Page 64 - Journal of Structural Heart Disease Volume 5, Issue 4

Meeting Abstracts
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infusion until the time of procedure, serves as a landmark for ductal stent implantation, and decreases the likelihood of stent embolization or migration by creating a mild con- striction. More importantly, it allows both the surgeon and interventionalist the ability to determine the ideal ductal diameter prior to PDA stent implantation.
84. TRANSCATHETER CLOSURE OF MODERATE TO LARGE PERIMEMBRANOUS VENTRICULAR SEPTAL DEFECTS IN CHILDREN WEIGHING ≤ 10 KG
Ajith Ananthakrishna Pillai1, Sasinthar Rangasamy1, Vidhyakar Balasubramanian2
1JIPMER Hospital , Pondicherry, India. 2PSG Hospital, Coimbatore, India
Background: Transcatheter device closure of ventricu- lar septal defect (VSD) is an alternative to the gold stan- dard surgical closure. Device closure of moderate to large perimembranous VSD (pm VSD) is considered technically challenging in smaller children weighing ≤ 10kg. Very few studies are published on the outcomes of the same.
Methods: Descriptive single center retrospective study. Data of 49 children ≤10 kg with moderate to large pmVSDs taken up for trans-catheter device closure in our institute were analysed and their follow-up details were reviewed.
84. Table 2. Procedure details
1. Successful deployment of the device, n (%)
2. Mean size of the device used, mm (Range)
3. Anesthesia used, n (%) General anesthesia
Techniques utilized, n (%) Antegrade with av loop
Antegrade without av loop Retrograde
Types of devices used, n (%)
1) Cera PDA occluder (LifeTech)
2) Cera VSD occluder (Lifetech)
3) Amplatzer duct occluder Type II
4) Cocoon duct occluder
5) SearCare PDA occluder
6) Amplatzer muscular VSD occluder
7) Amplatzer membranous VSD occluder 8) Amplatzer vascular plug II
Procedure duration in minutes (Mean ± SD) Hospital stay, days (Mean ± SD)
42/49 (85.7) 8.26 (4-14) 49 (100)
33 (78.6) 6 (14.3) 3 (7.1)
17 (40.5) 8 (19) 6 (14) 6 (14) 2 (5)
1 (2.5) 1 (2.5) 1 (2.5)
45.6 ±12.6 2.1 ± 0.4
84. Table 1. Baseline patient characteristics
Results: Out of the 87 patients referred for VSD closure, 49 patients qualified for the inclusion criteria. Median age was 18 months (IQR 13-22). Successful device deployment was achieved in 42 patients (85.7%). Mean size of the VSD by transthoracic echocardiography (TTE) was 5.98 mm (Range: 4-12). Mean waist size of the device used was 8.26 mm (Range: 4-14). There was one device embolization. Minor complications like device related persistent new aortic regurgitation was noted in one patient and mild tri- cuspid regurgitation and transient heart block occurred in two patients each. There was no mortality or CHB requir- ing permanent pacemaker implantation immediately or during mid-term follow-up (mean follow-up: 19 months; Range: 2.5 – 72.5).
Conclusion: Device closure of moderate to large pm VSDs in children weighing ≤ 10kg is feasible and safe. We had a success rate of 85.7%. Careful selection of patients and avoidance of oversizing the defect makes the immediate and mid-term results acceptable.
85. LEFT ATRIAL DECOMPRESSION IN A PATIENT WITH COMPLEX CONGENITAL HEART DISEASE. CHALLENGES OF ATRIAL FLOW REGULATOR IMPLAN- TATION NEXT TO A PRE-EXISTING ATRIAL STENT Robin Hay Son Chen1,2, Simon Lam3, Pak Cheong Chow1, Adolphus Kai Tung Chau1, Tak Cheung Yung1
1. 2. 3. 4.
5.
6.
7.
Total number of patients (n) Females, n (%)
Median Age, months (IQR)
Age in months, n (%)
a. <12 months (%) b. 12-18 months (%) c. 18-24 months (%) d. 24-30 months (%)
Weight, kg (Mean ± SD)
Mean size of the VSD, mm (Range) Size of the aortic rim, mm (Mean ± SD)
49
26 (53) 18 (13-22)
5 (10) 19 (39) 14 (29) 11 (22)
7.9 ± 1.2 5.98 (4-12) 3.9 ± 0.8
35.45 ± 8.8 +2.2 ± 0.62
35.23 ± 17.85 39.12 ± 10.90 15.34 ± 4.82 2.54 ± 1.78
8. LVEDD, mm (Mean ± SD)
Z score (Mean ± SD)
9. VSD Pressure gradient by doppler, mmHg
(Mean ± SD)
10. Pulmonary artery systolic pressure, mmHg (Mean ± SD)
11. Mean pulmonary artery pressure, mmHg (Mean ± SD)
12. Qp/Qs (Mean ± SD)
Journal of Structural Heart Disease, August 2019
Volume 5, Issue 4:75-205