Page 29 - Journal of Structural Heart Disease Volume 4, Issue 4

131
Meeting Abstracts
Results: 20 patients out of 142 Norwood procedures performed were placed on ECMO (14%) with a total mor- tality rate of 70 %.12 BT shunt (mortality rate 75%) vs. 8 Sano (Mortality rate 62 %).16 caths performed, 8 group 1, 4 group 2, 4 group 3 and 8 group 4 with a mortality rate of 50%,75%,100% and 62% respectively.10/12 BT shunt group had cath , 7 interventional and 3 none interven- tional with a mortality rate of 71% and 66 % respectively. 6/8 Sano group had cath , 3 interventional and 3 none interventional with a mortality rate of 33% and 100 %.
Discussion: Patients who need ECMO Post Norwood pro- cedure have high mortality rate (70%)wich is consistant with other studies. While Performing cath and/or an inter- vention is safe and was performed with no complications, it did not improve outcome in most patients.those who had a cath nding con rming a post-op echo adverse nd- ing and had a therapeutic intervention may have a better prognosis. This was more evident in the Sano shunt group (33%). Patients who did not have an indication for inter- vention had a worse outcome due to a none anatomical etiology causing clinical worsening but not responding to medical treatment such as pulmonary hypertension. Sano shunt patients had lower rate of interventions and may have a better outcome. The number of patients is small to have statistical signi cance
34. A RARE CAUSE OF CYANOSIS IN CHILDREN, COMPLEX PULMONARY AV FISTULA-OCCLUSION WITH ADO-II DEVICE
Ali Baykan1, Suleyman Sunkak1, Onur Tasci1, Cagdas Vural1, Ozge Pamukcu1, Kazim Uzum1, Nazmi Narin2
1Erciyes University Medical Faculty, Kayseri, Turkey. 2Erciyes University Medical FacultyErciyes University Medical Faculty, Kayseri, Turkey
Pulmonary arteriovenous (AV) malformations are rare vascular anomalies of the lung, in which abnormally dilated vessels provide a right-to-left shunt between pul- monary artery and vein.
Despite most patients being asymptomatic, some may have cyanosis and dyspnea. Age of presentation can be extremely variable from infant to old age in proportion to the size of malformation.
Herein, we reported a girl with pulmonary AV malforma- tion treated with trans-catheter method.
Case: A 7 months old age girl was referred forcyano- sis. The patient had no complaints other than central
cyanosis. Other physical examination ndings were nor- mal. Transcutaneous oxygen saturation was measured as 80-82%. Hemoglobin level was 10.4 g/dl. Chest x-ray and echocardiographic examination showed no abnormal ndings. CT angiography revealed a stula in left lung lower lobe.
The stula was planned to be closed by transcatheter method. In catheterization laboratory, hemodynamic evaluation was performed. Pulmonary artery pressure was in normal range. When pulmonary angiography per- formed pulmonary AV stula was seen in left lung lower lobe. There were 4 arterial branches and venous return was directly to left atrium. The balloon occlusion test resultedd in signi cant elevation on oxygen saturation. The main two branches that feed the stula were closed with 6x6 ADO II and 5x6 ADO II,. In the control angiogram, a marked reduc- tion in stula blood ow was noticed and saturation was increased signi cantly (% 94). Remained two smaller ves- sels planned to be closed in the following months, because of prolonged procedure time and for not exceeding the maximum radioopaque and radiation doses
Discussion: De nite therapy for pulmonary AV malforma- tions are therapeutic embolization or surgical resection.
Transcatheter technique is a safety treatment choice instead of major surgery. Long-term follow-up evalua- tion has shown potentially serious complications in 2% of patients treated with transcatheter occlusion. Symptomatic recanalization was observed with 0.5% of procedures. In this case we used Amplatzer duct occluder II for branches occlusion. We occluded only 2 branches for prolonged pro- cedure time and not for exceeding the maximum radio- opaque and radiation doses. We planned to follow up patient with clinical symptoms. If necessary, re-evaluation and treatment with angiography may be considered.
35. USING IN VITRO MODEL TO ASSESS STENT-STENT INTERACTION IN PATIENTS WITH CORONARY ARTERY COMPRESSION
Jenny E. Zablah, Rachel Fry, Neil Wilson, Michael Ross, Gareth Morgan
Children's Hospital of Colorado, Aurora, USA
Background: One rare but potentially devastating com- plication of percutaneous pulmonary valve implantation is coronary artery compression due to pre-stent or pros- thetic valve placement in the right ventricular out ow tract.In these cases, percutaneous stent implantation in the coronary artery is a potential bailout option,but the
Hijazi, Z
21st Annual PICS/AICS Meeting