Page 61 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
An 8mm Amplatzer Vascular Plug was advanced and exte- riorized, After confirmation of proper positioning, the device was released, a control angiogram was performed without evidence of another PAVF. The oxygen saturation increased to 92%.
We present a succesful case of occlusion of multiple pul- monary arteriovenous fistulae in the same pulmonary lobe with five Amplatzer Vascular Plug devices in two different procedures with 6 years of difference. The patient is now asymptomatic with normal oxygen saturation, with a close monitoring for the risk of new fistulas.
80. TRANSCATHETER PDA CLOSURE USING THE AMPLATZER PICCOLOTM OCCLUDER IN INFANTS WEIGHING ≤ 1 KG
Shyam Sathanandam 1, Thomas Forbes2, Matthew Gillespie3, Brian Morray4, Darren Berman5, Shabana Shahanavaz6, Thomas Jones7, Evan Zahn8
1LeBonheur Children’s Hospital, Memphis, USA. 2Children's Hospital of Michigan, Detroit, USA. 3Children's Hospital of Philadelphia, Philadelphia, USA. 4Seattle Children's Hospital, Seattle, USA. 5Nationwide Children's Hospital, Columbus, USA. 6St. Louis Children's Hospital, St Louis, USA. 7Seattle Children's Hospital, Seattle, United Kingdom. 8Cedars-Sinai Medical Center, Los Angeles, USA
Background: The presence of a hemodynamically sig- nificant patent ductus arteriosus (PDA) in extremely low birth weight (ELBW) infants has been associated with an increased risk of morbidity and mortality. Historically, tran- scatheter closure of PDA in ELBW infants has not been per- formed for a variety of reasons, including the fear of patient fragility, and the absence of a suitable PDA closure device.
Methods: A single arm, multicenter, prospective, investi- gational study was conducted in the United States to test the efficacy and safety of the Amplatzer PiccoloTM Occluder in infants ≥ 700 g with PDA ≤ 4 mm in diameter. The objec- tive of this report is to describe the results of using the Amplatzer PiccoloTM Occluder for PDA occlusion in a sub- group of ELBW infants that weighed ≤ 1 kg at the time of the procedure.
Results: Transcatheter PDA closure was attempted in 33 patients weighing ≤ 1 kg at the time of the proce- dure. Implant success was 100%. All implants were per- formed via an anterograde approach without arterial access. There was 94% PDA closure post-procedure. Two patients had mild residual shunts that resolved on fol- low-up. There were no instances of device embolization or vascular access injury. Serious adverse events occurred
80. Table 1.
Demographics:
Gestational age at birth (weeks) Mean ± SD (n)
Range (Min, Max)
Birth Weight (gm)
Mean ± SD (n) Range (Min, Max)
Comorbidities:
Mechanical Respiratory Support Required Respiratory distress syndrome (RDS) Intraventricular hemorrhage (IVH)
Sepsis
Necrotizing enterocolitis (NEC) Ionotropic Support Required
Baseline Characteristics:
Age at Implant (days)
Mean ± SD (n) Range (Min, Max)
Weight at Implant (grams)
Mean ± SD (n) Range (Min, Max)
PDA minimal diameter (mm)
Mean ± SD (n) Range (Min, Max)
PDA length (mm)
Mean ± SD (n) Range (Min, Max)
Procedure Characteristics:
Procedure Time (min)
Mean ± SD (n) Range (Min, Max)
Fluoroscopy Time (min)
Mean ± SD (n) Range (Min, Max)
IV Contrast (mL/kg)
Mean ± SD (n) Range (Min, Max)
Femoral Arterial Access Heparin Usage
24.7 ± 1.3 (33) (22, 28)
696 ± 143 (33) (430, 1060)
100.0% (33/33) 93.9% (31/33) 51.5% (17/33) 24.2% (8/33) 15.2% (5/33) 12.1% (4/33)
25.4 ± 9.2 (33) (10, 51)
869 ± 97.6 (33) (700, 1000)
3.01 ± 0.59 (31) (1.8, 4.0)
10.33 ± 1.65 (31) (6.1, 14.0)
42.3 ± 19.3 (33) (14, 93)
8.3 ± 6.2 (33) (3, 31)
2.65 ± 1.48 (33) (0.00, 5.92)
0% (0/33) 9.1% (3/33)
in 2 patients (6%) including: hemolysis (1), and aortic arch obstruction requiring stent implantation (1). Survival was
Hijazi, Z
22nd Annual PICS/AICS Meeting