Page 141 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
Septal Occluder. We report the first series of 7 cases of cardiac erosions occurring with the Occlutech Figulla Flex Occluder. The cases were retrospectively collected until February 2018.
Results: Median age was 8(4 to 38) year-old. There were 5 females and 5 subjects were less than 18-year-old. Three patients had aortic rim deficiency. One device was over- sized. The mean time interval between device implanta- tion and erosion was 36±46.3 days. Four patients (57%) developed clinical symptoms within four days after the procedure whereas 3(43%) presented late, at 49, 78 and 116 days after the implantation. Six patients presented with pericardial effusion necessitating drainage whereas one patient was asymptomatic, diagnosed during fol- low-up. They all underwent urgent surgery with device removal and repair of the erosion. Intraoperative examina- tion revealed that the erosion was located at the left (n=3) or right (n=1) atrium roof, whereas 3 were between the aorta and the right atrium. There were no deaths and no postoperative complications. Based on the estimation of more than 60000 implanted devices at the time of data col- lection, the rate of erosion with the Figulla Flex Occluder seems very low as compared to previously published data on other devices.
Conclusion: Similar to other devices, cardiac erosion occurs with the Figulla Flex Occluder. We recommend regular short and long-term follow-up after percutaneous ASD closure with all devices to better clarify cardiac ero- sion rates and to identify high risk patients.
187. A CASE OF CREATION OF A TRANSCATHETER FENESTRATION IN FONTAN FAILURE WITH CHRONIC PLEURAL EFFUSION ASSOCIATED WITH HIGH ALTITUDE
Ju Ae Shin, Kyung Min Kim, Ji Hong Yoon, Jae Young Lee
Catholic University of Korea, Seoul, Korea, Democratic People's Republic of
Failed fontan circulation in single ventricle presented with low cardiac output, plastic bronchitis, protein-los- ing enteropathy, and recurrent pleural effusions. High altitude was known as a risk factor for fontan failure. We report the case of creation of a transcatheter fenestra- tion in 9-years-old child who had chronic recurrent both pleural effusion due to failing fontan circulation associ- ated with high altitude. He was diagnosed double-outlet right ventricle with remote ventricular septal defect in Ulaanbaatar, Mongolia at an altitude of 1350 meters. He was initially palliated with bilateral bidirectional Glenn shunt at 4-years-old in India, and underwent extracardiac
conduit Fontan operation (non-fenestration) in 7-years- old in Seoul St. Mary’s Hospital, Korea. After returning to Mongolia, he had exertional dyspnea, facial edema, and cyanosis with chronic recurrent both pleural effusion for 2 years. Successful Fontan fenestration with stent implanta- tion was performed in our institution. At 1-year follow-up, his symptoms of pleural effusion improved significantly. This case may help clinicians stratify patients at risk of fon- tan failure in advance and improve outcomes in these crit- ically-ill patients.
187. Figure 1. Frontal view of the chest radiograph shows both pleural effusions.
188. IMPACT OF CALPAIN-9 ON INTIMAL HYPERPLA- SIA IN HUMAN PULMONARY VEIN STENOSIS
Takahiro Inoue1,2, Hiroshi Matsushita1,2, Enoch Yeung1, Sara Abdollahi1, James Beckett1, John Coulson1, Harry Dietz1, Narutoshi Hibino1,2,3
1Johns Hopkins, Baltimore, USA. 2University of Chicago, Chicago, USA. 3Advocate Children's Hospital, Chicago, USA
Objectives: Severe progressive pulmonary vein (PV) ste- nosis remains very difficult to manage with limited treat- ments. Several growth factors, including VEGF, PDGF and TGF-β1, are involved in PV stenosis. However, increased knowledge of the downstream signaling cascades is needed to develop effective clinical interventions. Calpain provides an interesting candidate therapeutic target, since it is activated by EGF, PDGF and TGF-β1. We have also
Hijazi, Z
22nd Annual PICS/AICS Meeting