Abstraktband als pdf - DGPK-Deutsche Gesellschaft für Pädiatrische ...

44. Jahrestagung der Deutschen Gesellschaft für Pädiatrische Kardiologie
– Abstracts –
27
Erfahrungen mit dem „neuen“ Gore Septal Occluder bei
ASD II und PFO Verschlüssen
P12
W. Wiebe, N. Toussaint–Götz, P.Zartner, M.B.E. Schneider
(Abt. angeborene Herzfehler und Kinderkardiologie DKHZ St. Augustin)
Wir berichten über die Erfahrungen mit dem neuen Verschlußsystem
„Gore Septal Occluder“ mit Zulassung seit 7/2011.
Behandelt wurden 19 Patienten in 10 Monaten (18 ASD II; 1 PFO) auch
mit komplexen ASD`s im Alter von 2 1/2 bis 51 Jahre. Der Occluder steht
in Größe 15,20,25,30 mm zur Verfügung von denen 4x20mm; 11x25mm
und 4x30mm Occluder verwendet wurden. Defekte von 6 – 16 mm
wurden verschlossen bei einem mittleren Qp: Qs 1,59:1. Das mittlere
Gewicht der Patienten betrug 27kg bei einer Länge von 121 cm.
Ein primär vollständiger Verschluß konnte in 74% erreicht werden.
Das System ist vergleichbar mit dem Amplatz ASD Occluder Device in
der Anwendung insbesondere was die Steifigkeit des Einführsystems betrifft.
Vorteile und Nachteile gegenüber den bislang verwendeten Systemen
und die Erfahrungen in der Applikation werden dargestellt.
First experience with paclitaxel-coated balloon catheters
for treatment of in-stent restenosis and small vessels P14
obstructions in infants and children.
H. Abdul-Khaliq (1), B. Cremers (2), A. Lindinger (1), B. Scheller (2)
Clinics for Pediatric Cardiology (1) and Internal Medicine and
Cardiology (2). Saarland University Hospital, Homburg Saar
Implantation of small non-growth adaptive stents, mostly coronary stents,
in neonates and infants is associated with rapid intimal-proliferation and
in-stent stenosis. We report the initial safety of treatment of the new paclitaxel
eluting balloons (DEB) for treatment of such vessel obstructions
in infants and children with CHD.
Patients and results: 5 infants and children (age: 6 month - 10.9 years)
were treated during the last 2 years because of following vessels morbidities:
stent occlusion in hypoplastic LPA, in-stent stenosis in the RVOT
after, in-stent stenosis in the RPA after TOF repair, in-stent stenosis in the
RVOT after interventional perforation and stent implantation, AP shunt
closure, and pulmonary venous obstruction after TAPVD-corrective
surgery and re-operation. In 2 treated patients with vessel occlusion including
in-stent stenosis successful recanalization and significant long
term improvement was achieved. The pulmonary vein re-stenosis was
successful leading to persistent improvement of PAH and clinical symptoms.
The measured plasma levels of paclitaxel 2 and 24 hours after the
intervention remained under the pharmacological effective levels.
Conclusion: In a heterogeneous group of infants and children with CHD
treatment of small vessel obstructions particularly in-stent re-stenosis and
pulmonary vein restenosis with the paclitaxel-coated balloons was safe
and successful. In some selected cases such interventional option may
make implantation of small stents in infants unnecessary.
PDA and RVOT stenting in infants with cyanotic heart
disease and duct-dependent pulmonary blood flow P13
D. Quandt (1), W. Knirsch (1), H. Dave (2), O. Kretschmar (1)
1) Division of Paediatric Cardiology and
2) Division of Congenital Cardiac Surgery,
University Children’s Hospital, Zurich, Switzerland
Objective: To assess feasibility and effectiveness of RVOT and/or PDA
stenting in infants with cyanotic heart disease and duct-dependent pulmonary
blood flow. Methods: Review of all infants undergoing catheterization
for RVOT and/or PDA stenting as first palliative procedure between
09/2002 and 03/2012. 13 patients (6 female), median age 10 days
(range 1-107) were included. The underlying cardiac lesion, stent localisation,
increase of oxygen saturation, pulmonary artery growth, overall
stent duration and need for re-intervention were analysed. Results: 6
patients received RVOT stenting, 6 patients PDA stenting and one both.
All intended procedures were feasible, despite one in a patient with cc-
TGA, situs inversus totalis and absent MPA. Oxygen saturation increased
from initially 80% (mean, ±19%) to 91% (mean, ±4%) post intervention.
LPA diameter increased from 3.4mm (± 0.8mm) initially to 5.0mm (±
2.0mm) preoperatively (p=0.03). RPA diameter increased from 3.5mm
(± 0.7mm) to 4.9mm (±1.9mm) (p=0.13) respectively. No re-intervention
was necessary in 6 patients (46%). Stents remained at their position until
corrective surgery for 107 days (mean, ± 134) and complete surgical stent
explantation was uneventfull. Re-catheterization (balloon dilatation or restenting)
was necessary in 4 patients (31%), early surgery was necessary
in 2 patients (15%). Time until first re-intervention was 30 days (mean,
± 34 days). Conclusions: RVOT or PDA stenting provides a feasible and
effective management alternative to early palliative surgery. It improves
arterial oxygen saturation and shows to have significant pulmonary artery
growth. These interventional catheterization procedures showed to prevent
early shunt surgery in 85%, but re-catheterization procedures were
frequently needed (31%).