Page 37 - Journal of Structural Heart Disease Volume 4, Issue 3

Meeting Abstracts
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Indication for Intervention: According to 2017 AHA guide- lines, further imaging with angiography (CT, MRI, invasive) may be considered for diagnostic and prognostic purposes during the rst year and may be considered for periodic surveillance every 1 to 5 years thereafter (Class IIb;Level of Evidence C).
Intervention: Due to the patient’s parents worry and the risk of intervention, we decided to arrange the MDCT rather than catheterization angiography.
Learning Points Of The Procedure: MDCT is also a good choice to evaluate the sizes and number of coronary artery aneurysms under the safer condition.
11. RENAL VEIN STENTING IN A FILIPINO TEENAGER WITH NUTCRACKER SYNDROME – FIRST REPORTED CASE IN THE PHILIPPINES
Jonas D. Del Rosario, MD, Maria Dorotan-Guevara MD, Erwin O. Ybañez, MD, Nicholas A. Cruz, MD
Heart Institute, St. Luke’s Medical Center, Global City, Philippines
Nutcracker syndrome, also known as left renal vein entrap- ment is often a neglected cause of microscopic or gross hematuria. We present a case of a 15-year old female who presented with recurrent ank pain associated with hema- turia. Whole abdominal CT scan revealed a decreased in the abdominal aorta:superior mesenteric artery angle measuring approximately 280 (normal value: 38-560) with resultant compression of the left renal vein and tortuos- ity of the second lumbar vein suggestive of nutcracker
syndrome. Renal duplex ultrasound showed compres- sion of the left renal vein by the abdominal aorta and the superior mesenteric artery with an anteroposterior (AP) diameter of 0.13cm. There is note of renal vein distention (transverse AP diameter of 0.80 cm) after the area of com- pression. The patient underwent endovascular treatment of the renal vein using a 14 mm x 60cm self-expanding stent (Boston Scienti c, Epic). Post left renal vein stenting duplex scan was done which revealed a patent stent and increased in the transverse AP diameter of the renal vein to 0.92 cm with normal venous ow. There were no immedi- ate post-operative complications and resolution of symp- toms after 3 days. At one-year follow-up, the patient has no recurrence of ank pain and hematuria. This is the rst reported case of renal vein stenting in the pediatric popu- lation in the Philippines.
12. CUTTING BALLOON ATRIAL SEPTOSTOMY IN AN ADULT FILIPINO FEMALE WITH END-STAGE FENFLURAMIN-INDUCED PULMONARY ARTERIAL HYPERTENSION – FIRST REPORTED CASE IN THE PHILIPPINES
Jonas D. Del Rosario, MD, Maria C. Dorotan-Guevara, Edmund A. Ang, MD
Heart Institute, St. Luke’s Medical Center, Global City, Philippines
Group 1 Pulmonary arterial hypertension (PAH) is a debil- itating, progressive disease resulting to recurrent morbid- ity and early mortality despite advance medical therapy. Atrial septostomy creates a right-to- left interatrial shunt, decreases right-sided heart lling pressure, and improves left-sided heart lling with eventual goal of improving systemic oxygen delivery due to improved cardiac output. This procedure has been proven as an e ective therapeu- tic option providing notable clinical and hemodynamic improvement and increased survival in patients with advanced PAH.
We present a case of a 38-year-old female known case of Group 1 Pulmonary arterial hypertension (PAH) for 9 years who initially presented with syncope, shortness of breath, and bipedal edema. Patient also had prior intake of Fen uramine (Bangkok), a diet pill known to cause PAH. Her 2D echocardiography at that time showed severely dilated right atrium and right ventricle with ventricular volume and pressure overload and severe pulmonary hypertension. Subsequent diagnostic right heart cath- eterization con rmed severe pulmonary hypertension with right atrial pressure (RAP) of 15 mmHg and mean pulmonary artery pressure (PAP) of 72 mmHg. Despite the patient's compliance with medical therapy consisting of
Journal of Structural Heart Disease, April 2018
Volume 4, Issue 2:85-113