Page 59 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
post-procedural complications (including duration of ino- tropes, fluid requirements, effusions, residual defects).
Results: Total of 53 TOF patients during the above time frame. 38 patients met inclusion criteria of which, 32% (12 of 38) underwent cath pre-operatively and 68% (26 of 38) did not. The group that underwent RVOT ballooning were smaller and younger with lower oxygen saturations at time of full repair. Median LOS was 8 days (95% CI: 5 to 14) in patients who had cath, 6 days (95% CI: 5 to 10) in those who did not. Median duration of intubation was 2 days (95% CI: 0.5 to 4) in patients who underwent cath, and 1 day (95% CI: 0 to 1) in patients who did not. Overall, 24% (9 of 38) patients had JET post-op. No significant associa- tion was observed between cath status and LOS, duration of intubation or JET.
Conclusions: At time of full repair patients typically con- sidered higher risk and underwent RVOT ballooning still had surgery at smaller size and younger age than those who did not. However we found no associations between cath status and longer LOS, duration of intubation or JET compared with patients who did not require cath interven- tions. We are able to delay surgery in patients who would have needed early single stage or even refrain from multi- stage surgical approach without increase in morbidity or mortality. While a limitation of this study is the sample size and our ability therefore to assess statistical significance, it provides helpful data in assessing our current approach of delaying surgical intervention in this TOF population.
77. PERCUTANEOUS CLOSURE OF PERSISTENT ARTERIOUS DUCTUS IN PREMATURE INFANTS WITH AMPLATZER DEVICE DUCT OCCLUDER II AS: EXPERIENCE IN COLOMBIAN INFANTS
Alonso Gómez 1,2, Laura Tatiana Gómez3, Andrés Marin1,2
1Clinica San Rafael Pereira , Pereira, Colombia. 2Hospital San Jorge - Imágenes Diagnosticas, Pereira, Colombia. 3Sociedad Cardiovascular del Eje Cafetero, Armenia, Colombia
Objective: To describe our experience with percutane- ous closure of patent ductus arteriosus (PDA) in preterm infants using the Amplatzer Duct Occluder II Additional Size device (ADO II AS) in 7 centers in Colombia.
Methods: Retrospective analysis of data of 12 preterm infants with symptomatic PDA who underwent to percu- taneous closure with the ADO II AS device, made by our team in 7 centers in Colombia from 2013 to 2019. Selection of cases was given by weight (g), ductus size, hemody- namic repercussion by clinical and ultrasound (US) and failure of pharmacological closure. Except for one case, the
approach was venous femoral in all patients, the position of the occluder was directed by X-ray and US, avoiding arterial injury.
Results: The percutaneous closure of PAD was per- formed in 12 premature infants with a gestational age between 27 and 35 weeks (median 27.5 weeks) and a median weight of 1927g (range of 1290 to 2800g). The ductus type C was the most frequent in this population (75%) with a median for ductal diameter of 3.8. The device was successfully implanted in all cases, frecuently used the one with dimensiones of 5x4mm (n=5), followed by 5x2mm (n=3). The median fluoroscopy was 8.8 minutes (range 2 to 16 minutes) and mean procedural time of 60 minute.Complete closure was achieved in all patients. Complications included were mild stenosis of the left pul- monary branch (n = 3), initial slight residual shunt (n = 1) and deterioration of the previous left ventricular dysfunc- tion (n = 1). There were no deaths related to the procedure, embolization, or aortic obstruction.
Conclusion: According to our experience in preterm infants, percutaneous closure of DAP with ADO II AS is a safe and effective alternative to standard surgical treatment. The US guidance prevents arterial access and decreases the risk of arterial vascular injury in these population.
Keywords: Patent ductus arteriosus, premature infants, percutaneous intervention.
78. PERCUTANEOUS ANGIOPLASTY IN A RARE CASE OF PULMONARY ARTERY CALCIFICATION AFTER TWIN-TO-TWIN TRANSFUSION SYNDROME
Steven Healan, George Nicholson, Dana Janssen, Thomas Doyle
Vanderbilt Children's Hospital, Nashville, USA
Background: Twin-to-twin transfusion syndrome compli- cates 10-30% of monochorionic twin pregnancies, and is associated with various cardiac defects, primarily affecting the recipient twin. One rare complication is pulmonary artery calcification. Sporadic case reports have described this process with prognosis varying from spontaneous regression of calcification to progression resulting in death or requiring surgical pulmonary arterioplasty. Here we present a case of progressive pulmonary artery calcifica- tion in a recipient of twin-to-twin transfusion, which was successfully palliated with percutaneous angioplasty. This has not previously been described in the literature.
Case: A recipient of twin-twin transfusion had developed diffuse neonatal calcification of her pulmonary arteries.
Hijazi, Z
22nd Annual PICS/AICS Meeting