Page 46 - Journal of Structural Heart Disease Volume 4, Issue 4

Meeting Abstracts
148
he was diagnosed with chronic kidney disease with unde- termined etiology. GFR estimated to be 32 ml/min/1.73m2. An MRI con rmed a severe juxtaductal coarctation.
Management: Typically, this patient is a candidate for stent placement. However, this would be problematic in the presence of CKD. A decision was made to attempt stent placement without using angiography. Patient underwent right and retrograde left cardiac catheterization without angiogram. We used an 18mm Amplatzer sizing balloon II to exactly locate and measure the Coarctation. The bal- loon sizing diameter was 7.2mm. We elected to place a covered stent to preemptively cover even small possible tears because angiography post stent placement would not be available for assessment. A35 mm long covered CP stent mounted on a 20mm X 4cm BIB balloon was used. Temporary pacing of the right ventricle was done to avoid dislodgement of the stent during deployment. Coarctation diameter increased to 15.5mm and the pressure gradient was eliminated. Patient tolerated the procedure well.
Conclusion: Endovascular intervention, including stent placement, in the presence of CKD is challenging. The use of a sizing balloon and measures to prevent complications can facilitate Transcatheter treatment of aortic Coarctation without the use of contrast
66. PERCUTANEOUS ASD CLOSURE OF CHILDREN
LESS THAN 10 KG
Nazmi Narin1, Osman Baspinar2, Ozge Pamukcu1, Ali
Baykan1, Suleyman Sunkak1, Aydin Tuncay1, Onur Tasci1
1Erciyes University, Kayseri, Turkey. 2Gaziantep University, Gaziantep, Turkey
Introduction & Aim: Traditionally the procedure of percu- taneous ASD closure is used to be done in children more than 15kg. Main limitation factor for small children is the size of delivery system and how to manage in a state of complication.
The aim of this study was to discuss the success, e cacy, and safety of the percutaneous closure of symptomatic ASD in children less than10kg
Method: Study was performed in two Pediatric Cardiology centers: Erciyes and Gaziantep University. Total 38 patients were included. Demographic and angiographic data of these patients were gathered retrospectively from patients’ records.
Results: Median weight of patients was 9,0(8,0-9,5)kg. Bodyweight of 21patients were less than 3 percentiles. In the follow-up this number was lowered to 9 at 12 months. However, we lost contact with 16 of 38 patients. Median age of patients was 18 (12,75-30,0)months. Female/male ratio was 27/11. Median mean pulmonary pressure was 25 (20,0-29,0) mmHg. The values of median defect size were measured angiographically as 13,0(10,75-15,3) mm. Median device size was 13,0(9,0-15,0) mm. Defect size was evaluated according to body weight and body surface area. The ratio of weight per defect size was 0,64(0,55- 0,83) also ratio of body surface area per defect size was ise 0,030(0,028-0,041). Ratio of total septum per device diam- eter was 2,5(2,1-3,1).
Additional medical problems of patients were growth hor- mone de ciency, Mucopolysaccharidosis, Down syndrome in 3 patients. Additional heart problems of patients were severe pulmonary stenosis in 4 patients, large PDA in one patient, VSD in 2 patients. Pulmonary valvuloplasty and PDA occlusion, percutaneous VSD occlusion was done in these patients in the same session with ASD closure. Types of devices used were Amplatzer Septal Occluder in 30 patients, CeraFlex Septal Occluder in 2patients, Figulla FlexII Atrial Septal Occluder in 5patients, Memopart sep- tal Occluder in 1 patient. The device had to be retrieved in one patient after successful positioning because it was detected that device compressed the aorta. No major com- plication was seen.
Conclusion: In the experienced centers, percutaneous ASD closure can be done e ectively and safely in symp- tomatic children less than 10kg.
67. CARDIAC CATHETERIZATION VIA UPPER EXTREMITY VEINS IN PEDIATRIC CARDIAC CATHETERIZATION LABORATORY
Jess Randall1, Osamah Aldoss1, Asra Khan2, Melissa Challman2, Gurumuthy Hiremath3, Athar Qureshi2, Manish Bansal1
1University of Iowa Stead Family Children's Hospital, Iowa City, USA. 2Texas Children's Hospital, Baylor College of Medicine, Houston, USA. 3University of Minnesota Masonic Children's Hospital, Minneapolis, USA
Background: Traditional approaches to pediatric cardiac catheterization have relied on femoral venous access. Upper extremity venous access may enable cardiac cath- eterization procedures to be performed without the need for general anesthesia, lead to quicker recovery times and in some instances, facilitate interventions. The objective of
Journal of Structural Heart Disease, August 2018
Volume 4, Issue 4:114-206