Page 56 - Journal of Structural Heart Disease Volume 4, Issue 4

Meeting Abstracts
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larger than group 6 (7.78±0.37 vs 6.67±0.7 mm, P=0.004), frequent overlap in absolute measurements occurred. The gradients decreased signi cantly (P<0.0001) and similarly in two groups (P=0.46). Post BAV, no or trace AR occurred in all infants in group 6 while in group 7 there was no or trace AR in 3(37.5%), mild AR in 4(50%) and moderate to severe AR in 1(12.5%) (P=0.004). On 2-3 month follow-up, echocardiogram demonstrated 50% incidence of moder- ate to severe AR (3 out of 6) in infants with residual peak gradient of < 15 mmHg post BAV. This incidence was 7% (1 out of 14) in infants with residual gradient of 15 to 30 mmHg (P=0.07). On long term follow up (median 10 years), 4 infants (50%) in group 7 needed surgeries for AR (3-Ross operation,1-aortic valve repair) while 1 needed Ross oper- ation (7%) in group 6. Increasing pressure gradient across aortic valve needed repeat BAV in 4(33%) infants in group 6 vs 1(12.5%) infants in group 7 (P=0.33). No mortality occurred.
Conclusion: Balloon size ≤6 mm adequately decreases pressure gradients to safe level (≤30 mmHg) and mini- mizes AR. Repeat BAV as in group 6 carries less morbidity than surgeries for AR as in group 7. Thus, a ≤6 mm balloon is ideal for CCAS.
85. VIRTUAL REALITY CARDIAC MODELLING
FOR ANATOMIC EVALUATION OF PATIENTS WITH COMPLEX SINGLE VENTRICLE ANATOMY
Jenny E. Zablah, Michael Dimaria, Daniel Ehrmann, Michal Schafer, Daniel Vargas, Gareth Morgan, Neil Wilson, Michael Ross
University of Colorado School of Medicine, Aurora, USA
Background: Virtual Reality imaging (VR) is a novel imaging modality, with potential to provide more rapid assimilation and profound understanding of complex three-dimensional structures in congenital heart disease. Three dimensional(3D) reconstructions for use in VR can be created from computed tomographic angiography(CTA) or cardiac magnetic resonance imaging(cMRI) datasets. Patients undergoing staged palliation of single ventricle frequently require cross-sectional imaging related to poor visualization of crucial aspects of the anatomy using ultra- sound. Based on the hypothesis that VR will provide both material and intangible advancements in comprehension of complex anatomy compared to traditional measure- ment of CT datasets, we sought to validate our novel mea- surement tool in a VR environment.
Methods: We developed a VR visualization software plat- form that enables assessment of 3D cardiac models derived
from CTA.A retrospective chart review identi ed infants with shunt dependent pulmonary blood ow who had CTA performed between January 2010 and September 2015. All gold-standard measurements of the proximal branch pulmonary arteries, aortic isthmus and descending aorta were performed using multiplanar reconstruction of a CTA dataset to achieve mutually orthogonal planes by a single investigator.3D virtual models were created from the CTA dataset using Materialise Mimics 2.0 and uploaded in our VR environment. Using Oculus Rift goggles and our novel measurement tool, the same structures noted above were also measured by selecting two points on opposite sides of the vessel wall of interest. The measurements were com- pared using intraclass correlation coe cients and Bland- Altman plots.
Results: 22 patients were included. The VRI-derived measurements demonstrated excellent correlation and agreement with the CTA measurements with a mean di erence of 0.2mm±0.7mm(r=0.98) for descend- ing aorta,0.3mm±0.7mm(r=0.93) for aortic isthmus, 0.31mm±1mm(r=0.99) for LPA and 0.33m±1mm(r=0.98) for RPA. Aortic arch measurements showed stronger cor- relation when compared with the proximal pulmonary arteries.
Conclusion: We developed a novel tool for visualization and measurement of complex 3D structures in a VR envi- ronment showing excellent correlation and agreement of vessel diameter assessment with the gold standard approach. There was higher variability in VR assessment of pulmonary artery diameter maybe due to di culty identi- fying common landmarks in the postsurgical anatomy.
86. TO STUDY THE SAFETY, FEASILBILITY OF TRANSCATHETER CLOSURE OF DOUBLY COMMITTED SEPTAL VSD USING DUCT OCCLUDER DEVICE. Muthukumaran Sivaprakasam, Anuradha Sridhar, Rajesh Kumar
Apollo Children Hospital, Chennai, India
Introduction: Doubly committed defect is de ned as per- imembranous extension with brous continuity between the lea ets of the aortic and tricuspid valves as well as between the aortic and pulmonary valves. A doubly com- mitted defect used to be a contraindication for device closure.
Method: Total 20 patients were selected for transcatheter closure for doubly committed septal VSD. Mean age of the patients was 4 years (1-11 years).
Journal of Structural Heart Disease, August 2018
Volume 4, Issue 4:114-206