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OP-085 Ten Years Experience of a Single Center in Percutaneous Atrial Septal Defect Closure
MARCH 13e16, 2014 intended outcomes. In this study, everolimus eluting stent (XIENCE V) implantations and follow up results in patients with coronary artery disease were evaluated. 833 patients who underwent everolimus eluting stent deployment for coronary artery lesions in Hacettepe University Faculty of Medicine Department of Cardiology between 1 January 2008 and 31 August 2013 included. Baseline demographic, clinic and angiographic data, procedure related complications and outcomes during follow up were studied. As primary endpoints all-cause mortality was %1,3 and target lesion failure was %2,2. As secondary outcomes, cardiac death, target leson revascolarization, target vessel revascularization, myocardial infarction, stent thrombosis and major adverse cardiovascular events were seen % 0,84, %0,8, %2,2, %0,6, %0,24 and %5,6, respectively. For all outcomes, premature discontinuation of dual antiplatelet therapy _ was a strong predictor. BIfurcation lesion and presentation with acute coronary syndrome were also observed as high risk critertia. Despite heterogeneity and high risk profile of our patients, procedural related complications and primary and secondary outcomes were very low with high clinical device and procedure success. These results demonstrate effectiveness and safety of the XIENCE V everolimus eluting stent in a highly complex, real world patient population.
Congenital Structural and Vascular Abnormalities: Diagnostic and Therapautic Options Friday, March 14, 2014 8:30 AM w 10:00 AM, Hall 6 (Abstract nos. OP-085 w OP-094) - OP-085 Ten Years Experience of a Single Center in Percutaneous Atrial Septal Defect Closure. A. Baykan, Ö. Pamukçu, A. Özyurt, M. Argun, S.H. Onan, S. Sezer, K. Üzüm, N. Narin. Department of Pediatric Cardiology, Erciyes University, Kayseri, Turkey. Background: Nowadays percutaneous closure is prefered as treatment in pediatric ASD patients. The purposes of the study were to (a) share ten years experience of our center in percutaneous ASD closure, (b) compare the septal closure procedure using transtoracic echocardiography with the transesophageal used ones. (c) show whether transtoracic echocardiography can be sufficient in ASD closure in certain circumstances. As far as we know our study is the first study that huge number of only children patients were included in a single center. Method: 340 patients whose ASD were closed between dates December 2003-August 2013 were included in this study. Physical examinations, electrocardiograms, transtoracic echocardiography, were done before the procedure and 24 hours, 1st,3rd, 6th months after the procedure. The patients whose ASD were closed by TEE guidance compared with ones done by TTE. Results: There was not a statistically significance in the epidemiologic features of patients between two groups. Size of device,procedure â
The American Journal of Cardiology
time a was significantly higher in TEE group.But there wasn’t a significant difference between the complication and residual shunt rates between two groups. Conclusion: In this study, we do not support the usage of TTE in every case for ASD closure. That is by sure that in certain cases like large ASD and the ones with deficient rims or bad acoustic window TEE should be done. We want to emphasize that in pediatric population since it requires sedation and intubation TEE procedure has certain risks. Therefore it should not be done routinely in ASD closure; but only in selected cases. The usage of TTE must be increased and if the conditions are suitable TTE should be done priorily because no difference was shown in success and complication rates in ASD closure between TTE and TEE guided groups.
- OP-086 New Modified Balloon-Assisted Technique to Provide Appropriate Deployment in the Closure of Large Secundum Atrial Septal Defect Using Amplatzer Septal Occluder. N. Narin1, A. Baykan1, M. Argun1, A. Ozyurt1, O. Pamukcu1, A. Bayram2, K. Uzum1. 1 Department of Pediatric Cardiology, Erciyes University, Kayseri, Turkey; 2Department of Anaesthesiology, Erciyes University, Kayseri, Turkey. Objective: Transcatheter closure of secundum atrial septal defects (ASD) has been a well accepted, safe, alternative method to surgery. However the deployment of the device across the septum using the conventional method presents difficulties in large ASDs. Material-Methods: In the modified balloon-assisted technique (modified BAT): a Tyshak balloon (Numed, Inc. USA) is placed in one of the left pulmonary veins and along sheath is placed in the right upper pulmonary vein. Through this sheath Amplatzer septal occluder deployed in a proper position with the help of Tyshak balloon, which prevents the left atrial disc to prolapse into the right atrium. Beginning from June 2011, the modified BAT has been used in the closure procedure of 30 (female/male: 18/12) patients with large ASD (group I). The outcomes of 58 (female/male: 40/18) age matched (under the age of 12) ASD patients with a minimum defect diameter of 15 mm, measured by transesophageal echocardiography, who underwent a conventional transcatheter ASD closure procedure were compared with the outcomes of group I. Results: In the comparison of the results between group I and group II, there was no significant difference between the mean ages, mean body weights, mean maximal ASD sizes by TTE, mean maximal ASD sizes by TEE, Qp/Qs ratios, mean PAPs, mean diameter of devices, residual shunt, and incidences of embolization. However there were a significant difference in the unsuccessful rate and fluoroscopy time between group I and group II.
Figure 1.
th
MARCH 13e16, 2014 10 INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
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O R A L A B S T R A C T S
Congenital Structural and Vascular Abnormalities: Diagnostic and Therapautic Options Friday, March 14, 2014 8:30 AM w 10:00 AM, Hall 6 (Abstract nos. OP-085 w OP-094) - OP-085 Ten Years Experience of a Single Center in Percutaneous Atrial Septal Defect Closure. A. Baykan, Ö. Pamukçu, A. Özyurt, M. Argun, S.H. Onan, S. Sezer, K. Üzüm, N. Narin. Department of Pediatric Cardiology, Erciyes University, Kayseri, Turkey. Background: Nowadays percutaneous closure is prefered as treatment in pediatric ASD patients. The purposes of the study were to (a) share ten years experience of our center in percutaneous ASD closure, (b) compare the septal closure procedure using transtoracic echocardiography with the transesophageal used ones. (c) show whether transtoracic echocardiography can be sufficient in ASD closure in certain circumstances. As far as we know our study is the first study that huge number of only children patients were included in a single center. Method: 340 patients whose ASD were closed between dates December 2003-August 2013 were included in this study. Physical examinations, electrocardiograms, transtoracic echocardiography, were done before the procedure and 24 hours, 1st,3rd, 6th months after the procedure. The patients whose ASD were closed by TEE guidance compared with ones done by TTE. Results: There was not a statistically significance in the epidemiologic features of patients between two groups. Size of device,procedure â
The American Journal of Cardiology
time a was significantly higher in TEE group.But there wasn’t a significant difference between the complication and residual shunt rates between two groups. Conclusion: In this study, we do not support the usage of TTE in every case for ASD closure. That is by sure that in certain cases like large ASD and the ones with deficient rims or bad acoustic window TEE should be done. We want to emphasize that in pediatric population since it requires sedation and intubation TEE procedure has certain risks. Therefore it should not be done routinely in ASD closure; but only in selected cases. The usage of TTE must be increased and if the conditions are suitable TTE should be done priorily because no difference was shown in success and complication rates in ASD closure between TTE and TEE guided groups.
- OP-086 New Modified Balloon-Assisted Technique to Provide Appropriate Deployment in the Closure of Large Secundum Atrial Septal Defect Using Amplatzer Septal Occluder. N. Narin1, A. Baykan1, M. Argun1, A. Ozyurt1, O. Pamukcu1, A. Bayram2, K. Uzum1. 1 Department of Pediatric Cardiology, Erciyes University, Kayseri, Turkey; 2Department of Anaesthesiology, Erciyes University, Kayseri, Turkey. Objective: Transcatheter closure of secundum atrial septal defects (ASD) has been a well accepted, safe, alternative method to surgery. However the deployment of the device across the septum using the conventional method presents difficulties in large ASDs. Material-Methods: In the modified balloon-assisted technique (modified BAT): a Tyshak balloon (Numed, Inc. USA) is placed in one of the left pulmonary veins and along sheath is placed in the right upper pulmonary vein. Through this sheath Amplatzer septal occluder deployed in a proper position with the help of Tyshak balloon, which prevents the left atrial disc to prolapse into the right atrium. Beginning from June 2011, the modified BAT has been used in the closure procedure of 30 (female/male: 18/12) patients with large ASD (group I). The outcomes of 58 (female/male: 40/18) age matched (under the age of 12) ASD patients with a minimum defect diameter of 15 mm, measured by transesophageal echocardiography, who underwent a conventional transcatheter ASD closure procedure were compared with the outcomes of group I. Results: In the comparison of the results between group I and group II, there was no significant difference between the mean ages, mean body weights, mean maximal ASD sizes by TTE, mean maximal ASD sizes by TEE, Qp/Qs ratios, mean PAPs, mean diameter of devices, residual shunt, and incidences of embolization. However there were a significant difference in the unsuccessful rate and fluoroscopy time between group I and group II.
Figure 1.
th
MARCH 13e16, 2014 10 INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S21
O R A L A B S T R A C T S