Page 125 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
of pulmonary vasodilators. In addition, we believe that knowledge of dyastolic function might help the surgical team decide if a fenestrated Fontan is a better strategy.
Since we still have little data and all of our patients had ODD, we couldn't detect any clinical impact of the test.
However, cardiac catheterization is a routine procedure in all patients scheduled to Fontan surgery. Since the volume test had no additional cost or complications, we believe it can easily provide one more information about the phisiol- ogy of each individual patient.
164. INTERVENTIONS USING AXILLARY ARTERY IN PEDIATRIC PATIENTS WITH CONGENITAL HEART DISEASE
Giolana Mascarenhas Cunha, Germana Cerqueira Coimbra, Luiz Junya Kajita, Raul Arrieta
Heart Institute of University of Sao Paulo-Brazil, São Paulo, Brazil
Introduction: Vascular access is an important issue for interventional therapies in critical congenital heart dis- eases, specially in children weighing less than 20 kilograms.
The use of axillary vascular aproach is not so frequent in pediatrics, but may be useful in several types of procedures.
We aimed to evaluate the use of the axillary artery in differ- ent procedures performed on children weighing less than 20 kilograms.
Methods: We performed a retrospective review of all patients under 20kg managed with therapeutic catheter- ization using axillary artery approach in a tertiary care cen- ter in South America since august 2013 until February 2019 (total 5515 cases). The medical records of these patients were reviewed to demographic and procedural details.
Procedural technique: The right axillary artery was used in all cases, direct percutaneous access to the right axillary artery was achieved using either ultrasound guidance or feel pulse. The puncture was performed with a 21 G nee- dle, with the arm abducted at 90°, and a 0.014 inch guide- wire was positioned in the descending aorta. A 5 Fr x 11 cm pediatric introducer was initially used for the procedure and whenever required, it was replaced for a larger one. Manual compression hemostasis was performed after the intervention.
Results: Were included in the study 30 patients ≤ 20kg, in wich 26 cases(16 males), the axillary artery was the access via to therapeutic procedure. Median age and
weight were1,7 yo (25 days – 7,7yo) and 9,0 (3,29-20kg) respectively.
Thirteen patients underwent intervention in aortic coarc- tation (balloon or stenting), six patients underwent stent- ing in mBT-shunt, four cases primary PDA stenting, one case aortic valvuloplasty and one coil embolization of MAPCAs. Nine procedures were classified as an emergency. The median fluoroscopy time was 17,58 min (17-33min).
There wasn’t major complication linked to axillary access. Limb pulses and perfusion were monitored post procedure and remained normal. Technical success was observed in all patients.
164. Table 1.
Age (days-months) Weight (kg) Procedure
BT shunt stenting
PDA stenting
Recoarctation stenting Recoarctation balloon angioplasty Aorta coarctation stenting Pulmonary artery stenting Balloon aortic valvuloplasty Coiling in MAPCAs
Final sheat
5Fr 6Fr 7Fr 8Fr 10Fr
Complications
Local bleeding Hematoma
20 (25d-93m) 9 (3,2-20kg)
5 4 6 4 3 1 1 1
12 4 7 1 1
2 2
Study number (n=25)
Discussion: The use of the axillary artery was safe and effective in all patients included in our study; being an excellent alternative access route to treat different types of congenital heart diseases, besides it allows to conserve the other puncture sites for future interventions
Hijazi, Z
22nd Annual PICS/AICS Meeting