Page 104 - Journal of Structural Heart Disease Volume 4, Issue 4

Meeting Abstracts
206
Results: 70 patients were enrolled in 6 cities in China: 27 females, 43 males; 1.5-33.8 years; 9.2-79Kg. 73 PASS were implanted in the 70 patients: 44 in LPA, 29 in RPA with percutaneous delivery in 64 pts and Hybrid in 6 pts. ~ 98% pts received a S or M PASS, with only 2% requiring L. Pre-implant mean gradient 41.5mmHg was reduced to 12.1mmHg post implant, while the mean vessel diameter increased from 4 to 9.5mm. There were no deaths and no signi cant morbidities.
Conclusions:
1. The speci cally designed PASS was delivered safely and e ectively.
2. The Hybrid design and cobalt chromium composition are unique for the transcatheter therapy of PAS.
3. Longer follow up will be important to evaluate the e - cacy with patient and vessel growth.
171. COMPARISON OF INTRACARDIAC ECHOCARDIOGRAPHY AND TRANS-CRANIAL DOPPLER ULTRASOUND IN DETECTING CARDIAC RIGHT TO LEFT SHUNT
Mohammed Numan
Driscoll Children’s Hospital, Corpus Christi, Texas
Background and Objectives: Right to left shunts (RLS) found with patent foramen ovale (PFO) are implicated in the pathophysiology of cryptogenic stroke, migraine head- aches as well as decompression illness. RLS are typically diagnosed using intravenous agitated saline injections with transthoracic (TTE), transesophageal (TEE) and/or Intracardiac (ICE) echocardiography. Transcranial Doppler (TCD) is an another method for detecting RLS that is not dependent on topographic imaging. Intracardiac echocar- diography (ICE) provides a superior image of the cardiac septum. There is scarce data in the literature about com- paring TCD and ICE in detecting right to left shunt across PFO and or ASD in children and adolescents.
Methods: We performed a retrospective analysis of a pro- spectively obtained registry of patients that underwent simultaneous TCD and ICE shunt testing ± endovascular PFO/ASD closure. All patients had previously undergone a transthoracic echocardiogram bubble study (TTE) to con- rm a RLS and then underwent general anesthesia and bilateral TCD monitoring of the middle cerebral artery. Valsalva was manually produced by the anesthesiologist at 40 mmHg. Simultaneous assessment of RLS was per- formed using ICE/TEE and TCD monitoring after injection of agitated saline into the femoral vein sheath. If negative, a direct right atrial injection was performed.
Results: Between 9/2010 and 7/2012, 112 patients under- went testing. Mean age 16 years (range 8 to 24 years). RLS was found in 82.1, 81.1 and 71.4 percent by TTE,ICE/TEE and TCD, respectively. After peripheral femoral vein injec- tion (n=85), when compared to ICE, TCD had a sensitivity, speci city, PPV, NPV and accuracy of 95,100, 100, 64 and 95%, respectively. Combined peripheral and Intracardiac injections (n=112) when compared to ICE, TCD, and a sen- sitivity, speci city, PPV, NPV and accuracy of 88,100, 100, 66 and 90%, respectively. Curtain (Spencer Grade V) TCD shunts had larger physical ASDs compared to non-cur- tain (Spencer grade ≤ IV) (2.8mm ± 1.7 vs 1.7mm ± 0.9, p=0.004). Additional cardiac abnormalities had larger PFO/ASD sizes compared to those without (3.5mm ± 1.7 vs 1.9 ± 1.3, p=0.0001).
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Journal of Structural Heart Disease, August 2018
Volume 4, Issue 4:114-206
Cite this article as: Hijazi ZM. The Pediatric and Adult Interventional Cardiac Symposium (PICS/AICS) 21st Annual Meeting, Las Vegas, Nevada. Structural Heart Disease. 2018;4(4):114-206. DOI: https://doi.org/10.12945/j. jshd.2018.020.18