Page 84 - Journal of Structural Heart Disease Volume 4, Issue 4

Meeting Abstracts
186
Results: 21 cases of CCF were seen from January 2009 to December 2017. The median age of patients was 2 years (range 15 days-65years), with M:F ratio of 1.33 .Presentation was asymptomatic (60%), chest pain(10%),and heart fail- ure(30%). 4 were adults who presented with myocardial steal, atrial brillation,murmur and palpitation respec- tively. All patients had continuous murmur. Fistulae most commonly arose from RCA (8/21),draining into RA (4), RV (3), and LV (1). Fistulae from LMCA drained into RA (5), LAA (1) and PA(1). One patient had LAD to RV stula. Left cir- cum ex stula drained in RA (2) and RV (3). Thirteen and eight patients had proximal and distal stula respectively. Fistulae were closed at the distally, proximally and at both ends in 15,4 and 2 cases respectively. Standard arteriove- nous loop, retrograde arterial route and both routes were was used in 13, 5 and 2 respectively and one case ( LMCA to LAA stula) was closed separately from venous end and arterial end without forming a rail road. Devices used were ADO in 5 cases, ADO II in 1 case, AVP I in 4 cases, AVP II in 7 cases, AVP IV in 4 cases and coils in 4 cases. More than one devices were used in 4 cases. Post procedure all were kept on DAPT except 2 (warfarin and aspirin). All were followed regularly by clinical examination, ECG, Echocardiography at 1, 6, and 12 months interval. There were no clinical, ECG changes or residual stulae on echocardiography at followup. Check angiogram was done one year post pro- cedure in 7 cases, one of this case had evidence of throm- bosis in conduit artery with the distal device in situ. Four
136.
cases with proximal stula showed good ows in the conduit artery and two distal stulae cases showed good remodelling of the conduit artery.
Conclusions: Percutaneuous closure of coronary cam- eral stula of varying sizes can be safely undertaken with excellent mid-term results.
136. SYSTEMIC RAPAMYCIN TO PREVENT IN-STENT STENOSIS IN PULMONARY VEIN STENOSIS
Ryan Callahan, Jesse Esch, Grace Wang, Jim Lock
Boston Children's Hospital, Boston, USA
Objectives: Evaluate the e cacy of systemic rapamycin (sirolimus) in preventing in-stent stenosis (ISS) in pulmo- nary vein stenosis (PVS). Report the adverse events related to rapamycin therapy.
Background: There is a high incidence of ISS following stent implantation in stenotic pulmonary veins. The use of systemic rapamycin in preventing ISS in PVS has not been reported.
Methods: Retrospective review of all patients who received systemic rapamycin (based on institutional protocol for ISS in peripheral pulmonary artery stenosis) for treatment of ISS for PVS between January 2013 and December 2017.
Journal of Structural Heart Disease, August 2018
Volume 4, Issue 4:114-206