Page 44 - Journal of Structural Heart Disease Volume 4, Issue 4

Meeting Abstracts
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case of right atrial disc of the device rubs perpendicularly and deeply, lethal complication can occur.
62. CLOSURE DEVIE FOR CONGENITAL HEART DISEASE: SINGLE CENTRE EXPERIENCE FROM A DEVELOPING COUNTRY
Taw q Shahriar Huq
National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
Bangladesh is a country of 170 million people, which is the fth largest country in the world by population. With a crude birth rate of 19.45 and Neonatal mortality rate of 20.1. It is estimated 12% of these deaths are due to con- genital abnormalities and 1% of these may be due to car- diac anomalies. Early diagnosis and treatment still remains a challenge. National Heart Foundation Hospital and Research Institute which is a tertiary care cardiac hospital and the prime institute for cardiac care has a well organized department for diagnosis and treatment of congenital heart disease. Besides diagnostic cardiac catheterization since 2015 this institute is performing intervention for congenital heart disease. Till December 2017 a total of 595 patients both pediatric and adult age group underwent implantation of device for ASD, VSD and PDA. Of them 342 (57.5%) are for Atrial Septal Defect, 214 (36%) for PDA and 39 (6.6%) for VSD. Female population was dominant 377 (63.8%). Procedural success was high and complication rate was low. Thorough pre procedural assessment through di erent imaging modalities team work is the key behind success. On the ip side besides it is remarkable that the patient population was older than expected. At the same time signi cant number of patients with ASD presented to us with pulmonary hypertension. Lack of regulation for proper health check up of preschool children at the same time failure to understand the natural history of the dis- ease by the primary care physicians are to be blamed. By creating awareness both among general population and health care providers are essential to reduce mortality and morbidity from congenital heart disease.
63. STENTING OF STRAIGHT AND TORTUOUS PDAS IS SAFE AND EFFECTIVE PALLIATION FOR NEONATES WITH DUCTAL-DEPENDENT PULMONARY BLOOD FLOW
Carrie Herbert1,2, Je rey Jacobs1,2, Nhue Do1,2, Colleen Bauza1, Gary Stapleton1,2
1Johns Hopkins All Children's Hospital, Saint Petersburg, FL, USA. 2Johns Hopkins University, Baltimore, MD, USA
Purpose: Ductal stenting in neonates with ductal-depen- dent pulmonary blood ow is an alternative palliation strategy to surgical shunt placement that may reduce cumulative morbidity and mortality. We reviewed our entire institutional experience with ductal stenting to assess safety and e cacy.
Methods: We placed our rst ductal stent for palliation of ductal-dependent pulmonary blood ow in November 2014, and by 2016, we adopted an institutional policy of preferential ductal stenting in patients with suitable anatomy.
For all patients undergoing attempted ductal stenting, we reviewed anatomic, preprocedural, procedural, and postprocedural data. All procedures were performed by the same 2 interventionists; therefore, uoroscopy time and radiation dose were used as surrogates for procedural di culty.
Results: Ductal stenting was attempted in 24 neonates and was successful in 22 (91.6%). Diagnoses: PA/IVS (6), DORV/PS (5), TOF (4), PA/VSD (3), Heterotaxy syndrome/PS (3), DILV/TGA/PS (2), and TGA/VSD/PS (1).
9/24 patients had tortuous ducts (7/9 successfully stented). Unsuccessful PDAs had a 360° loop or a 180° “hairpin” turn that could not be straightened.
Table 1 documents uoroscopy time and radiation dose strati ed by ductal anatomy and the angle of ductal sheath.
3/22 (13.6%) patients who received a ductal stent required catheter-based re-intervention (2 for end of PDA uncov- ered, 1 for intimal buildup). Approach: 13/25=femoral
Journal of Structural Heart Disease, August 2018
Volume 4, Issue 4:114-206