Page 97 - Journal of Structural Heart Disease Volume 4, Issue 4

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Meeting Abstracts
Aim: Aortic coarctation (AC) is an important cause of childhood morbidity and mortality, which account for seg- mental narrowing in the aorta. Our aim in this study is to investigate the di erences between the treatment modal- ities of patients who have received, treated and followed up with AC in our clinic, to evaluate their prognosis and to determine the current data which will shed light on the choice of treatment for future patients with AC.
Methods: This study included 133 cases (86 males, 47 females) admitted to Erciyes University Faculty of Medicine, Department of Pediatric Cardiology between 1999-2016.
Results: When the relationship between treatment options according to the age groups of the patients studied is examined; balloon angioplasty in 80.8% of newborns, surgery in 19.2%, balloon angioplasty in 95% of infants in the term, surgery in 5%, stent angio- plasty in 45.6% of patients in 12 months determined. Four patients (28.5%) of the 14 patients who under- went surgery in the rst treatment developed recoarc- tation after 52.4 ± 40.8 months and cured in 10 patients. Of the 98 patients who underwent balloon angioplasty, 56 patients (57.1%) had recoarctation after 12.6 ± 17.3 months and 42 patients were cured. Of the 21 patients who underwent stent angioplasty, 13 (61.0%) had recoarc- tation after 25.2 ± 24.5 months, and 8 of them were cured. After the rst treatment, 60 of the 133 patients were cured, and 73 was the second treatment. After the second treatment, 46 patients were cured and 27 patients were treated third. Fourth and fth treatments were performed in nine of the 27 patients and in two of the nine patients, no recoarctation was detected after the fth treatment. It was determined that 71.4% of the patients treated with interventional methods were cured without the need for surgery.
Conclusions: There is no clear consensus regarding pri- mary treatment. Although surgical treatment is accepted as the rst choice in neonatal period, diagnostic catheter- ization and palliative angioplasty are preferable options because they will provide partially or completely decom- pensated patients with elective surgery.
156. CRITICAL PULMONARY VALVE STENOSIS IN A 9 YEAR OLD FEMALE, NEVER IS TOO LATE
Alberto Zarate Fuentes1, Iñaki Navarro Castellanos1, Claudia Orozco Galicia2
1Issste, Mexico, Mexico. 2Issste, Cdmx, Mexico
Case Report: We report a case illustrating a 9 year old female with delayed presentation of critical pulmonary valve (PV) stenosis. Clinical evidence of congestive right heart failure: cianosis and clubbing, enlarged liver, raised jugular venous pressure, and anasarca. Chest X-ray show enlarged right chambers, electrocardiogram showed sig- ni cant right ventricular hypertrophy. Echocardiography show right ventricular disfunction, Right ventricular sys- tolic pressure RVSP 215 mmhg assessed by tricuspid insuf- ciency. Critical pulmonary valve stenosis. Atrial septal defect with right to left shunt.
In the lab we recorded median right atrial pressure: 23 mmhg, Right ventricule 130/23 mmhg, Left ventricle 80/10 mmhg. Initial gradient in the pulmonary valve: 115 mmhg. Extremely sensitive right ventricle. We did an angiography reveling a critical valve stenosis with a high velocity jet of 3 mm, and pulmonary ring of 14mm. We performed a sequential valvuloplasty starting with mini Tyshak 6mmx20mm, and then 9 mmx20mm trying to avoid as much as possible reperfusion pulmonary syndrome.
The nal gradient was 28 mmhg, the oximetry raised to 92% immediately after the valvuloplasty, and the patient 24 hrs later improve her clinical status. She was discharge 5 days after procedure, with oximetry 93% room air.
157. IMPLANTATION OF THE OCCLUTECH ATRIAL FLOW REGULATOR: PRELIMINARY RESULTS FROM SWINE MODELS.
Daniel McLennan, Gareth Morgan
Children's Hospital Colorado, Aurora, USA
Objective: Histopathological assessment of the Atrial Flow Regulator (AFR) (Occlutech) 1 month after implantation to assess the degree of endotheliazation and the atrial com- munication size in relation to the initial communication diameter in a swine model.
Background: Pulmonary arterial hypertension (PAH) and left ventricular diastolic failure are diseases in which high diastolic pressure in either atrium can lead to poor cardiac output and atrial distension. The concept of reducing right and left atrial hypertension in these diseases has been the subject of much debate. One of many controversies has revolved around the technical ability to produce a reliable and predictably sized hole between the atrial chambers;
Methods: Five adolescent domestic pigs had transeptal punctures performed by standard technique using an SL-1 sheath via the femoral vein and a BRK 1 extra sharp needle
Hijazi, Z
21st Annual PICS/AICS Meeting