Page 106 - Journal of Structural Heart Disease Volume 5, Issue 4

Meeting Abstracts 168
137. Figure 1. Case examples showing severe lymphatic insufficiency by T2-weighted MR lymphangiography (T2W-MRL, left) and volume rendered dynamic contrast MR lymphangiography (DCMRL, right).
visualization. All patients initially underwent a non-con- trast T2W-MRL. High risk patients were subsequently accessed via bilateral inguinal lymph nodes to allow for dilated contrast injection for the DCMRL. Based on lym- phatic insufficiency burden, patients were classified into 4 types (Dori subtypes).
Results: T2W-MRL was performed in 16 patients followed by DCMRL in 3 high risk patients. Median age and weight were 6.25 y (range 1-15 y) and 20.0 kg (7.9-35.9 kg), respec- tively. Of the 16 evaluations, 9 were pre-Fontan and 7 were post-Fontan for PLE and/or cyanosis. Time taken for first pass RHC and LHC/aortic pull back was 4.9 and 2.9 minutes, respectively. Majority of patients were found to have Dori Types 1 and 2 [Type 1: n = 5 (33%); Type 2: n = 4 (27%)]. Three patients in the cohort were deemed high risk based on T2W-MRL imaging with four (27%) categorized as Dori Type 3 and two (13%) categorized as Dori Type 4. 15 patients had acceptable data on the T2W-MRL. Two of the three high risk DCMRL patients subsequently underwent transabdominal puncture to access the thoracic duct for coil/glue embolization.
Conclusions: This iCMR pilot study shows feasibility and safety for performing contrast and non-contrast lymphatic
imaging during routine SV evaluations. Cardiac catheter- ization of pre- and post-Fontan patients in the MRI suite combines the best of both modalities to obtain more accurate flow, cardiac output, MR-based ventricular func- tion, and catheter-based pressures. In addition, iCMR adds incremental value for the SV population by allowing for lymphatic evaluations that cannot be obtained in the tra- ditional cardiac catheterization laboratory. Using iCMR, the SV lymphatic circulation can be thoroughly studied alongside routine assessments. Further work is needed to optimize lymphatic scanning protocols and clinically cor- relate lymphatic findings to short and long term patient outcomes.
138. LONG TERM DEGRADATION STUDY OF A NOVEL BIORESORBABLE STENT FOR CONGENITAL HEART DISEASE – A 5 YEAR FOLLOW-UP STUDY.
Surendranath R. Veeram Reddy1, Tre Welch1, Jian Wang1, Jamie Wright1, Annie Nguyen1, Matthew Riegel2, James Richardson1, Joseph Forbess3, Robert Jaquiss1, Alan Nugent3 1UT Southwestern Medical Center, Dallas, USA. 2Kansas University, Lawrence, USA. 3Northwestern University Feinberg School of Medicine/Lurie Childrens , Chicago, USA
Journal of Structural Heart Disease, August 2019
Volume 5, Issue 4:75-205