Page 69 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
online system to capture: pacemaker threshold voltages, R waves, and impedance values.
Results: To date, we have successfully inserted the Micra pacemaker device in four paediatric patients aged 13 – 17 years, with weight range of 33 – 60kg. There have been no failed implantations. None of our patient group has su ered complications as a result of their procedure with a follow up range of 1 to 6 months. The immediate post procedural threshold voltages ranged from (0.35 – 1.5Vs @ 0.24ms), with satisfactory R waves in each patient (7.5 – 17mV) and mean impedance of (630 - 960 ohms). Repeat thresholds improved in three of the four patients and impedance values improved in all four patients at follow up.
Conclusion: This case series highlights the feasibility of implanting the Micra Leadless device in a younger patient group with no complications to date. Long term follow up studies with larger patient numbers are required to estab- lish data on e cacy and complication rates in children.
108. THE IMPACT OF RIGHT VENTRICULAR OUTFLOW TRACT STENTING ON EARLY POST OPERATIVE CARE IN PATIENTS WITH TETRALOGY OF FALLOT
Colm Breatnach, Aidan McGee, Sophie Duignan, Aine Lynch, Terence Prendiville, Paul Oslizlok, Kevin Walsh, Damien Kenny, Orla Franklin, Cathy McMahon, Colin McMahon
Our Lady's Children's Hospital, Dublin, Ireland
Backround: Timing of surgical repair for tetralogy of fallot is dictated by patient weight, however early intervention may be needed in patients with severe pulmonary steno- sis and low oxygen saturation. Recently, early intervention has incorporated the use of a right ventricular out ow tract (RVOT) stent as a temporising measure in cyanotic low weight patients. We review our early post operative data in patients with and without an RVOT stent following com- plete tetralogy of fallot repair.
Methods: We performed a retrospective review of all patients undergoing tetralogy of fallot repair over a 5 year period. Peri-operative data during surgical repair was collected from the ICU electronic patient database (ICIP). Demographic details and clinical parameters were assessed. Outcomes included duration of ventilation and length of time in ICU. The patients were divided into those receiving an RVOT stent (stented) and those who under- went primary repair (non stented).
Results: Seventy nine patients were included in the study, twenty ve stented and fty four non stented. The mean age and weight at surgery were [6 months and 6.4kg in the stented versus 6 months and 6.8kg in the non stented group] respectively. The mean cardiopulmonary bypass and cross clamp times were longer in the stented group [189 and 141 versus and 144 and 103 minutes]. Mean dura- tion of invasive ventilation and ICU stay were both longer in the stented group [89 minutes and 7.5 days versus 48 minutes and 4.4 days]. The vasoactive inotrope score was higher in the stented group [19.9 versus 10.1]. Complication rates were higher in the stented group including: post operative chylothorax and junctional ectopic tachycardia. There was one death in the stented group.
Conclusion: Our review compares the early post operative clinical course in patients with tetralogy of fallot (with and without an RVOT stent) following surgical repair. We have demonstrated the protracted treatment course in patients requiring early stenting. This is likely due to the severity of the condition in this group. Awareness of the increased challenges in stented patients is important for peri-opera- tive care planning. Further studies are needed to ascertain long term outcomes in this cohort.
109. VARIABLE APPROACHES TO HYBRID PULMONARY VALVE REPLACEMENT IN THE PAEDIATRIC SETTING
Colm Breatnach, Khalid Al-Alawi, Paul Oslizlok, Kevin Walsh, Damien Kenny
Our Lady's Children's Hospital, Dublin, Ireland
Introduction: Hybrid approach to pulmonary valve replac- ment (PVR) in the paediatric population has been previ- ously reported. Several strategies are possible including perventricular valve insertion; pulmonary artery plication; and surgically sutured valve insertion with intra opera- tive ballooning. The aim of this study was to review our hybrid PVR strategy outlining a variety of di erent hybrid approaches employed in our centre.
Methods: We performed a retrospective case series review of paediatric patients that underwent hybrid PVR. The patients were identi ed from our dedicated National Institute for Cardiovascular Outcomes Research (NICOR) database. The medical records of these patients were reviewed to ascertain demographic and clinical details. Data was summarized using medians (range) and descrip- tive evaluation.
Hijazi, Z
21st Annual PICS/AICS Meeting