Page 16 - Journal of Structural Heart Disease Volume 5, Issue 4

Meeting Abstracts
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valve delivered via the Ensemble® system. Six patients had a 39mm Andramed XXL stent mounted over the Melody valve, six patients had a 36mm IntraStent LD Max mounted over the Melody and one patient had a 3110 Palmaz XL stent mounted over the Melody valve. Conduit prepara- tion for 2 of these patients included piggybacked stents (CP covered stent and a bare metal stent) mounted on a BIB balloon and deployed simultaneously followed by pig- gyback stent and Melody valve deployment. Access was via the femoral vein in 10/13 of patients, right internal jug- ular vein in 2/13 cases and left internal jugular vein in one patient. The mean total procedural time was 95 minutes. No patient had RVOT injury or increase tricuspid regurgita- tion noted during or after the procedure. All patients had satisfactory resolution of significant outflow tract stenosis with no evidence of melody valve dysfunction on immedi- ate or 6 week follow-up echocardiography.
Conclusions: Conduit preparation, stent and valve deliv- ery and deployment techniques have evolved significantly over the last 10yrs. Alongside this evolution, the complex- ity of outflow tracts deemed potentially suitable for per- cutaneous valve implantation has broadened. Given the knowledge that multiple prestent placement is mandatory in Melody valve deployment, this technique aims to sim- plify and facilitate adequate conduit preparation and valve deployment by minimizing manipulation across the out- flow tract and decreasing the risk of stent distortion, mis- alignment and embolization. It inherently decreases the number of angiograms, radiation dose and procedure time for Melody valve deployment.
9. EFFECTS OF PERCUTANEOUS VSD CLOSURE ON NUTRITIONAL STATUS, APPETITE, ANTHROPOMETRIC MEASUREMENTS OF CHILDREN
Nazmi Narin1, Ozge Pamukcu2, Onur Tasci2, Didem Barlakketi2, Figen Narin1, Aydin Tuncay2
1Katip Celebi University, Izmir, Turkey. 2Erciyes University, Kayseri, Turkey
Objectives: The aim of this study was to investigate the changes in symptoms, nutritional growth status of patients before and after the transcatheter closure of ventricular septal defect.
Method: The study was performed prospectively in our clinic. Anthropometric measurements (weight and height for age, Z scores of body mass index (BMI)) were recorded at hospital admission and repeated at 1st and 6th month controls. WHO Anthro/ AnthroPlus programs were used to evaluate these measurements. The patients' subjec- tive appetite evaluation was performed using a 100 mm
long Visual Analog Scale (VAS). Children’s Eating Behavior Questionnaire-CEBQ was applied to parents. Furthermore; insulin growth factor-1(IGF-1),insulin growth factor bind- ing protein-3(IGFBP-3), AST, ALT, total protein, albumin, ghrelin, leptin measurements were done and repeated at 1st and 6th month control.
Results: Twenty patients withVSD (13 girls, 7 boys) aged between 2-171(median 27) months and as con- trol group, 25 subjects (11 girls, 14 boys) (aged between 3-187(median:46) months were enrolled in the study. The weight for height, BMI and BMI Z scores were signifi- cantly higher in the control group (p=0,016, p=0,029 and p=0,019). The results of questionnaire asked to parents about appetite, frequency of illness, rapid breathing, fatigue and weight gain were similar.
In the first month after VSD closure, there was a significant increase in the z score of weight for age, weight for height, BMI and BMI Z scores of patients (p=0,05 p=0.048 p=0,012 and p = 0.018). There was an increase in Anthropometric measurements of 6th months compared to others. Ghrelin levels were decreased linearly and appetite increased. Leptin, IGF-1, IGFBP-3, albumin levels before the procedure were significantly lower than control group. However; after the procedure the levels of all these parameters were ele- vated significantly .
Conclusion: Nutritional deficiency and failure to thrive are important problems of the patients with large VSDs. Treatment of patients should be planned at the appropriate time in order not to disturb their growth. Percutaneous VSD closure is one of the treatments that has an evident positive effect on appetite, nutritional, growth status and hormones.
10. ECHOCARDIOGRAPHIC EVALUATION OF THE PATIENTS AFTER PERCUTANEOUS VSD CLOSURE Nazmi Narin1, Ozge Pamukcu1, Onur Tasci1, Didem Barlakketi1, Figen Narin2, Aydin Tuncay1
1Erciyes University, Kayseri, Turkey. 2Katip Celebi University, Izmir, Turkey
Objective: We aimed to show the echocardiographic changes of the patients after transkateter VSD closure.
Methods: This study was performed prospectively in our clinic. Left Ventricle Tei index (LVTEI), Right ventricle Tei index (RVTEI), Tricuspid annular plane systolic excursion (TAPSE), Mitral annular plane systolic excursion(MAPSE), inferior vena cava elasticity index (VCI-EI), left, right ven- tricle end diastolic diameters (LVDD, RVDD) measurements
Journal of Structural Heart Disease, August 2019
Volume 5, Issue 4:75-205