Page 45 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
= 0.018 and p = 0.018). During a mean follow-up of 446.4 ± 226.1 days after TPVI one patient died. BNP levels were not significantly different from baseline. Despite self-re- ported functional capacity and exercise capacity improve- ment after TPVI (p<0.001), all parameters remained lower in r-RVP group. One year after TPVI, pulmonary and tricus- pid regurgitation decrease significantly, as well as RVEDV, in both groups. However, RV systolic function remained unchanged. Regarding to the dysrhythmic profile, all patients with need for animplantable cardiac defibrillato- rand seven of the eight patients requiring radiofrequency ablation for sustained supraventricular arrhythmias during follow-up were in the group without r-RVP. In multvariate analysis only non r-RVP predicted rythmic events (p=0.038).
Conclusion: TPVI had a positive impact in clinical status in a cohort of patients withpredominant PR regardless the presence of restrictive physiology. Moreover, besides higher VO2max and anaerobic threshold in the non-restric- tive group, the magnitude of the improvement was not statistically different between the two groups. We ques- tion about the benefit of treating non r-RVP patients with RVEDV<150 mL/m2, in order to improve symptoms and prevent progression of RV dysfunction and dysrythmic events.
56. PERCUTANEOUS INTERVENTIONS IN PATIENTS AFTER THE GLENN PROCEDURE: OUR EXPERIENCE.
Jacek Kusa1,2, Pawel Czesniewicz2
1Medical University of Silesia, Katowice, Poland. 2Regional Specialist Hospital in Wroclaw, Research and Development Centre, Wroclaw, Poland
Objectives: A routine, diagnostic cardiac catheterization before Fontan procedure is nowadays usually combined with catheter intervention. Modern interventional proce- dures improved the prognosis in this challenging group of patients and in some circumstance can replace the surgical treatment.
This paper summarises our experience of interventional treatment of patients after the Glenn procedure.
Methods: We analyzed data of 77 patient with single ven- tricle anatomy after Glenn shunt (age 8 months - 17 years, mean 4 years) who underwent percutaneous interventions during cardiac catheterization from 2013 to 2016 at our institutions.
The clinical characteristics of the study population were described. The complete hemodynamic data, type of cath- eter interventions and complications were defined.
Patients were divided into two groups: with the right (n=49) and left (n=28) ventricular morphology.
Results: A total of 205 interventions were performed in 77 patients (1-4 interventions per patient). These include: the closure of major aortopulmonary collateral artery (n=70), balloon angioplasty (n=47) and stent implantation (n=20) of stenosed pulmonary arteries, balloon angioplasty of ste- nosed cavopulmonary anastomosis (n=27), balloon angio- plasty (n=25) and stent implantation (n=4) of coarctation of the aorta and others.
Patients with right ventricular morphology had smaller pulmonary arterial sizes with less favorable McGoon ratio (1,56 vs. 2,01 p<0,05) and for this reason, those patients required a larger number of percutaneous interventions (3,18 vs. 1,79 p<0,05).
There were no catheter-related deaths. The frequency of procedure-related complications was low and in the majority were related to vascular complications on punc- ture site (bleeding in 5 patients, loss of pulse in 3 patients). The occurrence of serious complications such as implant migration (n=1), vessel rupture (n=1) and thromboembolic event (n=2) was rare at our institutions.
Conclusion: Percutaneous interventions in patients after Glenn procedure are a safe and effective treatment for residual lesions and may help to avoid extensive surgery during the last stage of Fontan palliation.
57. PERCUTANEOUS CLOSURE OF VENTRICLE-PUL- MONARY CONNECTIONS IN PATIENTS AFTER GLENN PROCEDURE: IF IT IS FEASIBLE SHOULD IT BE PERFORMED?
Pawel Czesniewicz1, Jacek Kusa2,1
1Regional Specialist Hospital in Wroclaw, Research and Development Centre, Wroclaw, Poland. 2Medical University of Silesia, Katowice, Poland
Background: The anterograde pulmonary blood flow (through pulmonary artery banding or recanalization of surgically sutured pulmonary trunk) after Glenn proce- dures can lead to elevated mean pulmonary artery blood pressure (MPAP) and volume overload resulting in a reduc- tion in ventricular function.
Objective: We analyzed our patients after Glenn proce- dure, who had undergone a routine cardiac catheteriza- tion, regarding the incidence of maintained anterograde pulmonary blood flow as well as the therapeutic options.
Hijazi, Z
22nd Annual PICS/AICS Meeting