Page 62 - Journal of Structural Heart Disease Volume 4, Issue 4

Meeting Abstracts
164
Results: Initial mean LA pressure as measured with pres- sure wire was 25 mmHg. Following placement of the atrial septal stent, mean LA pressure immediately fell to 9 mmHg with corresponding immediate normalization in pulmo- nary venous Doppler pattern and increase in F/R VTI ratio to 20 ( gure). There was non-restrictive stent ow by color ow Doppler.
Conclusions: Intracardiac pressure measurements using a pressure guidewire during fetal atrial septal stent place- ment provides adjunctive hemodynamic information that is useful to assess the e ectiveness of intervention and may also provide information for postintervention prognostication.
95. AMPLATZER VASCULAR PLUGS AND AMPLATZER DUCT OCCLUDER II ADDITIONAL SIZES FOR OCCLUSION OF PATENT DUCTUS ARTERIOSUS: A MULTI-INSTITUTIONAL STUDY
months (range 0.75-852) and 11.4 kg (range 1-92), with 51 pts < 5 kg. Type A PDA was most common in 48% (n=225), followed by type E (27%, n=129), type D (13%, n=61), type C (10%, n=49) and type B (2%, n=7). AVP II was used in 421 pts (89%), ADO II-AS in 30 pts (6%) and the remaining pts received AVP I and IV. At follow up, mild LPA stenosis was the most common complication overall (n=20), with no sig- ni cant di erence between device type (p=1.0), PDA mor- phology (p=0.16) or patient size (p=0.56). Mild aortic arch gradient was seen in 5 pts (1.2%), all with AVP II. Device embolization was more common with ADO II AS (n=3, 10%) compared to AVP II (n=5, 1.2%) (p=0.001). Referral to surgery was required in 5 pts, all < 5kg.
Conclusion: The AVP II and ADO II AS appear promising for PDA closure. However, the complication of LPA stenosis remains the same in both groups and embolization may be more common with ADO II AS. We believe both devices are e ective in PDA closure with complex morphology and smaller size pts.
96. USE OF ROTATIONAL ANGIOGRAPHY TO GENERATE 3-D PRINTED MODELS - PROOF OF CONCEPT
Michael D. Seckeler1, Brian Boe2, Darren Berman2, Aimee K.
Armstrong2
1Banner University Medical Center/University of Arizona,
Tucson, USA. 2Nationwide Children's Hospital, The Heart Center, Columbus, USA
Background: Three-dimensional (3-D) printing has been increasingly utilized in medicine for interventional plan- ning, particularly in congenital heart disease. Typical datasets used are axial imaging (CT or MR), however sim- ilar datasets can be created in the catheterization labo- ratory using rotational angiography (RA). The purpose of this study was to assess the potential for generating 3-D printed models from RA datasets.
Methods: After approval from the Institutional Review Board, clinically indicated congenital catheterizations that used RA were identi ed. Catheterizations were performed in Toshiba and Philips laboratories. Use of rapid ventricu- lar pacing, contrast concentration and contrast volume were based on standard practice and operator preference. DICOM data were segmented, cleaned, prepared for print- ing and then printed with poly-lactic acid on a Dremel® 3D Idea Builder (Dremel, Mount Prospect, IL, $1,299; Figure). Data collected included demographics, diagnosis, contrast concentration and volume used, printing time and mate- rials’ costs. Two independent, non-interventional pediatric
Dennis VanLoozen, MD1, Juan Pablo Sandoval, MD2, Je rey Delaney, MD3, Carlos Pedra, MD4, Damien Kenny, MD5, Bharat Dalvi, MD6, Zahid Amin, MD1
1Children's Hospital of Georgia, Augusta, USA. 2Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico. 3University of Nebraska, Children's Hospital & Medical Center, Omaha, USA. 4Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil. 5Our Lady’s Children’s Hospital, Dublin, Ireland. 6Glenmark Cardiac Centre, Mumbai, India
Background: Variable patent ductus arteriosus (PDA) mor- phology and the desire to close PDAs in small size patients has led physicians to use Amplatzer Vascular Plug (AVP) I – IV and newly available Amplatzer Duct Occluder II – Additional Sizes (ADO II-AS). The purpose of this study was to analyze data, extrapolate results and compare compli- cations of patients who underwent PDA closure with these devices.
Methods: Patients who underwent PDA closure with ADO I or II were excluded. Variables analyzed included demographics, procedure and device data, complica- tions during the procedure and at 6 month follow up. Demographics included age, weight, gender and prematu- rity. Procedure and device data included PDA morphology, size, hemodynamic signi cance, device type and size used. Complications during procedure included device emboli- zation, removal or referral to surgery. Follow up complica- tions included assessment of left pulmonary artery (LPA) stenosis and aortic arch gradient.
Results: PDA closure was successfully accomplished in 466/471 pts (98.9%). Median age and weight were 27
Journal of Structural Heart Disease, August 2018
Volume 4, Issue 4:114-206