Page 44 - Journal of Structural Heart Disease Volume 5, Issue 4

Meeting Abstracts
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Results: Between September 2018 to April 2019, 7 patients were recruited till date, 5 with pulmonary atresia intact ventricular septum (PAIVS) and 2 with critical pulmonary stenosis. The mean age was 29 days and mean weight was 3.2 kg. No procedural related mortality. The X-ray visibility and ease to implant was similar to cobalt-chromium BMS. Patients generally demonstrated features of overshunting early post procedure with 1 requiring surgery for necrotiz- ing enterocollitis but all were discharged well. 1 mortality at 1 month post discharge for viral illness. Normal serum iron study was documented before procedure and on regular follow-ups. The longest follow up was 7 months in a patient with PAIVS, where surgery was performed for severe residual right ventricular outflow obstruction and occluded IBS stent.
Conclusion: Early results showed that IBS implantation is safe, feasible and efficacious in simple PDA. Longer term results await study completion. Positive results would encourage wider study with application to more complex PDA morphology.
54. A NOVEL COMPLETELY BIODEGRADABLE OCCLUDER FOR VENTRICULAR SEPTAL DEFECT CLOSURE: INITIAL EXPERIENCE AND EARLY FOLLOW-UP RESULTS
Xiangbin Pan, Long Chen, Wenbin Ouyang, Fengwen Zhang
Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, China & Fuwai Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
Background: Bioabsorbable occluders may circumvent the long-term complications associated with metallic occluders for VSD closure. Thus far, some partial bioabsorb- able occluders have been studied in vivo, and the non-ab- sorbable parts yielded new complications.
Objectives: To assess effectiveness and safety of a novel completely bioabsorbable VSD occluder before endothelialization.
Methods: From February to June 2018, five patients were recruited (mean age 8.74±3.02 years) for periventricular VSD closure under echocardiography guidance with a com- pletely bioabsorbable occluder. The occluder consists of a “double-umbrella” polydioxanone (PDO) framework, poly- L-lactic acid (PLLA) fabric and a built-in shape line designed to improve shaping problem. Patients were followed up at 1 months, 3 months, and 6 months after closure. The degra- dation of occluder was measured using QLAB quantitative analysis software and Integrated backscatter technique.
Results: All patients underwent successful VSD closure in 59±11 minutes and had postoperative hospital stay of 3±1.41 days, without residual shunt, hemolysis, aor- tic valve regurgitation, or arrhythmia occurrence. After 6 months follow-up, the density of left disc decreased from 170.96±19.78db to 34.02±16.91db and the den- sity of right disc decreased from 167.95±24.67db to 45.42±9.13db (both p<0.01). The area of left disc decreased from73.33±8.44mm2 to 18.18±7.42mm2 and area of right disc decreased from 87.67±5.46mm2 (both p<0.01). The decrease rate of left disc area (0.76±0.08) was significantly higher than that of right disc area (0.57±0.13) (p<0.01).
Conclusions: The completely bioabsorbable occluder made up of PDO and PLLA with a built-in shape line effec- tively closed VSDs under echocardiography guidance and was absorbed gradually without residual shunt and malpo- sition before endothelialization.
55. INFLUENCE OF RESTRICTIVE RIGHT VENTRICULAR PHYSIOLOGY IN OUTCOMES AFTER TRANSCATHE- TER PULMONARY VALVE IMPLANTATION IN ADULT PATIENTS
Clement karsenty1, Ana rita Francisco2, Sophie Malekzadeh- Milani3
1CHU, Toulouse, France. 2Hospital, Lisbonne, Portugal. 3Necker, Paris, France
Background: A restrictive right ventricular (RV) physiol- ogy (r-RVP) is present in almost half of the patients with repaired tetralogy of Fallot (ToF), but its effect on later patients’ clinical status is controversial.
Objectives: Evaluate the outcomes after transcatheter pulmonary valve implantation (TPVI) in patients with restrictive versus non-restrictive RV.
Methods: Single-center retrospective study of patients who underwent TPVI for pulmonary regurgitation between 2008 and 2017. Electrocardiogram, transthoracic echo- cardiogram, cardic magnetic resonance and cardio-pul- monary exercise test were performed previous to TPVI and repeated 12 months after. For statistical analysis we defined restrictive physiology as the presence of end-dia- stolic forward flow (EDFF) and RVEDVi < 150ml/m2.
Results: Fifty-nine patients (including 55 tetralogy of fal- lot) were included and r-RVP was present in 23 patients (39.0%).At the baseline, the majority of the patients were symptomatic, in NYHA functional class II-III (n=48, 81.4%) with reduced cardiopulmonary performance (VO2max = 20.5mL/min/kg) both worse among patients with r-RVP (p
Journal of Structural Heart Disease, August 2019
Volume 5, Issue 4:75-205