Page 15 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
the PDA was 16.71 ± 3.37 mm and mean stent diameter was 4.01 ± 0.24 mm. Fifty-five cases (94.8%) were success- fully implanted and 52 cases (89.6%) were completely successful. Three cases (5.2%) died. Five cases (8.6%) devel- oped complications which were properly managed with successful outcome. The mean O2 saturation increased from 71.2 ± 6.8 % to 88.2 ± 4.3%. The mean duration of stent patency was 10.5±2.25 months.
Conclusion: PDA stenting is a very good alternative to sur- gical shunt with less complications and very good results, nevertheless it is technically demanding. In experienced hands it is feasible to stent nearly all types of PDAs even the very tortous ones.
Keywords: PDA • PDA stent • Duct-dependent pulmonary circulation.
7. THE RELATIONSHIP BETWEEN LEFT VENTRICULAR DILATION AND RIGHT VENTRICULAR DIASTOLIC FUNCTION IN CHILDREN WITH A PATENT DUCTUS ARTERIOSUS
Jamison Miller1, William Anderson2, Joseph Paolillo3, Matthew Schwartz3
1Atrium Health- Levine Children's Hospital, Charlotte, USA. 2Atrium Health, Charlotte, USA. 3Atrium Health- Sanger Heart and Vascular Institute- Charlotte Pediatric Cardiology, Charlotte, USA
Introduction: Right ventricular (RV) dilation can lead to left ventricular (LV) diastolic dysfunction due to nega- tive ventricular-ventricular interaction in various forms of congenital heart disease such as repaired tetralogy of Fallot. However, the effect of LV dilation on RV diastolic function has not been examined. Patients with a patent ductus arteriosus (PDA) experience left ventricular volume loading and dilation. We aimed to determine if LV dilation is associated with RV diastolic dysfunction in patients with a PDA.
Methods: We retrospectively identified patients ages 6 months to 18 years who underwent attempted transcath- eter PDA closure at our institution between 01/10 and 6/18. Patients with an elevated pulmonary artery pres- sure were excluded. Demographic variables, pre-cath- eterization echocardiographic data, and catheterization hemodynamic and angiographic data were examined. We evaluated the relationship between right ventricu- lar end-diastolic pressure (RVEDP) and various patient variables.
Results: A total of 114 patients were included with a median age of 3.0 years (0.5 to 18) and weight of 13.6 kg
(6.2 to 76.4). 53.5% of patients had a small PDA and 43% had a moderate duct. Using linear regression, there was no significant association between RVEDP and LVEDD Z-score (p=0.74). Additionally, no association was found between RVEDP with LV end-diastolic volume (p=0.96) or Qp/Qs (p=0.32). A positive association was found between RVEDP and RV systolic pressure (p<0.01), the ratio of pulmonary artery systolic pressure/aortic systolic pres- sure (p<0.01), and pulmonary capillary wedge pressure (p<0.01). Student’s t-test found no statistical significance when comparing the RVEDP between those with a LVEDD Z-score >2 to those with Z-score <2 (p=0.57).
Conclusions: In our cohort of children with a small or moderate PDA and normal pulmonary artery pressures, elevated RVEDP was not associated with left ventricular dilation, but was associated with markers of RV afterload including RV systolic pressure and the ratio of pulmonary artery/aortic systolic pressure. In children with a PDA, left ventricular enlargement does not appear to impact RV dia- stolic function through ventricular-ventricular interaction and, instead, RV diastolic function appears to be deter- mined by RV afterload.
8. PIGGYBACK STENT MOUNTING AND DEPLOYMENT FOR RVOT PREPARATION DURING TRANSCATHETER PULMONARY VALVE IMPLANTATION
Jenny Zablah1, Gaute Døhlen2, Martin Ystgaard2, Gareth Morgan1
1University of Colorado, Aurora, USA. 2Oslo University, Oslo, Norway
Background: Heterogeneous complexities of the Right Ventricular Outflow Tract (RVOT) may complicate the deliv- ery and deployment of stents in preparing the landing zone for a transcatheter pulmonary valve. We report our experience with dual stent mounting on a single balloon for deployment of stents in the RVOT before and during transcatheter pulmonary valve placement.
Methods: Retrospective analysis of all patients from Children’s Hospital of Colorado, USA; and Oslo University Hospital, Norway; undergoing transcatheter pulmonary valve replacement that had 2 stents mounted on a single balloon and deployed simultaneously in the RVOT. Data collection was carried out from procedural notes and the patients’ medical record.
Results: Over a 12-month period, 13 patients (9 male) with a median age of 15.8 years (range 13-21) underwent piggy- back stent deployment. All cases involved mounting a bare metal stent on top of a Melody® transcatheter pulmonary
Hijazi, Z
22nd Annual PICS/AICS Meeting