Fractional Sodium Excretion and Its Relation to In-hospital Morbidity and Mortality in Patients Admitted with Decompensated Heart Failure

APRIL 23e26, 2013 Here present two cases of persistent residual shunt after the initial VSD closure. The first one is an 11-year old girl, who received percutaneous closure of VSD with a 8-mm device 4 years ago. A follow-up TTE performed 6 months after the initial device deployment showed a 3-mm residual shunt at the superior border of the previous device (Figure 1). She was then taken to the catheterization laboratory for closure of the residual shunt with a second 5-mm device. The second case describes a 19-year old boy who was noted to have a 4-mm residual shunt after the VSD-closure device deployment 5 years ago. He underwent transcatheter closure using a second 6-mm asymmetrical device, “sandwiching” the initial device and eliminating the residual shunt completely (Figure 2). The technique was successful in both two cases. Conclusion: Our study suggests that in patients with residual VSD shunts, percutaneous reintervention using a second device implant is safe and effective. However, during re-intervention, the delivery sheath should be gently placed across the interventricular communication, taking care to avoid damage to the initial device. And endothelialization of closure devices may be significantly delayed for a long time following reimplantation.

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Background: In general, failure to decrease the extracellular fluid volume despite liberal use of diuretics is often termed diuretic resistance. We aimed to correlate between urinary fractional sodium excretion as a marker of diuretic resistance in patients admitted with congestive heart failure and its impact on length of hospital stay together with in-hospital morbidity and mortality. Methods: 46 decompensated heart failure patients were enrolled in this study. We decided that the urine sample from which we can calculate the FENa level will be a 24-hour sample in an attempt to decrease the variability of FENa levels. FENa ¼ 100 x Na (urinary) x creatinine (plasma)/Na (plasma) x creatinine (urinary) Intravenous furosemide was started on admission either as a continuous infusion or shots. They were followed-up during the hospital stay for inhospital mortality and morbidity. Results: FENa results came out with a median value of 1.5% with minimum and maximum FENa results equal to 0.05% and 5.2% respectively. The only three variables that contributed significantly to the prediction of hospital stay were Hb, LVEF, and FENa; with the latter variable showing the most significant relation. Conclusion: FENa can be used upon the patient.

Fractional Sodium Excretion and Its Relation to In-hospital Morbidity and Mortality in Patients Admitted with Decompensated Heart Failure. Basem Enany, Sameh Sabt, Kareem Roshdy. Ainshams University, Cairo, Egypt.

P O S T E R A B S T R A C T S

The American Journal of Cardiologyâ APRIL 23e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Poster

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