Meeting Abstracts Journal of Structural Heart Disease, August 2019, Published online: August 2019 Volume 5, Issue 4:75-205 DOI: https://doi.org/10.12945/j.jshd.2019.018.19 The Pediatric and Adult Interventional Cardiac Symposium (PICS/AICS) 22nd Annual Meeting San Diego, California, September 4-7, 2019 2. ENDOVASCULAR TREATMENT OF CRITICAL Patients with hypoplasia of the aorta and concomitant CHD COARCTATION OF THE AORTA (COA) IN NEWBORNS referred surgery. In presence of low pulmonary flow, and AND INFANTS absence or hypoplasia of the aorta, dilatation performed Elnur Imanov1,1, Sabina Hasanova2, Aysel Yusifli 1, Vasiliy urgently. After angioplasty pressure gradient decreased to Lazoryshynets3, Leman Rüstemzade2, Fuad Abdullayev4, 19 ±7 mm Hg; LVEF increased to 63 ± 7%. Farida Hajyeva2, Samir Mamedov2, Oleksandr Pliska 5 1 Health Ministry of Republic of Azerbaijanjan Education Group with endovascular treatment made an uneventful Therapeutic Clinic of Azerbaijan Medical University, Baku, recovery. 13 (68.4%) patients need surgery for re - CoA on Azerbaijan. 2Health Ministry of Republic of Azerbaijanjan 3 - 6 months after dilation. Education Therapeutic Clinic of Azerbaijan Medical University, Baku, Azerbaijan. 3Amosov National Institute of Cardiovascular Conclusion: In critic patients endovascular interven- Surgery, Kiev, Ukraine. 4Health Ministry of Republic of Azerbaijan tion should be preferred with good immediate results. Scientific Center of Surgery Named After M.A.Topchubashov Feasibility of angioplasty of CoA in newborns and infants Pediatric Cardiac Surgery and Neonatal Surgery center, Baku, with CoA remains controversial through a high rate of Azerbaijan. 5Dragomanov National Pedagogical University, Kiev, re-coarctation and re-interventions Ukraine 4. CARDIOVASCULAR DISEASE AND IT PREVENTION Background: Newborns and infants with CoA combined Purusharth Kumar Sharma with hypoplasia of the aorta, CHD, and Ductus dependent Jaipur Rajasthan India flow (DDF) referred to critical heart defects. Dental College Affilated to Rajasthan University of Health Science Objective: To present in-hospital and mid-term results of endovascular interventions in newborns and infants with This is a condition which affects our heart, they are of many CoA. type such as heart attack, heart failure, CAD, aorta disease and many more. There are many other ways through which Material: 60 patients with CoA underwent intervention, we can prevent this so my research work is on that how we of them: 41(68.3%) - surgery; 19 (31.7%) - balloon dila- can manage these fatal diseases at their early stages so we tation. Age of patients =1 to 360 days (98.9 ± 10.8). In 34 can prevent the death of patient, or some ways to man- (57.6%) patients the diagnosis was prenatal. In patients with age this disease and I think these ways are very helpful to DDF, prostaglandin E1 used after prior to the intervention. people and some technique which a person can do at their level. If they get heart attack and some medicine which has In 22 (36.6%) patients CoA combined with other CHD. less side effects and more response. Pressure gradient in the CoA site during hospitalization was 58 ± 1.7mm Hg. LVEF (51 ± 12%). Mean pressure gra- Method and Sources: To reduce the level of LDL I have dient in endovascular group before dilatation was 59 ± 18 now introduced a new compound that will help decrease mm Hg. LVEF 41 ± 9%. © 2019 Journal of Structural Heart Disease Published by Science International Corp. ISSN 2326-4004 Fax +1 203 785 3346 E-Mail: [email protected] Accessible online at: http://structuralheartdisease.org/ http://structuralheartdisease.org/ Meeting Abstracts 76 the level of LDL by working on the receptor and dilute or We considered linear dimensions clinically equivalent we can say dissolve the obstruction in the artery and pre- if the 95% confidence intervals of the difference of the vent cardiac disease and help the patient to survive. It is dimensions was <1 mm. basically used as solid dosage from oral route. In liquid dosage form it can be given intravenously to the patient. Twenty-six patients were included. The AP projection The action time in oral rout is around 20-25 minutes while dimensions on models from all 4 3D printers were >1 mm intravenously action takes place in 5-7 minutes. larger than CCA dimensions, while the lateral dimensions were not larger. Dimensions derived from 2D dimensions Summary: We find that there is decrease in LDL level in were clinically similar to CCA dimensions. There were sig- the body as it is good lowering agent as well as it has anti- nificant differences in spatial overlap and model volumes oxidant property, also does not cause any type of gastric between printers. irritation. Conclusion: There is decrease in level of LDL, so I think it Conclusions: We show that there are differences in should be used as medicine for patient. dimensions between CCA and 3DPMs. The 3DPMs can be different from source data both in size and shape. There 5. ACCURACY OF 3D PRINTED MODELS OF THE RIGHT are limitations to both 1D measurements on CCA images VENTRICULAR OUTFLOW TRACT: IMPLICATIONS FOR and measurements on digital representations of 3D INTERVENTIONAL PLANNING objects. We suggest that when using 3D prints for clinical Animesh Tandon1,2, Surendranath Veeram Reddy3,2, Nicholas purposes, it is important to understand their strengths Brown3,2, Paige McKenzie3,2, Barbara Burkhardt3,4, Song and limitations. Zhang5, Rami Hallac6, Alex Kane6, Sana Ullah7, Gerald Greil1,2, 1,2 6. INITIAL AND MEDIUM-TERM FOLLOW-UP RESULTS Tarique Hussain OF STENT IMPLANTATION OF PATENT DUCTUS 1 Departments of Pediatrics (Cardiology); Radiology; UT ARTERIOSUS IN DUCT-DEPENDENT PULMONARY 2 Southwestern Medical Center, Dallas, USA. Children's Medical CIRCULATION (PULMONARY ATRESIA VARIANTS) Center Dallas, Dallas, USA. 3Department of Pediatrics, UT Southwestern Medical Center, Dallas, USA. 4Pediatric Cardiology, Hani Mahmoud Adel, MD Pediatric Heart Center, Department of Surgery, University Pediatric Cardiology Unit, Department of Pediatrics, Alexandria Children’s Hospital Zurich, Zurich, Switzerland. 5Department University,Alexandria , Egypt of Clinical Sciences, UT Southwestern Medical Center, Dallas, University of Alexandria Children's Hospital, Alexandria, Egypt USA. 6Department of Plastic Surgery, UT Southwestern, Dallas, USA. 7Department of Anesthesiology and Pain Management, UT Objective: To study the initial and medium-term results of Southwestern, Dallas, USA patent ductus arteriosus (PDA) stenting in cyanotic con- genital heart disease with duct-dependant pulmonary Background: Three-dimensional printed models circulation (DPC), in the Alexandria University Children’s (3DPMs) are used to plan percutaneous pulmonary valve Hospital. implantation, but their accuracy is not well-characterized. We assessed the accuracy of 3DPMs of right ventricular Background: PDA stenting has been proposed as an alter- outflow tracts (RVOTs) of patients with congenital heart native to surgical shunt on account of postoperative com- disease. plications and mortality. The initial results of PDA stenting have been discouraging. However, with improvement in coronary stent design and delivery systems, the results of Methods and Results: We used magnetic resonance PDA stenting became promising. angiograms from patients with RVOT disease and created 3D stereolithography (STL) files. These files were sent Patients and Methods: Babies with PDA-dependent pul- to 4 different 3D printers. The 3DPMs were optically monary circulation in our NICU or referred to our unit were scanned to create 3D digital models. We compared offered an attempt of PDA stenting after written informed dimensions measured on anterior-posterior (AP) and parental consent. The study was conducted on 58 cases lateral patient cardiac catheterization angiogram (CCA) from 2010 through 2018. projections to the models, created idealized diameters from 2D dimensions of the digital models, and compared Results: The mean age of the patients was 22.9 ± 21.4 the volumes and spatial overlaps of the 3D models. days and mean weight 3.1 ± 0.7 kg. The mean length of Journal of Structural Heart Disease, August 2019 Volume 5, Issue 4:75-205 77 Meeting Abstracts the PDA was 16.71 ± 3.37 mm and mean stent diameter (6.2 to 76.4). 53.5% of patients had a small PDA and 43% was 4.01 ± 0.24 mm. Fifty-five cases (94.8%) were success- had a moderate duct. Using linear regression, there was fully implanted and 52 cases (89.6%) were completely no significant association between RVEDP and LVEDD successful. Three cases (5.2%) died. Five cases (8.6%) devel- Z-score (p=0.74). Additionally, no association was found oped complications which were properly managed with between RVEDP with LV end-diastolic volume (p=0.96) or successful outcome. The mean O2 saturation increased Qp/Qs (p=0.32). A positive association was found between from 71.2 ± 6.8 % to 88.2 ± 4.3%. The mean duration of stent RVEDP and RV systolic pressure (p<0.01), the ratio of patency was 10.5±2.25 months. pulmonary artery systolic pressure/aortic systolic pres- sure (p<0.01), and pulmonary capillary wedge pressure Conclusion: PDA stenting is a very good alternative to sur- (p<0.01). Student’s t-test found no statistical significance gical shunt with less complications and very good results, when comparing the RVEDP between those with a LVEDD nevertheless it is technically demanding. In experienced Z-score >2 to those with Z-score <2 (p=0.57). hands it is feasible to stent nearly