Page 12 - Journal of Structural Heart Disease Volume 4, Issue 4

Meeting Abstracts
Journal of Structural Heart Disease, August 2018, Volume 4, Issue 4:114-206
DOI: https://doi.org/10.12945/j.jshd.2018.020.18
Published online: August 2018
The Pediatric and Adult Interventional Cardiac Symposium (PICS/AICS) 21st Annual Meeting
Las Vegas, Nevada, September 5-8, 2018
1. TRANSCATHETER CLOSURE OF PATENT DUCTUS ARTERIOSUS IN INTERRUPTED LEFT-SIDED IVC WITH HEMIAZYGOS CONTINUATION: SUBCLAVIAN VENOUS APPROACH
Balasubramani Nallaperumal, Dr Swapan Se, Dr Soumya Patra
Apollo Gleneagles hospitals, Kolkata, India
Introduction: A 15-years old girl presented with the his- tory of recurrent chest infection, poor weight gain and clin- ically with bounding pulse, LV enlargement, continuous murmur at left infra-clavicular area. Chest X-ray showed cardiomegaly with prominent pulmonary conus and lung plethora. Echocardiogram revealed a moderate sized (6 mm) Patent ductus arteriosus (PDA), dilated left ventricle and left atrium with pulmonary artery pressure of 40 mm Hg.
Objective: The plan was to close the PDA with an Amplatzer duct occluder-I by conventional antegrade femoral vein approach in the cath lab.
Procedure: The descending aortogram in left lateral view con rmed of a moderate sized PDA lling pulmonary artery. A 5 French Multipurpose catheter was inserted into the femoral vein to cross the PDA. As soon as the catheter crossed renal level, the anomalous course of inferior vena cava (IVC) took everyone by surprise. It was a rare anomaly of Interrupted left-sided IVC with hemiazygos continua- tion. Though the PDA could be crossed with wire and cath- eters, the device delivery system with the length of 80cm was not long enough to be across PDA. So the procedure was to be continued with an alternate approach. The alter- nate approaches were;
1. Right internal jugular vein
2. Retrograde transarterial: Amplatzer duct occluder-II
preferred
3. Subclavian vein: rarely tried
We chose subclavian vein approach and a 5 French multi- purpose catheter was used to cross the PDA. Though the course was tortuous the 0.035X260cm Amplatzer super sti wire made the tough task of tracking of 7 French deliv- ery system smooth across PDA. A Amplatzer duct occluder size of 8 mm/6 mm positioned across the duct and con- rmed by arotogram before deployment. Final angiogram showed no residual ow across the PDA.
Conclusion: Congenital interruption of IVC is a rare devel- opmental variation (0.6–2.0%). The prevalence of left sided IVC is even rare (0.2%–0.5%) and usually continues as hemiazygos or accessory hemiazygos vein. Interruption of IVC make transcatheter closure of PDA a challenging pro- cedure. Echocardiographic assessment of systemic venous drainage is essential. Subclavian vein approach is an alter- native of femoral vein or IJV in a case with interrupted IVC.
2. BALLOON ANGIOPLASTY OF CRITIC COARCTATION OF THE AORTA IN NEWBORNS AND INFANTS - FIRST LINE DEFENCE
Imanov Elnur1, Lazoryshynets Vasil2, Abdullayev Fuad1, Hasanov Elnur1, Jahangirov To k3
1Topchibashev Research Centre of Surgery, Baku, Azerbaijan
2Amosov National Institute of Cardiovascular Surgery, Kiev, Ukraine
3Abdullayev Research Institition of Cardiology, Baku, Azerbaijan
Background: Endovascular intervention in newborns and infants with critic coarctation of the aorta (CoA) is choise of option vs. surgical intervention especially in Ductus dependent patients.
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