Page 60 - Journal of Structural Heart Disease Volume 4, Issue 4

Meeting Abstracts
162
migration, vascular dissection and guide retention. These complications were more frequent although not statisti- cally signi cant in patients less than 10 kgrs. The analysis of mortality at 30 days, 6 and 12 months recorded a fre- quency of 3.6%, 9.2% and 19.3% respectively. The highest mortality was recorded in patients with SVIH.
Conclusions: There are a variety of procedures that can be performed in di erent groups of patients with univentricu- lar physiology with low morbidity and mortality. The cases with SVHI are the most susceptible to merit cardiovascular interventions with lower survival at 12 months.
92. USE OF THE SAPIEN VALVE FOR PERCUTANEOUS TRANSCATHETER PULMONARY VALVE REPLACEMENT WITHOUT “PRE-STENTING”: A MULTI- INSTITUTIONAL EXPERIENCE
Dan Levi1, S Sadeghi1, Morris Salem2, Neil Wilson3, Joseph Kay4, A Rothman5, A Galindo5, Mary Martin6, Bob Gray6, Michael Ross3, Jamil Aboulhosn1, Gareth Morgan3,4 1University of California Los Angeles, Los Angeles, USA. 2Keiser Permenente, Los Angeles, USA. 3Childrens Hospital of Colorado, Denver, USA. 4University of Colorado, Denver, USA. 5Childrens Heart Centre of Nevada, Las Vegas, USA. 6Primary Childrens Hospital, Salt Lake City, USA
Objectives: To describe a multi-center experience of per- cutaneous transcatheter pulmonary valve replacement (TPVR) using the Edwards Sapien S3TM Valve without the use of a prior stent (“pre-stenting”).
Background: Both the Sapien S3 and XT valves have durable cobalt-chromium stent frames. It has been hypothesized that they can allow for TPVRin large diam- eter dysfunctional right ventricular out ow tract (RVOT) without the use of other stents to buttress the landing zone. A multi-institutional experience at four centers with the SAPIEN valve for TPVR is presented.
Methods: A retrospective review was performed of all patients with CHD and dysfunctional RVOT who under- went TPVR using the Sapien valve without the use of a pre-stent. Imaging data, procedural elements and clinical follow-up data were collected to evaluate short and inter- mediate-term results.
Results: A total of 61 patients underwent percutaneous placement of the Sapien Valve in the pulmonary posi- tion without the use of pre-stenting. After elimination of Sapien TCPVRs performed after a surgical plication of the RVOT, a total of 57 cases remained for analysis in native RVOTs (n=41), conduits (n=10) and bioprosthetic valves
(BPVs, n=6). There were no cases in which the valve could not be implanted after introduction and no cases of valve embolization or misplacement. On short and intermediate term follow up (range 1 months (mo) to 2.2 years, median 5.3 months), no patients had signi cant obstruction or regurgitation around the valve requiring intervention There were no frame fractures. There were no procedural deaths. Major complications included severe aortic com- pression (n=1) requiring surgical explantation and tricus- pid valve injury requiring surgical intervention (n=2).
Conclusions: This limited multi-institutional experience demonstrates that the Sapien valve can be used for TCPVR without the use of a prestent without short term signi - cant risk of frame fractures, perivalvar leak or emboliza- tion. Longer term follow-up is needed to ensure that late frame fracture is not an issue.
93. TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECT WITH THE OCCLUTECH FIGULLA ASD OCCLUDER - A COMPARATIVE STUDY WITH THE AMPLATZERSEPTAL OCCLUDER. SINGLE CENTER EXPERIENCE.
Vakhtang Khelashvili, Lilia Kapanadze, Ekaterine Kapanadze
The Jo Ann Medical Center, Tbilisi, Georgia
Background: The closure of an atrial septal defect is procedure that is frequently performed in both adults and children. The most commonly used devices are the Occlutech Figulla and Amplatzer atrial septal occlud- ers. These devices all have similar performance e ciency for the closure of secundum atrial septal defects.
Objectives: To evaluate and compare the performance of Occlutech Figulla and Amplatzer atrial septal occluders in the pediatric and adult population.
Results: We compared the results in 221 patients (73.6 % female) who underwent ASD device closure in our center using Occlutech Figulla from 2013 to February 2018 (91 patients) and Amplatzer atrial septal occluder from 2002 to 2013 (130 patients). The patients ranged in age from 3.9 to 74.2 years. There were no statistically signi cant di er- ences between the two groups regarding patient baseline characteristics and procedure variables. The success rate using either device was excellent (OFSO 98.4 % and ASO 95.3 %). The median uoroscopic time in the OFSO group was OFSO 8.7 min and in the ASO 9.4 min). All patients were followed-up with contrast transthoracic echocardio- gram and clinical evaluation at 24 hours, 6 months and 12 months after the procedure. The overall median follow-up
Journal of Structural Heart Disease, August 2018
Volume 4, Issue 4:114-206