Page 34 - Journal of Structural Heart Disease Volume 4, Issue 4

Meeting Abstracts
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morphology of the dominant ventricle may predispose to the need to perform some percutaneous interventions.
Methods: We analyzed medical data of 77 patients aged 3,8 ± 3,3 years (range: 0,8-17,8) before last stage of Fontan pal- liation who underwent cardiac catheterization procedures in our institutions from 2013 to 2016. Patients were divided into two groups: with left ventricular morphology (LV) and right ventricular morphology (RV). Anthropometric measurements, haemodynamics variables, morphometric parameters and number of percutaneous procedures were compared in both groups of patients.
Results: Anthropometric measurements of LV and RV groups were not statistically signi cant. Mean pulmonary artery pressure and pulmonary vascular resistance were similar in both groups. RV patients had higher end-dia- stolic pressure (11,65 mmHg vs. 10,21 mmHg p<0,05) and smaller pulmonary arterial diameters with less favourable McGoon ratio (1,56 vs. 2,01 p<0,05). For this reason, those patients required a larger number of percutaneous inter- ventions (3,18 vs. 1,79 p<0,05).
Conclusion: Left ventricle anatomy of single ventricle in patients before last stage of Fontan procedure is associ- ated with signi cantly better diastolic function. They have better haemodynamic and morphometric conditions to complete Fontan procedure and require less interventions.
44. THE IMPACT OF ECHOCARDIOGRAPHIC AND HAEMODYNAMIC PARAMETERS ON FORMATION OF AORTO-PULMONARY COLLATERALS IN PATIENTS AFTER THE GLENN PROCEDURE.
Pawel Czesniewicz1, Jacek Kusa2,1
1Regional Specialist Hospital in Wroclaw, Research and Development Centre, Wroclaw, Poland. 2Medical University of Silesia, Katowice, Poland
Objectives: Aorto-pulmonary collaterals are common in patients after Glenn shunt and number of studies have shown that they might be associated with development of heart failure and adverse outcome after the Fontan opera- tion. The exact cause of formation of those vessels remains unknown. In this study we analyse the impact of echocar- diographic and hemodynamic parameters on formation of aortopulmonary collaterals.
Methods: We analysed data of 77 patients aged 3,8 ± 3,3 years (range: 0,8-17,8) with single ventricle anatomy after Glenn shunt who underwent cardiac catheterization from 2013 to 2016 at our institutions. We identi ed 70 signi cant
aorto-pulmonary collaterals in 52 patients. All collaterals were emobolized. Imaging and hemodynamic data were compared in two groups: patients with aorto-pulomonary collaterals versus patients without aorto-pulmonary collaterals.
Results: Echocardiographic measurements did not reveal any group di erences. Pulmonary arteries were equally developed in both groups. Patients with aorto-pulo- monary collaterals had lower mean pulmonary artery pressure (13,15 mmHg vs. 15,2 mmHg, p<0,05) and end diastolic pressure (10,63 mmHg vs. 12,16 mmHg, p<0,05). They had also lower pressure gradient between ascending and descending aorta (3,5 mmHg vs. 6,5 mmHg, p<0.05). Patients without aorto-pulmonary collaterals and with higher pressure gradients in aortic isthmus had more often aorto-aortic collaterals. The remaining haemodynamic parameters did not show statistical signi cance
Conclusion: Hypoperfusion of the pulmonary vascular bed contribute the development of aorto-pulmonary collaterals.
The higher gradient in the aortic isthmus can have a bene- cial e ect by inhibiting the formation of aorto-pulmonary collaterals. Because aorto-pulmonary and aorto-aortic col- laterals often arise from the same vessels we hypothesise that these vessels preferably participate in the creation of collateral circulation between ascending and descend- ing aorta rather then in formation of aorto-pulmonary collaterals.
45. EMBOLIZATION AND SUCCESSFUL TRANSCATHETER RETRIEVAL OF CERAMIC COATED PDA DEVICES: ARE WE SIZING THEM WRONG?
Supratim Sen1, Sneha Jain1, Bharat Dalvi1,2,3
1SRCC NH Children's Hospital, Mumbai, India. 2HN Reliance Hospital, Mumbai, India. 3Nanavati Hospital, Mumbai, India
PDA device closure is the commonest pediatric cardiac intervention, with excellent outcomes. The Amplatzer Duct Occluder and similar devices, especially the ceramic coated PDA devices, are a routine choice in most PDAs.
We present two cases of spontaneous embolization of ceramic coated PDA devices despite the initial angio- graphic result appearing adequate.
The 1st case was a 15-month, 8.2 kg female child with a Krichenko Type E PDA with a small ampulla and a slightly tubular PA end measuring 2.5 mm. A Lifetech Cera 4/6 mm
Journal of Structural Heart Disease, August 2018
Volume 4, Issue 4:114-206