Page 61 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
time was 3.6 years. In all subjects, the residual shunt was small to trivial during follow up and the reduction in preva- lence of residual shunt with time was similar in both groups. A high procedural and technical success was observed in both groups and no di erences were recorded in patent foramen ovale closure e cacy. There were no signi cant di erences between the complications when comparing the two devices.
Conclusions: For children and adults with an isolated secundum atrial septal defect percutaneous closure is equally safe and e ective with either Occlutech Figulla or Amplatzer atrial septal occluders.
94. FETAL INTRACARDIAC HEMODYNAMIC MEASUREMENT USING PRESSURE GUIDEWIRE DURING FETAL ATRIAL SEPTAL STENT PLACEMENT Wendy Whiteside1, Sarah Gelehrter2, Carlen G. Fifer2, Albert P. Rocchini2, Cosmas Van de Ven3, Majorie C. Treadwell4, Karena Wu5, Je rey D. Zampi2
1University of Michigan; Congenital Heart Center, Ann Arbor, USA. 2University of Michigan, Congenital Heart Center, Ann Arbor, USA. 3University of Michigan, Division of Maternal-Fetal Medicine, Ann Arbor, USA. 4University of Michigan Division
of Maternal-Fatal Medicine, Ann Arbor, USA. 5University of Medicine, Congenital Heart Center, Ann Arbir, USA
Background: Hypoplastic Left Heart Syndrome (HLHS) with intact atrial septum represents one of the most
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lethal forms of congenital heart disease due to pulmonary venous hypertension and resulting e ects on lung devel- opment. Fetal intervention with left atrial (LA) decompres- sion and atrial septal stent placement can be performed to lessen the urgency of post-natal atrial decompression, and may help improve survival by altering LA hemodynamics during fetal life. Data on direct intracardiac pressures in the fetus are limited. We report fetal hemodynamics using a pressure guidewire to record fetal intracardiac pressures and the corresponding change to echo Doppler tracings before and after LA decompression.
Methods: We report the case of a 33-year-old woman at 30 3/7 weeks gestation with fetal diagnosis of HLHS with an intact atrial septum. By fetal echocardiogram, the pul- monary veins were dilated with marked ow reversal and Doppler forward/reverse velocity time integral (F/R VTI) ratio <1 suggesting severely elevated LA pressures. She was referred for fetal intervention with atrial septal stent placement. With the mother under epidural anesthesia and under transabdominal ultrasound guidance, an 18-gauge x 15 cm Trocar was advanced through the maternal abdo- men and into the fetal right atrium, through the atrial sep- tum, and into the left atrium. Through the trocar, a 2.5 mm x 8 mm Medtronic Integrity stent and 0.014” Volcano pres- sure wire were advanced into the LA, positioning the stent across the atrial septum. Stent was deployed in good posi- tion and repeat pressure recorded with the pressure wire.
Hijazi, Z
21st Annual PICS/AICS Meeting