Page 83 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
describe the experience of percutaneous closure of patent ducts arteriosus in a Brazilian center.
Methods: It is a retrospective study of a single center between the years 2010 and 2017 that analyzed the fre- quency and the characteristic of PDA’s occlusion.
Results: From August 2010 to December 2017, a total of 89 patients underwent percutaneous occlusion of the ductus arteriosus, sixty (67.4%) of were female. The mean age was 4.5 years (5mo to 44yrs). By Krichenko's classi- cation, 60 (67.4%), patients were type A ,11pts (12.3%) type C, 5 (5.6%) type E, 3(3.3%) type D, and 10 (11.2%) pts has not been classi ed. Type C PDA was the most fre- quent in patients with pulmonary hypertension, type C. The used devices were: AVP II (51.68%), followed by Coil Flipper (33.7%), ADO II (5.61%) and AVP IV (2.24%). Six of this patients (6.74%) presented associated mild congen- ital heart disease, without hemodynamic repercussion. Immediate complete occlusion was obtained in 87 (97.7%) patients. Residual shunt and embolization, were observed in 2 (2.24%) patients only with Coil Flipper, only in patients with PDA and had a second closure performed using the AVP II, without residual shunt. All 2 embolized device were successful retrieved.
Conclusion: In our center, the percutaneous treatment of ductus arteriosus closure has been e ective and safe. Residual shunt and embolization were only seen in PDA occluded by coil Flipper. Since AVP plug were available in our center we do not have residual shunt neither device embolization.
134. TRANSCATHETER CREATION OF VENTRICULAR SEPTAL DEFECT FOR RELIEF OF RIGHT VENTRICULAR HYPERTENSION IN SEVERE PULMONARY ARTERIAL HYPERTENSION.
Varun Aggarwal, Corey Chartan, Ryan Coleman, Nidhy Varghese, Fadel Ruiz, George Mallory, Ernestina Melico - Portillo, Henri Justino
Texas Children's hospital, Houston, USA
Background: Pulmonary hypertension (PH) is a progres- sive disease and medical management can be insu cient and unpredictable in the late stage of the disease. Creation of an atrial septal defect (ASD) or reverse Potts shunt has been proposed as a bridge to lung transplant or even des- tination therapy for some of these patients. However, ASD unloads the right heart inconsistently and reverse Potts shunt creation carries signi cant procedural risk. Here, we describe transcatheter ventricular septal defect (VSD)
creation, for the relief of suprasystemic right ventricular (RV) hypertension in the setting of severe PH.
Methods: Retrospective review of patients with severe PH who underwent transcatheter VSD creation at Texas Children’s Hospital.
Results: Three children underwent VSD creation for the relief of RV hypertension over a three year period (2015-2018).
1. An 11-year-old boy on VA-ECMO support due to severe
pulmonary veno-occlusive disease underwent ASD creation (for conversion to VV-ECMO) and VSD creation with stent placement (for the relief of RV hypertension). He was successfully bridged to lung transplant at which time ASD/VSD were closed.
2. A 14-year-old girl with idiopathic PH and severe RV dys- function underwent VSD creation with stent placement. She had signi cant improvement in her cardiac func- tion and heart failure symptoms and has acceptable sys- temic desaturation at the last follow up 7 months post procedure.
3. A 5-year-old boy with repaired congenital diaphragmat- ic hernia, chronic lung disease, severe PH had progres- sive RV failure despite having an ASD. VSD creation with stent placement resulted in improvement in RV func- tion. In this small series, there was no procedural mor- tality or heart block. The improvement in RV function was sustained and quality of life remained good.
Conclusions: We present a novel interventional man- agement of VSD creation (with stent placement) as a via- ble option to salvage RV function in the setting of severe intractable PH. This approach allows for direct pressure unloading of the RV with subsequent function recovery. It appears to be a safe and feasible technique for a select group of patients experiencing worsening RV function with acceptable short-term results.
135. CONGENITAL ISOLATED CORONARY CAMERAL FISTULAE: TALE OF 21 TAMED DRAGONS WITH CLINICAL ,IMMEDIATE AND INTERMEDIATE TERM OUTCOME
Umamaheshwar K L, Sivakumar Kothandam
Madras Medical Mission, Chennai, India
Objective and Methods: 21 consecutive cases of coro- nary cameral stulae(CCF) who underwent percutaneous closure were assessed retrospectively for the clinical pre- sentation, immediate and midterm outcomes
Hijazi, Z
21st Annual PICS/AICS Meeting