Page 48 - Journal of Structural Heart Disease Volume 4, Issue 3

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Meeting Abstracts
Background: Duct dependent cardiac lesion is a life threat- ening condition. Surgical Blalock-Taussig (BT) shunt is a treatment of choice in rst stage palliation in such cases. Until recently, ductal stenting becomes a promising alter- native treatment with less complications. The aim of this study is to compare the e ectiveness and safety between ductal stenting and Blalock-Taussig shunt in duct depen- dent cyanotic lesions.
Method: Journal searching in PubMed, Cochrane, and MEDLINE databased from 2010 to 2017 was conducted. A total of 4 publications comprising 144 patients in ductal stenting group and 361 patients in Blalock-Taussig shunt group were included in this analysis. The primary outcome was one year survival rate and major adverse events con- sist of death related procedure, and restenosis that require reintervention to maintain adequate pulmonary blood ow.
Results: The pooled one year survival rate were 84% in duc- tal stenting group and 89% in BT shunt group. The pooled major adverse event rate were 18.8% in ductal stenting group and 28.5% in BT shunt group. Similar baseline char- acteristic (median age, median weight) and procedure type were adjusted. However, morphology of duct was variable among studies.
Conclusion: Ductal stenting is a promising alternative treatment for duct dependent cardiac lesion as it has com- parable survival rate and less complications than BT shunt. However, patient selection, vascular access, technique, morphology of duct, type and also size (or length) of stent are critical to ensure the good results. A further large mul- ticenter study was needed to support the practice of evi- dence-based medicine, especially in Indonesia and other South East Asia countries.
28. FIRST STAGE PALLIATION OF DUCT DEPENDENT LESIONS OF DUCTAL STENTING: A SYSTEMATIC REVIEW
Radityo Prakoso1, Prissilia Prasetyo2
1 National Cardiovascular Center Harapan Kita; Cardiology and Vascular Medicine Faculty of Medicine Universitas Indonesia; Pediatric Cardiology
2 University of Indonesia; Faculty of Medicine; General Practitioner
Background: Duct dependent cardiac lesion is a life threat- ening condition. Surgical Blalock-Taussig shunt is a treat- ment of choice for rst stage palliation in such cases. Until recently, ductal stenting becomes a promising alternative
treatment with less complications. The aim of this study is to describe the e ectiveness and safety of ductal stenting in duct dependent cyanotic lesions.
Method: Journal searching in PubMed and MEDLINE data- based from 2010 to 2017 was conducted. Results from 12 publications comprising 532 patients were included in this analysis. The primary outcomes were successful rate of the procedure, as well as immediate and mid-to-long term major adverse events (death related to procedure, device embolization, acute thrombosis, and restenosis).
Results: All of studies in this systematic review showed a consistent result. The pooled successful rate were 94%. Immediate and mid-to-long term major adverse event rate were found in 16% of the pooled study subjects. Limitation ofthisstudyis thehighvariabilityinpatientfactors,duct morphology, and techniques performed by operators.
Conclusion: Ductal stenting is relatively e ective and safe as an alternative treatment for duct-dependent car- diac lesion. However, patient selection, vascular access, technique, type and size (or length) of duct and stent are critical to ensure maximal outcomes. A further large mul- ticenter study was needed to support the practice of evi- dence-based medicine, especially in Indonesia and other South East Asia countries
29. PATENT DUCTUS ARTERIOSUS STENTING IN A PRETERM INFANT WITH HYPOPLASTIC RIGHT HEART SYNDROME (HRHS)
Cathleen Faye Recana-Lu1, Dexter Eugene Cheng2
1 Philippine General Hospital; Department of Pediatrics; Section of Pediatric Cardiology
2 The Medical City; Department of Pediatrics; Pediatric Cardiology
History and Physical: The patient is a preterm female, deliv- ered via emergency primary cesarean section, weighing 1.2kg. A congenital anomaly scan done at 20 weeks of ges- tation revealed hypoplastic right heart syndrome, tricuspid and pulmonary valve atresia with ventricular septal defect. She presented at birth with persistent severe cyanosis and desaturations as low as 50%.
Imaging: A transthoracic echocardiogram con rmed hypo- plastic right heart complex with tricuspid and pulmonary valve atresia, and con uent pulmonary arteries supplied by a patent ductus arteriosus (PDA) measuring 2mm in diameter and 10mm in approximate length.
Hijazi, Z
2017 CSI Africa Abstracts