Page 22 - Journal of Structural Heart Disease Volume 5, Issue 4

Meeting Abstracts
84
19. Table 1. Responses from interventionalists across the world on APC management.
Questions
N (%)
Most important trigger for development of APCs
Inflammation following surgery 6 (4.2)
Small pulmonary artery bed 26 (18.3)
Desaturation 77 (54.2)
Unsure 28 (19.7)
Other 5 (3.5)
Do APCs increase, decrease or stay the same following Fontan completion?
Unsure or unknown
When do you prefer to occlude APCs?
Pre-superior cavopulmonary connection (Pre-Glenn) evaluation
Pre-total cavopulmonary connection (Pre-Fontan) evaluation
Post cavopulmonary connection (Fontan) evaluation
The stage of palliation does not influence my decision
15 (10.6)
17 (12.0) 66 (46.5) 12 (8.5) 47 (33.1)
Increase
Decrease
Stay the same
Unsure
24 (16.9) 42 (29.6) 47 (33.1) 29 (20.4)
Coils
Plugs
Microspheres
Other
105 (73.9) 22 (15.5) 12 (8.5) 3 (2.1)
Do you perform segmental aortic angiograms for all
as the internal mammary artery?
Occlude the entire length of the vessel as much as possible (make the vessel impact- ed with devices)
Occlude only the origin of the vessel
Occlude the distal, middle, and proximal sites, but not the whole course
I don't occlude the feeder vessel, but occlude the distal network using micro- spheres
Other
pre-surgical evaluations?
Always Sometimes Never Other
45 (31.7) 79 (55.6) 13 (9.2) 5 (3.6)
71 (50.0)
19 (13.4) 31 (21.8)
10 (7.0) 11 (7.8)
Do you perform bilateral selective subclavian artery an- giograms for all pre-surgical evaluations?
Always Sometimes Never Other
35 (24.7) 87 (61.3) 17 (12.0) 3 (2.1)
What device do you most frequently use to occlude APCs?
What is your approach for occluding feeder vessels such
Do you measure oxygen saturation at different pulmo- nary artery branch segments?
20. TRANSCATHETER FONTAN COMPLETION USING CUSTOM-MADE CHEATHAM-PLATINUM STENT
Bassel Mohammad Nijres1, E. Oliver Aregullin1,2, Yasser Al-Khatib1,2, Jordan Gosnell1, John Byl1, Bennett Samuel1, Allison Amidon1, Cody Pinger3, Timothy Hudson4,2, Joseph Vettukattil1,2
1Spectrum Health Helen DeVos Children's Hospital, Grand Rapids, USA. 2Michigan State University College of Human Medicine, Grand Rapids, USA. 3Michigan State University, East Lansing, USA. 4West Michigan Anesthesia, PC, Grand Rapids, USA
Introduction: Transcatheter Fontan completion is a chal- lenging procedure with no dedicated commercially avail- able devices. We describe transcatheter Fontan completion using a custom-made Cheatham-Platinum (CP) StentTM (NuMED, Inc., Hopkinton, NY).
Case Description: A 15-year-old male with history of dou- ble inlet left ventricle and L-transposition of great arteries
Always Sometimes Never Other
8 (5.6) 61 (43.0) 72 (50.7) 1 (0.7)
Do you favor aggressive APC occlusion, i.e., to occlude all collaterals if deemed safe and feasible?
Yes
No
APC occlusion is
Permanently effective
Temporarily effective as new feeders even- tually grow and refeed the original network
Temporarily effective as new collateral networks will likely develop
80 (56.3) 62 (43.7)
20 (14.1) 36 (25.6)
71 (50.0)
Journal of Structural Heart Disease, August 2019
Volume 5, Issue 4:75-205