Page 65 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
6mm/14mm) trimmed into 11 mm length was placed by a hybrid procedure following failure of the percutaneous approach. Post-dilatation or additional stenting was per- formed due to development of desaturation associated with somatic growth. Post-dilatations were performed twice (case 1) and 3 times (case 2). Two additional stents (Express Vascular SD 6mm/18mm ×2) were placed at a nar- row pulmonary trunk in case 2. Both infants grew up with optimal pulmonary artery growth. The stents were partially removed in subsequent surgery; bidirectional Glenn at 6 m/o and 9 m/o. Pulmonary artery sizes (rt./lt./PA index) at the surgery were 7.6mm (z-score +1.9)/6.2mm (z-score +1.2)/279.7 and 6.2 mm (z-score -0.8)/6.8 mm (z-score +0.4)/162.2, respectively.
Conclusions: RVOT stenting in single ventricle with pulmonary stenosis not only brings augmentation and stabilization of pulmonary blood ow, but also allows man- agement of pulmonary blood ow on demand by post-dil- atation and additional stenting. Furthermore, unlike with TOF, there is no concern regarding stent removal during subsequent surgery because stent-landing sites (RVOT and pulmonary trunk) are not to be used for the pulmonary circulation pathway. These properties will o er signi cant bene ts for Fontan completion and better prognosis in univentricular physiology.
100. SUCCESFUL REDPLOYMENT OF A PROXIMALLY MIGRATED STENT IN A MALALIGNED SEVERE COARCTATION OF AORTA USING A BIOPTOME: DISCUSSING A UNIQUE CAUSE (MALALIGNMENT) AND A UNIQUE THERAPY
Neeraj Awasthy
Max Hospital, Delhi, India
Endovasuclar stenting is a established method of treat- ment of Coarctation of the Aorta (CoA) in a adolescent and adult. Stent migration is a dreaded complaication of any coarcation stenting. We present a case of stent migration in a 60 year old lady with coarctaion amounting to near interruption with malaligned segments which was reposi- tion with a bioptome.
Case: A 60 year old lady presented with mild chest pain on and o since the past 6 years aggravating on exertion and relieved by rest radiating to the left arm associated with fatigue and palpitations not associated with di culty in breathing not associated with cough and expectoration, no diurnal variations. History of giddiness was present and also failure to gain wait. There was no history of fever, vomiting, syncope. She was known case of hypertension
since the past 6 years and was on medications. She had no history ofdiabetes, bronchial asthama, COPD, Tuberculosis, seizure disorder, thyroid disorder, no bladder and bowel disturbances, no h/o previous surgeries. Her echo revealed coarctation of aorta with biscuspid aortic valve (thickened lea ets). On examination blood pressure (in supine posi- tion):upper limbs -130/70mmhg,lower limbs-80/60mmhg. Her CT aortogram was done which con rmed coarctation of aorta. In view of the above ndings the patient was taken for coarctation stenting of aorta. Aortogram shows long segment coarctation of aorta, No PDA. Coarctation stenting done successfully with CP covered stent 20 (8zig) x 45 with BIB balloon. The stent migrated slightly distally while in ating and was repositioned with the help of biot- ome and peripheral balloon. Post dilatation, no signi cant gradients across the coarctation segment. No complica- tion. Total gradient across the coarctation segment was 140 mmHg before stenting, post stenting the gradient was reduced to 10. Her post-op recovery was satisfactory she was discharged in stable condition. She is doing well with one and half year follow up.
101. NO DELIVERY SYSTEM: INGENEOUS DEVELOPMENT OF A DELIVERY SYSTEM IN PEDIATRIC POPULATION FOR DIAGNOSTIC CARDIAC CATHERIATION
Neeraj Awasthy
Max Hospital, Delhi, India
Introduction: Study of delivery of NO for diagnostic car- diac catheterization in paediatric patient BIPAP vs paedi- atric Hud.
Aims and objective: E ective delivery of NO with the HUD is comparable to BIPAP delivery, in pediatric spontaneously breathing patient with the use of NOXBOX machine.
Methods and material: This is comparative prospective pilot study, to assess e ectiveness of delivery of NO via HUD, compared to that of BIPAP mask. Study population is grouped into two based on mode of delivery as BIPAP receiving group and HUD receiving group. Each group contain 5 spontaneously breathing pediatric patient with underlying pulmonary hypertension, and, NO is delivered to assess reversibility of pulmonary vasculature.
Result: data collected as above, in HUD group, we were able to deliver NO e ectively in acceptable range in all 5 patients same in BIPAP group.
Hijazi, Z
21st Annual PICS/AICS Meeting