1, Yaser A Abd Elhady MD2, Mohamed M Zaki MSC3
1 Division of Cardiology; Benisuef University Hospital, Benisuef, Egypt 2 Division of Cardiology; Benisuef University Hospital, Benisuef, Egypt 3 Division of Cardiology; Benisuef University Hospital, Benisuef, Egypt
Background: Transcatheter closure has become the method of choice for most patients with secundum ASD. Although the Occlutech device may have some advantageous characteristics there is a pau- city of data on outcomes after the use of this relatively new device.
Objectives: To investigate the safety, e ectiveness & hemodynamic e ects of percutaneous atrial septal defect (ASD) closure using the Occlutech® devices in a prospective trial.
Methods: Observational, single arm study including 111 patients who underwent ASD closure between October 2013 and December 2015. Device performance, immediate, short and intermediate-term out- comes were assessed.
Results: Median age and ASD size were 7.8 years (8 months–59 years) and 16.5 mm (4.8–38 mm) respectively. De cient or absent retro-aortic rim was observed in 30 patients (27%). All patients had dilated right side chambers. Pulmonary artery systolic pressure > 35 mmHg was observed in 57 (51%) patients who had signi cantly larger ASDs (p=0.009) and larger RV lengths (p=0.006). Implantation of Occlutech device (mean size of 19.4±8 mm) with successful clo- sure was reported in 95.5%. Closure success was linked to larger IVC rims (p = 0.009). An IVC rim ≥ 7.2 mm is 97.1% sensitive, while IVC rim ≥ 11.2 mm is 100 % speci c for closure success. Median follow-up of 6 months was obtained in all patients. Successful closure lead to signi cant regression of RV & pulmonary artery dimensions at 1, 3 & 6-months follow up (p<0.001).
Conclusions: Transcatheter closure of secundum ASDs using the Occlutech septal Occluder is safe, and e ective in children, adoles- cents, and adults. The device performed well in a wide range of ana- tomical scenarios resulting in excellent short and intermediate-term outcomes. Su cient IVC rim is the most important factor in predict- ing successful closure.
SHORT AND INTERMEDIATE TERM SAFETY AND EFFICACY OF PERCUTANEOUS DEVICE CLOSURE HEART SURGERY FOR CONGENITAL HEART DISEASE IN RABAT'S PEDIATRIC HOSPITAL
Sara Hassani
Rabat´s University Hospital, Rabat. Marocco
Background: We aim to report the results of our experience in pedi- atric closed heart surgery for congenital heart disease in Rabat’s pedi- atric hospital, in a country that su ers from a lack of a strong health infrastructure.
Methods: We conducted a retrospective study of patients that under- went palliative or corrective surgery for congenital heart disease in Rabat’s pediatric hospital, in a period of 27 months, from 25 June 2014 to 12 September 2016.
Results: The mean age of our patients (n=62) was 2 years 8 months. 62% were infants, below X months old. Patent ductus arteriosus was the most frequent non-cyanotic lesion while tetralogy of Fallot was the most frequent cyanotic heart disease. Four patients had congen- ital dysrhythmia. 35 palliative procedures were performed (12 mod- i ed Blalock Taussig shunts, 13 pulmonary arterial bandings) while 33 were curative (24 ligations of patent ductus arteriosus, 6 Crafoord interventions and 3 ligations of double aortic arches). 4 patients underwent epicardial permanent pacing. The short-term (mortality rate was 8%, mainly in the group that underwent palliative proce- dures (a ratio of 4 to 1). Hemodynamic instability was by far the most frequent early complication whereas nosocomial infection was the most reported complication in the medium term. In the longer term, one death was reported a year after surgery in a patient who under- went a BT shunt. One case of residual hypertension was reported in our oldest patient that underwent a Crafoord intervention. 38% of the patients were lost to follow up while the control was satisfying for 62% of them. Three of the patients that underwent a Blalock Taussig shunt for a ToF have had a corrective surgery; 2 of them in private structures and one in Rabat’s children hospital during a surgical mis- sion by a Swiss team. The patients that underwent PA banding are still waiting for corrective surgery.
Conclusion: Congenital heart disease is still under-diagnosed and undertreated in our country. Our results are encouraging despite the lack of infrastructure and the complexity of the heart disease treated. Our country remains in need of specialized centers with multidisci- plinary teams and expert physicians.
BALLOON MITRAL VALVOTOMY IN A PATIENT WITH SITUS INVERSUS DEXTROCARDIA
Osama Rifaie
Ain Shams university Cairo, Egypt
Background: A 20 years old female with history of rheumatic fever at the age of 10.Three years ago, she started to note progressive short- ness of breath on moderate e ort followed by paroxysmal nocturnal dyspnoea and orthopnoea.
On Examination: Pulse =80/ min. regular with good volume, equal on both sides, well felt peripherally and without special character BP=120/80 mmHg. Normal jugular venous pressure no leg oedema. Liver was felt 2cm below the left costal margin. Apex was in the right fth space inside the mid clavicular line with slapping character. Auscultation revealed accentuated S1, loud P2+Opening snap+mid diastolic rumble at the apex.
Echo showed Dextrocardia +Situs inversus, Mitral stenosis with mitral valve area (MVA) =1cm2 by planimetry without mitral regurgitation (MR).Wilkins score =8/16,Rifaie score=2/12.TEE revealed free left atrial appendage( LAA)+thin atrial septum. Balloon mitral valvotomy (BMV) was planned.
Hijazi, Z
2017 CSI Africa Abstracts