Page 31 - Journal of Structural Heart Disease Volume 4, Issue 3

Meeting Abstracts
88
Case Reports:
Case 1: A 45 year old post aortic valve replacement presented with dyspnea on exertion (NYHA class IV). Evaluation revealed severe prosthetic valve dysfunction with severe Pulmonary arterial hypertension. Patient was taken up for cath to assess hemodynamics but surprisingly found to have associated coarctation of aorta with almost atresia subsequently underwent stenting of coarctation. Post procedure the gradient across the prosthetic aortic valve also decreased signi cantly.
Case 2: A 65 years old post angioplasty to LAD and LCx presented with chest pain. Angiogram done revealed normal coronaries but had coarcation of aorta. patient had deranged renal function and developed anuria. Subsequently patient was taken up for coarctation stent- ing. After the procedure the renal function improved dramatically.
Case 3: 42 years old presented with history of recurrent admissions for pulmonary edema. Evaluation revealed severe aortic regurgitation. He was planned for aortic valve replacement. He was taken up cath for evaluation of coronaries but found to have near atresia of arch which was then relived by stenting of coarctation. Severity of AR decreased post procedure.
Discussion: Coarctation in adults though usually presents with uncontrolled hypertension but it can be complicated by presence of associated lesions like aortic regurgitation or complications like renal failure and also it can overesti- mate the severity of associated lesion as in our case it over- estimated the severity of prosthetic valve dysfunction in rst case and Aortic regurgitation in second case.
5. PERCUTANEOUS ASD CLOSURE OF CHILDREN LESS THAN 10 KG
Ali Baykan1, Osman Baspinar2, Özge Pamukçu3, Suleyman
Sunkak3, Onur Tasci4, Ayse Sulu5, Kazim Uzum6, Nazmi Narin7
1 Kayseri Erciyes University; Interventional Cardiologist; Child Cardiology
2 Gaziantep University Medical Faculty; Interventional; Child Cardiology
3 Erciyes University; Interventional; Child Cardiology
4 Erciyes University; Pediatric; Pediatric Cardiology
5 Gaziantep University; Pediatrics; Pediatric Cardiology 6 Erciyes University; Non-Invasive; Child Cardiology
7 Erciyes University; Interventional; Kayseri
Background: Traditionally the procedure of percutaneous ASD closure is used to be done in children more than 15 kg.
Main limitation factor for small children is the size of deliv- ery system and how to manage in a state of complication.
Objective: The aim of this study was to discuss the success, e cacy and safety of the percutaneous closure of symp- tomatic ASD in children less than10 kg.
Method: Study was performed in 2 Pediatric Cardiology centers: Erciyes University and Gaziantep University. Total 32 patients were included. Demographic and angiographic data of these patients were gathered retrospectively from patients’ records.
Results: Median weight of patients was 9,0 (8,2-9,5) kg, median age of patients was 19 (12,5-31,5) months. Female/ male ratio was 21/11. Median mean pulmonary pressure was 25 (20,5-33) mmHg. The median value of measured defect sizes measured during angiograph was 13,0 (10,75- 15,0) mm. Median value for preferred device size was 13,0 (9,0-15,0) mm. Weight/defect and body surface area/ defect ratios were calculated. The ratio of weight per defect sizewas0,64(0,56-0,85)alsoratioofbodysurfaceareaper defect size was 0,030 (0,028-0,040).
Additional medical problems of patients were growth hor- mone de ciency, Mucopolysacharidosis, Down syndrome in 3 patients. Additional heart problems of patients were severe pulmonary stenosis in 4 patients, large PDA in one patient, VSD in 2 patients. Pulmonary valvuloplasty, PDA closure, and percutaneous VSD closure were done in those patients in the same session with ASD closure. Types of devices used were: Amplatzer Septal Occluder in 26 patients, CeraFlex Septal Occluder in 2 patients, Figulla FlexII Atrial Septal Occluder in 3 patients, Memopart Septal Occluder in 1 patient.
After successful positioning, before deploying the device in one patient device was retrieved because of compres- sion to the aorta.
No major complication was seen.
Conclusion: In experienced centers percutaneous ASD closure can be done e ectively and safely in symptomatic children less than 10kg.
Journal of Structural Heart Disease, April 2018
Volume 4, Issue 2:85-113