Page 51 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
Our rst case is a 36 years old lady who presented with complaints of occasional palpitation and dyspnea on exer- tion of recent onset. She was diagnosed to have an atrial septal defect 4 years ago during her second pregnancy. On examination she had a 2/6 ejection systolic murmur in left upper sternal border and wide xed split second sound. Her echocardiography showed a sinus venosus type of ASD with right upper pulmonary vein draining into the SVC RA junction.
The second case is a fty years old manual labourer who was recently detected to have a sinus venosus defect during an evaluation done for cough and fever. He com- plained of functional class II dyspnea on exertion.
Both the patients underwent cardiac catheterization under general anesthesia and TEE guidance. The sinus veno- sus defect and the anomalous RUPV was demonstrated. A pulmonary angiogram done in LAO cranial and lateral views with a sizing balloon kept in ated in the low RSVC (covering the area of entry of RUPV into SVC-RA junction as well as the septal defect) showed unobstructed right upper pulmonary venous drainage in its levophase. A 10 zig 7.5x24 covered cheatham platinum stent premounted over 24x12 BIB balloon was deployed under TEE and uoro- scopic guidance. Post deployment pulmonary angiogram showed unobstructed RUPV drainage with no evidence of any residual left to right shunt. The patient was discharged on aspirin and warfarin combination. The warfarin was subsequently discontinued on rst follow up at 1 month. A follow up transesophageal echo showed good stent posi- tion, unobstructed ows with in the stent and RUPV as well as no residual shunt.
Conclusion: Transcatheter closure of SV ASD can be con- sidered as an alternative to surgical option with appropri- ate planning in a patient with suitable anatomy
75. DROPPING THE ANCHOR: A NOVEL APPROACH TO ALTER GUIDEWIRE STIFFNESS FOR TRANSCATHETER BALLOON DILATION AND STENT PLACEMENT WITH DIFFICULT VESSEL ACCESS.
Rodrigo Rios1,2, Jesse Lee2,3, John Moore2, Howaida El-Said2
1Children's Minnesota, Minneapolis, USA. 2Rady Children's Hopsital/UCSD, San Diego, USA. 3Children's Hospital of San Antonio, San Antonio, USA
position in small distal vessels during the exchange pro- cess is common with sti guide wires. We describe a novel technique in which a exible and steerable guide wire, 0.035” Wholey wire (Medtronic, Minneapolis, MN), is anchored in distal vessels allowing for tracking of sheaths and balloon catheters eliminating the need to exchange for sti guidewires.
Methods/Results: We describe case examples where we used this technique during interventions on pulmonary veins or pulmonary arteries when sti wire position was di cult to obtain or maintain. Several key manipulations are required:
1. Utilizing a steerable catheter, the wire is advanced dis- tally in the vessel. The catheter should be advanced as close to the distal tip of the wire
2. Utilizing a torque device, the wire is rotated 10 to 20 times. This further advances the wire distally in the ves- sel locking the wire in place. The wire, locked in place, is utilized for interventions. Altering the tension allows tailoring guidewire sti ness to allow for balloon cathe- ter exchanges.
3. To remove the wire, the catheter is re-advanced as far distally over the wire as possible. The torque device is then utilized to rotate the wire in the opposite direction the same number of rotations disengaging the wire al- lowing removal. If freeing the wire proves di cult, a 5 or 6 French dilator, from a long sheath, may be used in place of the glide catheter to provide extra support and prevent unravelling of the wire tip.
Conclusions: We describe a novel technique in which an 0.035” Wholey guide wire can be anchored and utilized as a working wire facilitating the establishment and mainte- nance of guide wire position for stenoses that require com- plex wire and catheter manipulations.
76. THE RELATIONSHIP BETWEEN MATERNAL PERINATAL RISK FACTOR EXPOSURE AND CHILDHOOD CONGENITAL HEART DISEASE:A CASE- CONTROL STUDY IN TIBET
Yipin ZHAO
Second A liated Hospital of Zhengzhou University, Zhengzhou, China
Background: This study aims to investigate the relation- ship between maternal perinatal risk factors exposure and the incidence of congenital heart disease (CHD) in children and provide reference for prevention and control of the disease.
Background: Stenoses of vascular structures are com- monly in the congenital cardiac catheterization labora- tory. Establishment of guide wire position across a stenotic lesion is necessary to perform interventions. Losing wire
Hijazi, Z
21st Annual PICS/AICS Meeting