Page 80 - Journal of Structural Heart Disease Volume 5, Issue 4

Meeting Abstracts
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p=.0.562) and risk for severe adverse events (14.2 vs. 14.2 %, p=.999). All patients in each group underwent balloon dila- tion with 3 patients in each group having additional stent implantation. Utilization of FI resulted in lower contrast uti- lization (3.7 vs. 2.4 ml/kg, decrease of 31.5%; p=.219) and radiation exposure (Air kerma: 288 vs. 53 mGy, decrease of 82%; p=.219; Dose area product: 8852 vs. 1020 mGy*cm, decrease of 88.5%; p=.312). Finally, fluoroscopy (71 vs. 52 min, decrease of 27%; p=.437) and total study times (256 vs. 165 min, decrease of 35.5%; p=.219)were also shorter in cases guided with FI. However, none of these favorable trends reached statistical significance.
Conclusions: Our initial, limited experience shows a trend for lower contrast utilization and radiation exposure and shorter fluoroscopy and study times with FI for guidance of percutaneous PV interventions when compared to 2D angiography. A larger patient groups may allow us to determine if these differences are statistically significant.
105. PATENT DUCTUS ARTERIOSUS CATHETERIZATION CLOSURE IN PRETERM INFANTS: A DESCRIPTIVE STUDY OF OUR INSTITUTIONAL EXPERIENCE
Heidi Kim, MD, Surendranath Veeram Reddy, MD, Sushmita Yallapragada, MD
The University of Texas Southwestern Medical Center, Dallas, TX, USA
Introduction: A patent ductus arteriosus (PDA), i.e. the failure of the ductus arteriosus to close within 72 hours of life, can result in excessive shunting from the arterial to pulmonary circulation, causing pulmonary edema and pulmonary hypertension. In preterm infants (<32 weeks) the PDA may subsequently lead to respiratory insufficiency and chronic lung disease as well as necrotizing enterocolitis due to systemic hypoperfusion. Recently, catheter-based PDA closure has emerged as a potential alternative to inva- sive surgical ligation in preterm infants. However, evidence to support this procedure in infancy, particularly in the pre- mature population, is limited. The purpose of this study is to describe our preterm patient population and outcomes of their catheter-based PDA closures at our institution.
Methods: We will conduct a retrospective chart review to collect information regarding demographic data and clinical characteristics including antenatal, postnatal, and post-catheterization time frames (e.g. gestational age, pregnancy/delivery complications, level of required respi- ratory support, chronic lung disease, ventilator outcomes, etc.). The study will include infants <32 weeks gestational age with a PDA from January 2017 to present at Children’s Medical Center in Dallas, TX. Exclusion criteria are any
infants with congenital heart disease and/or lethal con- genital anomalies. Data will be analyzed with counts and percentages following the appropriate skip patterns.
Results: There are currently 24 neonates in our study who have received catheter-based PDA closures from January 2017 to present. At the time of intervention, infants ranged from a post-menstrual age of 27 1/7 weeks to 47 1/7 weeks. Weights ranged from 910 to 3600 grams. We will describe demographic data in Table 1. Comparative antenatal data (such as gestational age, maternal compli- cations, etc.) will be listed in Table 2. All catheter/inter- ventional data per patient will be listed in Table 3. All comparative outcomes and/or postnatal data will be listed in Table 4 and/or Table 5.
Conclusions: This study describes our institution’s expe- rience with catheter-based PDA closures since the begin- ning of our program (January 2017) to current. The next steps will be to compare long-term outcomes such as chronic lung disease, length of stay, ventilator days, etc. in age and weight-matched infants whose PDAs were closed percutaneously vs. surgically.
106. TRANSCATHETER CLOSURE OF A PARAVALVULAR AORTIC LEAK AFTER MECHANICAL AORTIC VALVE REPLACEMENT WITH AN OCCLUTECH PARAVALVULAR LEAK DEVICE
Heike Schneider, Thomas Paul, Claudius Jacobshagen, Matthias Mueller
University Medical Center, Goettingen, Germany
Transcatheter closure of paravalvular leaks (PVL) by plug implantation has emerged as an alternative treatment option to surgical correction, which is associated with high mortality rates for re-operation. We present the case of a 75-year-old male patient who had received mechan- ical aortic valve replacement (27 mm SJM prosthesis) 11 years prior to intervention. At that time, he had developed aortic valve endocarditis that had resulted in severe aor- tic valve insufficiency. For post-operative AV block, he had received a dual chamber pacemaker in addition. At his last follow-up, a large paravalvular aortic leak was noted in addition to moderate-severe mitral valve regurgitation and left ventricular dilatation. He had pedal edema and was assessed to be in heart failure NYHA III despite medi- cal management. After evaluation of the PVL by TEE, it was decided to close the aortic PVL interventionally. Cardiac catheterization was performed under general anesthe- sia, heparin was given to keep the ACT above 200 ms and Cephazolin was administered intravenously as prophy- laxis. Evaluation of the PVL by aortography, TEE including
Journal of Structural Heart Disease, August 2019
Volume 5, Issue 4:75-205