Page 30 - Journal of Structural Heart Disease Volume 4, Issue 3

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Meeting Abstracts
Results: In Nepal rst PDA device closure was done in March 2007. Till Novemebr 2017, 223 PDA device closure were done in four centres of Nepal. Most of the cases (203) were done in national heart Centre. During the study period 211 patients were attempted for transcatheter closure of PDA in national heart centre. Six patient were thought to have unfavorable size or shape, and transcatheter occlusion was not attempted. In one patients attempt was made to close the duct with cook coil which embolized to pulmo- nary artery. One patient device was retrieved as there was no signi cant decrease in the pulmonary artery pressure. Among the 203 PDA device closures most 149 procedures were done in the year 2016 and 2017. In 203 patient PDA was successfully closed. Among the 203 patients 155 were female and 48 were male. Age ranged from 0.4 years to 69 years with the mean of 13.5 years. The PDA was closed by Amplatzer duct occluder in 178 patients, Life tech PDA occluder in 14 patients, Hyperion PDA occlude in seven patients, Amplatzer muscular VSD in four patients. Most of the cases we did the antegrade technique.In few cases when we cannot cross the PDA through the pulmonary artery retrograde technique was used.In one case we closed a residual PDA after there was a PDA after the sur- gical closure.
Conclusions: Transcatheter closure of PDA can be done safely with high success rate in Nepal.
3. DEVICE CLOSURE OF NON ISCHEMIC, NON TRAUMATIC LEFT VENTRICULAR PSEUDOANEURYSM: A RARE PRESENTATION
Sushil Azad1, Sitaraman Radhakrishnan2
1 Department of Pediatric Cardiology; Fortis Escorts Heart Institute; Okhla Road
2 Fortis Escorts Heart Institute; Pediatric Cardiology; Dm Cardiology
Introduction: Pseudoaneurysm of the LV cavity has been reported after myocardial infarction and myocardial sur- gery. It has been associated with mitral regurgitation and a high mortality. Conventional surgery however carries sig- ni cant mortality, especially when combined with mitral valve replacement; and medical treatment carries an even higher mortality. We report a case of non ischemic and non traumatic pseudoaneurysm which was treated with device closure.
Case Report: 45 years old lady presented with history of dyspnea on exertion, chest pain since last 3 years with pro- gressive worsening since last 3 months presently in NYHA class 3. Investigations done revealed cardiomegaly on
chest X-Ray. Echo revealed large apical pseudoaneurysm with preserved left ventricular function. Cardiac MRI done revealed presence of lobulated psuedoaneurysms from LV with enhancing wall suggestive of scar and brosis. The larger psuedoaneurysm was measuring 10x6.6x5.0 cm in maximal dimensions with a narrow neck ,3 mm in diameter and 4 mm in length, arising from the apex communicating with the LV cavity with movement of blood and also having intracavitary lling defect suggestive of a thrombus.There was also presence of another lobulated pseudo aneurysm measuring 3.1x2.8 cm in maximal diameter with a narrow neck of 4mm diameter and 15mm length arising from sub- mitral lateral wall extending in the atrioventricular groove communicating with the left Ventricle and indenting the Left Atrium. Coronary angiogram was done which revealed normal coronaries.
She was planned for device closure in view of narrow neck and pseudoaneurysm was successfully closed with Amplatzer vascular plug 3 size 12mm. Post device clo- sure echocardiogram revealed complete occlusion of the pseudoaneurysm sac which was later con rmed on CT angiography.
Discussion: Pseudoaneurysm are mostly ischemic or trau- matic (post surgical). This case was unique in the sense that there was no history of any surgical procedure and also that coronaries were normal. Percutaneous approach is attractive option as it carries less morbidity as compared to standard surgical approach.
4. COARCTATION OF AORTA IN ADULTS: CHALLENGES FACE
Sushil Azad1, Sitaraman Radhakrishnan2
1 Department of Pediatric Cardiology; Fortis Escorts Heart Institute; Okhla Road
2 Fortis Escorts Heart Institute; Pediatric Cardiology; Dm Cardiology
Introduction: Coarctation of the aorta is a common con- genital defect, which although normally detected and sur- gically repaired in childhood may present in adolescence or adulthood. Most common presentation is hypertension. Presentation can be complicated by associated lesions. The natural history of untreated coarctation is that of prema- ture death from stroke and coronary heart disease or sud- den death. We present three cases of unusual presentation and challenges thus faced.
Hijazi, Z
2017 CSI Africa Abstracts