Tehran University of Medical Sciences
Office of Vice-Chancellor for Global Strategies & International Affairs
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Code : 9345-345249      Publish Date : Wednesday, February 25, 2015 Visit : 1968

Intl. Congress form | International Congress Report | International Congress Report For Faculty | Congenital and Structural Interventions

Congenital and Structural Interventions
The report of Congenital and Structural Interventions by Dr. Keyhan Sayadpour Zanjani
 
Application Code :
306-0214-0100
 
Created Date : Wednesday, September 3, 2014 20:59:28Update Date : Saturday, February 21, 2015 10:46:55IP Address : 194.225.212.150
Submit Date : Saturday, February 21, 2015 10:47:08Email : sayadpour@tums.ac.ir
Personal Information
Name : Keyhan
Surname : Sayadpour Zanjani
School/Research center : School of Medicine
If you choose other, please name your Research center :  
Possition : Assistant professor
Tel : +98-21-61472320
Information of Congress
Title of the Congress : Congenital and Structural Interventions
Title of your Abstract : 1-Coarctation stenting in infants using Cook Formula stent
2-Ventricular septal defect closure by Occlutech Duct Occluder
country : Germany
From : Thursday, June 26, 2014
To : Saturday, June 28, 2014
Abstract(Please copy/paste the abstract send to the congress) : Ventricular septal defect closure by Occlutech Duct Occluder
Keyhan Sayadpour Zanjani1, Seyed Hasan Voshtani2
1) Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
2) Heshmat Cardiovascular Center, Guilan University of Medical Sciences, Rasht, Iran

Background: Various devices have been used for ventricular septal defect (VSD) closure. Duct occluders are preferred in certain types of VSD, including Gerbode defects and VSD with aneurysm. We used a relatively new duct occluder from Occlutech to close two VSDs. 
Methods: The technique of VSD closure was traditional. We created an arteriovenous loop and advanced a 7 Fr Brite Tip sheath (Cordis) over the wire in both patients.
Results: The first patient was 5-year-old with a 5.7 mm Gerbode VSD and shunt ratio of 2.8. We occluded her VSD by a 10×8 device with short shank successfully. The second patient was 4-year-old with a 4.4 mm perimembranous defect at the end of an 8 mm aneurysm. We occluded her VSD by an 8×6 device with short shank successfully (Fig. 1). None of the patients experienced rhythm abnormality during the procedure and their short follow up periods.
Discussion: Occlutech Duct Occluder has some theoretical advantages over Amplatzer Duct Occluder for occluding VSD. Risk of thrombus formation may be lower as this device has not a distal clamp. The reverse shank shape may serve as a second disc decreasing the risk of embolization. Nitinol braiding increases device flexibility and pressure on the conduction system. The only disadvantage of this device is low radiopacity which hamper device visualization during implantation.
Conclusion: Occlutech Duct Occluder can be promising for the closure of Gerbode defects and VSD with aneurysm. 

Coarctation stenting in infants using Cook Formula stent
Keyhan Sayadpour Zanjani, MD
Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran

Background: The therapy of choice for coarctation of aorta (COA) in infants is surgery. However, the risk of surgery is increased in certain conditions like sepsis, residual COA after surgery, PHACES syndrome, or complex anatomy. Stenting can be a substitute in these situations.
Methods: For infants with COA and high risk of surgery, we used Cook Formula stent. This stent can be redilated up to twice the nominal diameter: a 7-mm stent can be redilated to 13-14 mm in future and deliverable via a 5 Fr sheath. We did not use a long sheath due to the risk of femoral arteries injury. We used a short 5 Fr radial sheath instead. For optimal positioning of the stent, we put a 20G pressure monitoring catheter in the left jugular artery for hand injection. Otherwise, stent implantation technique was traditional.
Results: The first patient was 2-month-old with severe COA, large ventricular septal defect, and a patent ductus arteriosus. She was septic with cardiac, pulmonary, and renal failures. She was refused by our surgeons; therefore, her COA was stented by a 6×20 Formula stent after obtaining informed consent. Although stenting was successful to decrease gradient from 15 to 4 mmHg and expand the coarctation area, she succumbed to her disease.
The second patient was 7-month-old with residual postsurgical COA. The pressure gradient was 30 mmHg which was decreased to 6 after stenting by a 7×16 Formula stent (Fig. 1).
The third patient was 9-month-old with a neglected COA after pulmonary artery banding for single ventricular physiology. The parents refused coarctation surgery. His COA was treated successfully by a 7×16 Formula stent.
Discussion: A stent dilatable up to 18 mm is recommended for COA stenting in children. A 7 mm Formula stent is redilatable up to 13-14 mm. This diameter may be sufficient in some patients with hypoplastic aortas. If signicant stenosis appears in adulthood, the stent can be broken by a high pressure balloon. Surgery can be the last option. Previous reports mostly used coronary or small peripheral stents which should be removed surgically in all patients.
Conclusion: Cook Formula stent is a safe and effective therapy for certain COA in infants with high surgical risk. 
Keywords of your Abstract : 1-Ventricular septal defect, Occluder, Occlutech
2-Coartation, stent, Cook
Acceptance Letter : http://gsia.tums.ac.ir/images/UserFiles/11588/Forms/306/Poster_Presentation_CSI_2014_-_ksayadpour_gmail.pdf
The presentation : Poster
The Cover of Abstract book :
Published abstract in the abstract book with the related code :
Where has your abstract been indexed? : none
If you choose other, please name :  
The Congress Reporting Form
How many volunteers were present at the Congress? : around 1000
Delegates from which countries presented in the congress? : many countries around the world, including Germany, India, Italy, USA, Uk, et al.
Were the delegates of any other organizations present in the congress? : No
If yes, please write the names of the organizations in the box :  
What were the responses to your talking points? Were specific questions or concerns raised? : Yes. For my two posters, I answered around 10 questions. Most of the questions were positive, specially to my VSD closure poster which was new worldwide. The questions were from India, USA, Italy, Germany, and UK.
If you met staff members, please list their full names & positions. : S. Qureshi, MD; F. Berger, MD; A. Celebi, MD; T. Lee, MD; O. Gala, MD; ....
Please inform us if there are any follow up actions we need to talk with the members of the congress : No. The congress is relatively old and well prepared. As it is a long time that it is held in a constant congress center each year, it is easy to reach it and as I participated for the 4th time, I know the location and nearby hotels very well. They give a good discount for poster presenters (200 euros).
Your experiences about the travel processes(Providing ticket, accommodation,...) : Unfortunately they are expensive now and the desire to learn is the first motive to participate.
Please give a briefing of your own observations and outcomes of the congress: : This congress (Congenita and Structural Interventions) is the best for pediatric and structural interventions outside USA or even worldwide (I have not yet participated in the USA or Canadian congresses on this field.). Long program (sometimes 12 hours a day) rich of live cases, oral lectures by top professors in this field, many discussions, and new experiences make it very useful. Every other year I participate in this meeting and I learn many new things which I use them in my practice and teaching to my fellows. I will participate in the next meetings as well. I recommend it to every pediatric or adult interventionist who like to learn more in this field.