Page 54 - Journal of Structural Heart Disease Volume 4, Issue 3

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Meeting Abstracts
Sizes of ASDs were 3.4×8.5 mm and 5.0×12.7 mm, and the length between both ASDs was 7.6 mm. A part of aortic rim was less than 5 mm, but the range was less than 30°, so we chose by transcatheter ASD closure. Balloon sizing was measured to be 10.5 mm for smaller ASD closer to the aortic rim (ASD1) and 12.3 mm for larger ASD in the center (ASD2). Considering short aortic rim, we chose and placed a 12 mm Figulla Flex II ASD occluder (FFO) for ASD1, then a 13.5 mm FFO placed for ASD2. After placed, a 12 mm FFO contacted with aortic vessel walls, but did not press the aortic vessel wall excessively at the contact point with FFO. Detachment was successful, and no complications have observed during follow-up period.
Erosion is a rare but serious complication of transcathe- ter ASD closure. In this case, FFO on the side of the aortic rim partly touched the aorta by overlapping both FFOs. FFO results in a soft contact with aortic vessel walls when placed adjacent to it. It is di cult to predict the device position after detachment in case of overlapping devices. We report a case of transcatheter ASD closure for multiple ASDs using FFOs.
35. SIMULTANEOUS TRANSCATHETER DEVICE CLOSURE OF ASD, VSD AND PDA IN AN INFANT WITH DOWN’S SYNDROME
Ravi Ranjan Tripathi
CHL Hospital; Ab Road; Near Lig Square
History and Physical Findings: An 11 month old infant with Down’s syndrome weighing 7 kg was referred to our hospital with frequent respiratory tract infections and soft systolic murmur for evaluation. External features of Down’s syndrome were present. Precordium was hyper dynamic with soft systolic murmur at Parasternal area with loud pul- monary component (P2).
Imaging: Chest radiograph revealed cardiomegaly with prominent vascular markings. Transthoracic echocardio- gram (TTE) revealed moderate sized ostium secundum ASD (10 mm), perimembranous VSD (5 mm) and PDA (3.5 mm). There was biventricular enlargement, with severe PAH (estimated PA pressures 55 mmHg).
Indication for Intervention: After careful imaging it was found that all the defects were suitable for transcatheter closure, hence it was decided to perform simultaneous device closure of VSD, PDA and ASD.
Intervention: Hemodynamic assessment during the tran- scatheter procedure showed high pulmonary artery (PA) pressures (60/25 mm Hg) against systemic arterial pressures of 75/35 mmHg. First VSD device closure was performed from arterial route using 6/4 Amplatzer duct occluder II (ADO II) device by 5 French guiding catheter. Then PDA was closed using standard technique by 6/4 Amplatzer duct occluder device. Finally ASD device closure was performed using 12 mm Amplatzer Septal occluder device with 7 French delivery system. Post procedure PA pressures reduced to 45/15 mmHg against systemic pres- sures of 80/45 mmHg. Electrocardiogram (ECG) showed sinus rhythm with Heart rate of 110/min. Patient was dis- charged from hospital after 72 hours of observation.
Learning Points: Simultaneous transcatheter device clo- sure of multiple defects is a safe alternative to surgery if suitable.
36. DEVICE SELECTION DURING TRANSCATHETER CLOSURE OF PATENT DUCTUS ARTERIOSUS IN PREMATURE INFANTS WEIGHING LESS THAN 2.5 KILOGRAMS
Jieh-Neng Wang1, Yung-Chieh Lin2, Min-Ling Hsieh3,
Ying-Tzu Ju1, Wei-Shyang Kung1, Yu-Jen Wei1, Jing-Ming Wu1
1 National Cheng Kung University Hospital; Department of Pediatrics; Pediatric Cardiology
2 National Cheng Kung University Hospital; Department of Pediatrics; Neonatology
3 Departments of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan; Pediatric Cardiology ; Pediatric Cardiology
Background: Transcatheter closure of patent ductus arteri- osus (PDA) in preterm babies remains a highly challenging procedure. There is no ideal device to t in these clinical scenarios.
Objective: The aim of this study was to describe our expe- riences in device selection during transcatheter device clo- sure of PDA in premature infants weighting less than 2.5 kilograms.
Methods: Hospital records and catheterization reports of all premature babies who underwent transcatheter PDA closure since October 2014 in our hospital were reviewed. Basic demographics clinical information, echocardio- graphic, angiographic data, and devices were recorded.
Results: Seventeen premature infants (seven boys and ten girls) born at gestational ages ranging between 22 and 35 weeks (median, 28 weeks) were identi ed. All patients had
Hijazi, Z
2017 CSI Africa Abstracts