Page 31 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
37. AMPLATZER DUCT OCCLUDER II IS AN IDEAL DEVICE FOR CLOSING CONGENITAL GERBODE DEFECTS
I B Vijayalakshmi
BMC&RI Super Specialty Hospital (PMSSY), Bengaluru, India
Background: Congenital left ventricle to right atrial com- munications (Gerbode defects) are extremely rare (0.08%) type of ventricular septal defects. They were traditionally closed by surgery in the past. There are few case reports and small series of acquired and congenital Gerbode defects, closed with various types of devices.
Aim of our study is to assess the feasibility, e cacy, and complications of transcatheter closure of congenital Gerbode defects with Amplatzer duct occluder II (ADO II).
Material and Results: Thirteen consecutive cases of Gerbode defects, age ranging from 10 months to 16 years (mean 6.7 years), weight ranging from 6.5 kg to 34 kg (mean 19.3 kg), were diagnosed on transthoracic echocardiogra- phy. The left ventricular angiogram done in AP, RAO view with 100 cranial angulation illustrated the contrast from LV opacifying the right atrium (RA). The defect was crossed by over the wire technique by 0.0 25” Terumo guide wire through the retrograde approach from aorta. 4F Cooks Shuttle sheath was passed over the guide wire anchored in SVC. The distal retention skirt was released in RA and the whole system was pulled under uoroscopy and TTE guidance to LV to release the proximal disc. Transcatheter closure of Gerbode defects was done successfully through retrograde approach with ADO II. No aortic or tricuspid regurgitation or residual shunt occurred in any of the patients. One patient developed transient complete heart block needing temporary pacing for 48 hours and steroids for ve days.
Discussion: The soft low pro le, easily trackable ADO II appears to be ideal for closure of Gerbode defects, as the central cylinder ts in the defect and the soft retention discs on either side, without polyester material, do not impinge on either aortic, mitral, or tricuspid valve. We report the successful transcatheter closure of thirteen cases of con- genital Gerbode defects with ADO II.
Conclusion: Transcatheter closure of congeni- tal Gerbode defects with ADO II is safe, e ective, and an attractive alternative to surgical closure. ADO II appears to be tailor made for Gerbode defects, as the success rate is very high and complication rate is very low.
38. ROLE OF TRANSCATHETER INTERVENTION IN DIVIDED RIGHT ATRIUM
I B Vijayalakshmi
BMC&RI Super Specialty Hospital (PMSSY), Bengaluru, India
Cor triatriatum Dexter is an extremely rare congenital anomaly (0.025%), in which the right atrium is divided into two chambers by a septum, diagnosed on autopsy in the past. We describe antemortem diagnosis, by 2D transtho- racic echocardiography with agitated saline contrast echo- cardiography and inferior venacava or superior venacaval venography. For the rst time we report a novel method of transcatheter balloon disruption of membrane along with the interventions for associated lesions, to reduce morbid- ity and mortality.
Objective: To describe the importance of transthoracic echocardiographywithagitatedsalinecontrastechocardi- ography and to assess the feasibility and e cacy of tran- scatheter interventions in divided right atrium.
Material and Results: Out of sixteen consecutive patients of divided right atrium diagnosed with transthoracic echo- cardiography with agitated saline contrast echocardiogra- phy, ve patients who underwent transcatheter balloon disruption of membrane and other interventions formed the material for study. Three patients were boys and two were girls, age ranged between 3 to 17 years, median age was 10 years. Three patients presented with extertional dyspnea and two were asymptomatic. Two who had rheu- matic heart disease with mitral stenosis underwent balloon mitral valvuloplasty and one case with atrial septal defect without pulmonary artery hypertension underwent device closure. For the rst time in the world we present the trans catheter intervention in divided right atrium.
Conclusion: Cor triatriatum Dexter is not benign as mor- tality occurs due to pulmonary embolism. Timely diagnosis with transthoracic echocardiography with simple agitated saline contrast echo followed by balloon disruption can prevent cyanosis, pulmonary artery hypertension, morbid- ity and mortality.
39. DEVICE CLOSURE IN RAREST OF RARE CONDITIONS
I B Vijayalakshmi
BMC&RI Super Specialty Hospital (PMSSY), Bengaluru, India
Amplatzer Duct Occluder II (ADO II) was especially designed for closing long ducts in infants. There are few reports of “o -label” use of ADO II in non-ductal positions.
Hijazi, Z
21st Annual PICS/AICS Meeting