Page 17 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
We used 21 muscular VSDs, 9 ADO II and 2 ADO I occluders. We had 7 unsuccessful implantation due to failure to cross the VSD and development AR. All these unsuccessful cases were attempted in the initial period of our learning curve. Since the sub pulmonic VSD is located anteriorly and the chance of heart block is less likely. We had two cases of triv- ial AR before deployment but they did not increase after the device was deployed. Out of 32 cases 30 cases were deployed through retrograde technique (from LV side) and the remaining two cases, where we used ADO I, were deployed through antegrade technique (from RV side). We did not see any complications in the follow up period of 10 years. We conclude that device closure of sub pulmonic VSD through retrograde technique using muscular or ADO II devices is feasible, safe, easy and fast.
11. OUTCOMES OF BALLOON ANGIOPLASTY IN NEONATAL TYPE COARCTATION OF AORTA IN SULAIMANI CARDIAC CENTER/ KURDISTAN/ IRAQ
Aso Salih1, Shaymaa Mohammed2
1Sulaimani University/College of Medicine, Sulaymanyah, Iraq. 2Sulaimany Pediatric Hospital, Sulaymanyah, Iraq
Background and Objectives: Coarctation of aorta is the fourth most prevalent heart disease in infants requiring catheterization and surgery during the rst year of life. Balloon angioplasty treatment introduced as an alterna- tive therapy for CoA in the 1980s.The aim of the study is to assess the immediate and intermediate outcome of bal- loon angioplasty in neonatal type COA.
Patients and methods: A case series study of 13 young infants with neonatal coarctation of aorta their ages between 10 days to 18 months. Admited to intensive care unit of pediatric teaching hospital and Shar hospital neonatal care unit in Sulaimani . Balloon angioplasty were done for them in Sulaimani cardiac center between Feb 2014 to Oct 2017.
Results: The patients ages between 10 days to 18 months with mean age at diagnosis in days (mean ± SD) was 90.92 ± 141.767, balloon angioplasty done for them with good result in 10/13 cases without any complication. The mean pressure gradient before and after procedure was 48 ± 18.57 and 28.15 ±16.12mmhg, respectively (p 0.2). The complications of balloon angioplasty were divided in to immediate complication within 24h post angioplastic pro- cedure include peripheral cyanosis 1case(7.7%), with small coarct aneurysm formation 1 case(7.7%), and intermedi- ate complication within 6 month of the angioplasty show
repeated angioplasty in 1 case (7.7%) with stent implanta- tion at 4 month of age, while 10 cases (76.9%) were com- pletely cured without any complications.
Conclusions: Balloon angioplasty is more e ective in severely ill infants compared to surgery and has many advantages in addition in cases in which none of the treat- ment modalities is de nitely superior it appears that tran- scatheter technique is perferable It has been concluded that balloon angioplasty is more e ective in severely ill infants compared to surgery and has many advantages in addition to cases in which none of the treatment modali- ties is de nitely superior it appears that transcatheter tech- nique is perferable.
12. SUCCESSFUL, DEFINITIVE PERCUTANEOUS CLOSURE OF SEVERE MITRAL REGURGITATION RESULTING FROM IATROGENIC PERFORATION OF ANTERIOR MITRAL LEAFLET DURING AORTIC VALVE REPLACEMENT
Aditya Goud, Steven Deutsch, Suneel Kumar, Amish Patel, Prashant Patel, Ashish Mukherjee, Prabhdeep Sethi, Ramdas Pai, Mohammed Kanakriyeh
University Of California, Riverside, USA
Case: A 79-year-old Hispanic female who had redo aortic valve replacement, coronary artery bypass surgery and aortic pseudoaneurysm repair 3 months earlier presented with intractable heart failure. A transesophageal echocar- diogram showed a 10 mm sized perforation at the very base of the anterior mitral lea et causing wide open mitral regurgitation along with a dissection ap into adjoining left atrial wall. The LV systolic and bioprosthetic aortic valve function were normal. The pulmonary artery systolic pres- sure was 90 mmHg. The etiology was felt to be iatrogenic during aortic valve resection. There were no features of prior or ongoing endocarditis.
Decision making: The heart team felt that she was too high risk for a third re-do surgery because of age, heart fail- ure and adhesions seen during the prior surgery. Expectant management was not acceptable because of severe symptoms. Percutaneous closure of the defect was con- templated and various devices were considered to t the anatomy (various AV plugs, ASD and VSD closure devices). The closure was performed under TEE guidance. Trans- septal approach was unsuccessful because of the trajectory of the defect. Aortic retrograde approach was successful in crossing the defect. The defect was closed with a 14 mm AVP II. To provide better support to withstand LV systolic pressure, initially, 2 of the 3 lobes of the device were placed
Hijazi, Z
21st Annual PICS/AICS Meeting