Page 59 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
90. PERCUTANEOUS CLOSURE OF NEONATAL COMPLEX VSD WITH THE NEW KONAR-MF MUTIFUNCTIONAL OCLUDDER DEVICE
Liliana Ferrin1, Jesus Damsky Barbosa2, Marcelo Rivarola3, Victorio Lucini2, Jose Alonso4
1Corrientes Cardiology Institute, Corrientes, Argentina. 2Children Hospital Pedro de Elizalde, Buenos Aires, Argentina. 3Austral Universitary Hospital, Buenos Aires, Argentina. 4High Complex Hospital Juan Domingo Peron, Formosa, Argentina
Percutaneous closure of ventricular septal defect (VSD) is a succesful therapeutic modality but remains challenging particurlaly in small patients. Congestive heart failure pre- sentation in neonates with VSD is commonly associated with other complex lessions requiring surgical treatment without VSD resolution.
We will demonstrate the feasibility and e ectivenes of per- cutaneous VSD closure in neonate patients with asociated congenital heart diseases using KONAR-MF multifunc- tional occluder device (MFO).
We report 3 neonates under 4 kg weigth with congenital heart diseases and non restrictive VSD with severe haemo- dinamics failure whom required percutaneous VSD closure at early post surgery stage.
A four month old baby, 5 kg weigth, with congestive heart failure post Swtich operation with residual moderate gra- dient at neopulmonar level was diagnosed a 5mm non restrictive muscular VSD at catheterization procedure. Therefore transcatheter closure was succesfully performed with a 6-4 MFO occluder by venous antegrade right ven- tricular direct VSD approach, 5F sheath without arterial puncture. Non residual shunt was evidence.
A 15 days, 3 kg weigth neonate with critic aortic stenosis and aortic coarctation undertook an e ective valvuloplasty and coarctation angioplasty. Non restrictive 8 mm mus- cular VSD was showed at the procedure and surgical aor- tic coartaction correction was performed four days after. Because of severe heart failure, VSD transcatheter closure was attempted with a 10-8 MFO occluder by antegrade approach trough the foramen ovale by 5F sheath avoiding arterial puncture.
The last patient, one month old, 2,9 kg weigth, post surgi- cal correction of Totally pulmonary venous anomally and muscular VSD. Because of severe heart failure the residual 5 mm muscular VSD was closed with a 8-6 MFO occluder, venous approach through the foramen oval, 4F sheath.
After VSD closure the patients did well, but the rst one went on sepsis and died three weeks later.
Conclusions: Neonates with congenital complex heart dis- ease and associated VSD are di cult to solve by only one surgical approach. Percutaneous VSD closure with new Konar-MF (MFO) nitinol low pro le occluder is an e ective and safe alternative of treatment in this challenge group of patients
91. ENDOVASCULAR INTERVENTION IN PATIENTS WITH UNIVENTRICULAR PHYSIOLOGY: RISK FACTORS AND MEDIUM-TERM MORBIDITY AND MORTALITY Justo Santiago1, Antonio Arias2, Juan Gallego1, Leonardo Blanco1, Claudia Flores1, Gabriela Karl1, Alvaro Duran1 1Colombian Cardiovascular Foundation, Bucaramanga, Colombia. 2Colombian Cardiovascular foundation, Bucaramanga, Colombia
Introduction: Patients with univentricular physiology merit di erent interventions during their evolution and management, whose nal objective is to achieve an ade- quate balance between pulmonary and systemic ow with a reduction in postload of the systemic ventricle. Many of these procedures can be performed endovascularly, how- ever there is little existing literature on the overall analysis of these patients.
Materials and methods: In order to evaluate the medium term results in a group of patients treated at our institu- tion, we conducted a retrospective study over a period of 2 years. The following data were investigated: demo- graphic, main diagnosis, palliation stage, types of surgery, type and number of hemodynamic procedures, complica- tions and results one year after the procedure. A summary and description of the variables was carried out and they were analyzed taking morbidity as a dependent variable.
Results: A total of 111 patients underwent cardiac catheter- ization during the period studied. The majority were males (63.5%), with a median weight of: 10 Kgrs and 11 months of age. The most frequent heart diseases were: Atresia tri- cuspidea (30%), Hypoplasic left heart syndrome (SVIH) (18.8%) and pulmonary atresia (13.5%). 75.6% of the cathe- terizations were therapeutic, of these the most performed procedures were: Collateral embolization (64%), balloon angioplasty (16%) and stent angioplasty (11%). There were no deaths related to catheterization. The complications in general were 10%, of which the majority (88.25%) were minor, with arrhythmias being the most frequent. Major complications were observed in 1.75% (3 cases), with stent
Hijazi, Z
21st Annual PICS/AICS Meeting