Page 93 - Journal of Structural Heart Disease Volume 5, Issue 4

155
Meeting Abstracts
(12%). Hands-on training and workshops are mentioned as the prime needs to get started, while medical devices are a good third. The wish list of needed devices is headed by guidewires (1), introducer sets (2), steerable catheters (3), balloon catheters (4) and bioptome (5). Current diagnostic procedures are mostly in pulmonary hypertension (n=11), post heart transplant (n=8) and post- and pre-Fontan pro- cedures (n=8). Remarkably, those interested to start (com- pleted by 56 responders) reported that their iCMR focus to be on single-ventricle patients (n=40) followed by coarcta- tion (33), pulmonary hypertension (n=33) and TOF/RV-PA surgical reconstruction (n=29).
Conclusion: Pediatric and adult congenital interventional cardiologists are aware of and interested to start iCMR pro- cedures and have a clear idea of what clinical indications can be handled now and in the near future with availability of much needed MRI compatible transcatheter devices. It is also apparent from the survey results that there is a need for additional hands on workshops, training and MR com- patible devices, in that order.
123. PRACTICE VARIATION IN TRANSCATHETER ATRIAL SEPTAL DEFECT DEVICE CLOSURE: FACTORS INFLUENCING LOWER RADIATION EXPOSURE
Lauren Shirley1, Brian Boe2, Susan Foerster3, Todd Gudausky3, David Harrison1, Nicola Maschietto1, George Nicholson4, Brian Quinn1, Sara Trucco5, Wendy Whiteside6, Lisa Bergersen1
1Boston Children's Hospital, Boston, USA. 2Nationwide Children's Hospital, Columbus, USA. 3Children's Hospital of Wisconsin, Milwaukee, USA. 4Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center, Nashville, USA. 5Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, USA. 6University of Michigan Medical School, Ann Arbor, USA
Background: Transcatheter atrial septal defect (ASD) clo- sure is a common congenital cardiac catheterization proce- dure subject to practice variation among different centers and providers, which introduces potential for variation in patient radiation exposure. This study sought to identify practice variation during transcatheter ASD closure related to differences in radiation dose using data from the multi- center registry Congenital Cardiac Catheterization Project on Outcomes (C3PO).
Methods: Data were recorded prospectively from 10 C3PO institutions over a two-year period. Patients noted to have had transcatheter ASD closure with complete data capture were included in this study. Cohort data included clinical and procedural information as well as radiation exposure, fluoroscopy time, procedure time, ASD procedural efficacy
data, and adverse events (AE) classified by severity on a five-level scale by previously established criteria. Radiation exposure was reported as median dose area product per kilogram (DAP/kg) (μGy*M2/kg) by center. Lower-radiation centers were classified as having median radiation dose less than or equal to 40 DAP/kg and higher-radiation cen- ters were designated as having median radiation doses greater than 40 DAP/kg based on empiric methods and expert opinion.
Results: A total of 421 transcatheter ASD closures from 10 centers were recorded between 1/1/2014 and 12/31/2015. The median and IQR for age was 6 years [4, 13] with a median weight of 21 kg [15, 49]. A single ASD was pres- ent in 88% of cases and 78% were successfully closed with the first device attempted. ASD sizes ranged up to 43 mm with a median diameter of 11 mm [8, 15]. An AMPLATZER® Septal Occluder was used as the initial closure device in 247 (62%) of defects, GORE® HELEX® Septal Occluder in 103 (26%), GORE® Septal Occluder in 39 (10%) and AMPLATZER Cribiform in 11 (3%). Lower-radiation centers (n=7) had a
123. Figure 1.
123. Figure 2.
Hijazi, Z
22nd Annual PICS/AICS Meeting