Page 67 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
completely occluded with thrombus. The common carotid to subclavian graft had mild stenosis. One year after the procedure, the patient was doing well clinically; he had a 24 mmHg peak systolic blood pressure di erence between the right and left arms, a left ventricular ejection fraction of 38-41% and a peak velocity distal to the stent of 1.9 m/sec, without diastolic runo .
Conclusion: Test balloon occlusion of the LSCA can aid in the interventional management of coarctation
104. EARLY ELECTROCARDIOGRAPHIC CHANGES IN PATIENTS WITH TETRALOGY OF FALLOT AFTER SURGICAL REPAIR
Lukas Ljung1, Ida Jeremiasen1, Carl-Johan Rosenkvist2, Annica Maxedius1, Misha Bhat1, Torsten Malm1, Katarina Hanseus1, Gunnar Sjöberg3, Petru Liuba1
1Skåne University Hospital, Lund, Sweden. 2Kalmar Hospital, Kalmar, Sweden. 3Karolinska Hospital, Stockholm, Sweden
Background: Surgical repair of Tetralogy of Fallot (TOF) with RVOT enlargement with transannular patch results in pulmonary regurgitation with subsequent increasing RV volume overload and need for later pulmonary valve replacement. These changes are typically associated with progression of QRS and QTc duration, which are predic- tive for long term adverse events. RVOT reconstruction with monocusp has been increasingly used during the past decade in the attempt to improve early postoperative recovery and delay the PR particularly during the rst years after surgery.
Aim of Study: To assess whether repair of TOF with mono- cusp in uences the progression of QRS and QTc duration during the rst years after surgical repair of TOF.
Methods: We performed a retrospective survey of all patients with TOF who underwent surgical repair between 1998-2014 with available conventional electrocardiograms:
• (A) before surgery
• (B) upon postoperative discharge
• (C) at 18-24 months after surgery who did not require re-
operation during this period. Demographic, clinical, sur- gical and electrocardiographic data were obtained.
Results: In total, 92 patients ful lling the above criteria were included. There was no mortality. Of these, 32 patients (median weight at repair 6.9kg) under- went pulmonary valve-sparing repair, 31 patients(median weight6.7kg)underwentTAPrepair,and29patients(median weight 6.5kg) had repair with TAP & monocusp. There were
no di erences between the groups in QRS and QTc dura- tions preoperatively or upon discharge after repair (p>0.15). At 18-24 months, both QRS and QTc durations were greater in the monocusp group(p<0.05 for QRS and p<0.01 for QTc). The percentage change in QRS and QTc durations from the early postoperative time were increased in the monocusp group as compared to the other groups(p<0.05).
Conclusion: Surgical repair of TOF with TAP and monocusp pulmonary valve appears to be associated with adverse changes in QRS and QTc durations during the rst years after repair. These changes could be due to a more pronounced myocardial remodeling as a result of a more extensive RVOT patch enlargement during TOF repair with monocusp. Prospective studies exploring underlying mechanisms of RV remodeling by measuring circulating biomarkers for myocardial remodeling after TOF repair with TAP and monocusp are under way.
105. STAGED PERCUTANOEUS BALLOON VALVOTOMY (PBMV) AND ASD DEVICE CLOSURE FOR SITUS INVERSUS TOTALIS DEXTROCARDIA AND LUTEMBACHER SYNDROME (LARGE ASD AND SEVERE MITRAL STENOSIS) IN A ELDERLY FEMALE
Sudeep Verma1, Dayasagar Rao2, Sharathbabu D3
1Krishna Institute of Medical Sciences, Secunderabad Hyderabad, India. 2Krishna Institute of Medical Sciences, Secunderabad- Hyderabad, India. 3Krishna Institue of Medical Sciences, Secunderabad- Hyderabad, India
Introduction: Lutembacher syndrome is a rare combina- tion of congenital ASD and acquired Mitral valve pathology particularly Mitral stenosis (MS). The resultant haemody- namics depends upon the interplay between size of ASD and severity of MS. We are describing here a rare case of situs inverses totalis with Lutembacher syndrome and severe Tricuspid regurgitation (TR) underwent successful s PBV rst followed by ASD device closure within 3 months. Patient symptoms improved dramatically after the proce- dure with complete abolition of TR.
Case Details: 41 years old lady weighing 40 kg presented with chief complaints of progressive dyspnoea and pedal oedema since 3 months. Examination revealed thin build habitus, situs inverses, dextrocardia, elevated left sided JVP with prominent V and Y descent, low volume pulses, right parasternal heave grade III, wide and xed split S2, 4/6 Systolic murmur at right upper sternal border and short MDM at right apex.
Hijazi, Z
21st Annual PICS/AICS Meeting