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Heart, Lung and Circulation Abstracts S1852008;17S:S1–S209

icant atrial septal defect (ASD), ventricular septal defect(VSD) and patent forman ovale (PFO). When performedin experienced and specialised centres there are excellentshort and long-term results, low complication rates andshorter hospital stays when compared to surgical inter-ventions. We report the trends observed in our institutionover an 8-year period.Methods: Data was retrospectively reviewed from the car-diac catheterization laboratory database at The PrinceCharles Hospital. Information was prospectively recordedon patient and procedural characteristics.Results: A total of 255 percutaneous device closures weresuccessfully deployed over an 8-year period (164 females,42 ± 21 years). This included 196 (76%) secundum ASD(130 females, 33 ± 22 years), 48 (18%) PFO (27 females,43 ± 14 years) and 11(4%) VSD (7 females, 51 ± 19 years)devices. PFO and VSD devices were first implanted at ourinstitution in 2003. The number of ASDs increased overthe first 5 years and remained stable from 2003. The num-ber of VSD cases remained small—3% (2003) to 7% (2007).In contrast, referrals for PFO closure for secondary strokeprevention, scuba diving and more recently, migraine con-trol continue to increase significantly (p < 0.01). Over a5-year period the PFO cases have increased from 7% (2003)to 38% (2007).Conclusion: The number of percutaneous PFO deviceclosures performed makes up a small but increasingphs

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formed at Monash Medical Centre and Royal AdelaideHospital. We report the procedural success and medium-term outcome.Method: Stenting was performed under general anaes-thetic using a percutaneous right femoral artery approachrequiring 14F sheath access. Arterial haemostasis wasachieved post catheterization by using a preclosure tech-nique with a 10F Prostar XL10 closure device. All patientshad implantation of Cheatham Platinum stents deliv-ered over a 0.035′′ Amplatz extra-stiff guidewire using aBalloon-in-Balloon implantation catheter.Results: Of the four patients (age 42 ± 17 years, all male),three had native and one had recurrent coarctation afterprevious childhood surgery. Stenting resulted in an imme-diate significant reduction in pressure gradient (50 ± 24to 2 ± 5mmHg; P = 0.02) and the coarctation site: descend-ing aorta diameter ratio increased from 0.22 ± 0.12 to0.87 ± 0.20. The only vascular complication was a minorbrachial artery dissection in 1 patient. Median patientlength of stay was 2.5 days (range: 2–6 days). During clinicalfollow-up of 19 ± 6 months, patient blood pressures haveimproved (systolic: 155 ± 17 to 128 ± 16 mmHg, (P = 0.04);diastolic: 91 ± 9 to 81 ± 10 mmHg, P = 0.02). One patientwith cardiac failure (EF 30%) had resolution of symptomsand normalisation of ejection fraction. No aneurysm for-mation, dissection or increase in flow-velocity has beendetected at the stented site with detailed imaging.Chss

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roportion of closures performed, while the number ofaemodynamically significant ASD closure remains con-tant.

oi:10.1016/j.hlc.2008.05.439

39tent Treatment for Coarctation of the Aorta in Adults:rocedural Success and Medium-term Outcome

ichael Leung 1,∗, Claudio La Posta 1, Stephen Worthley 1,atrick Disney 1, Ian Meredith 2, Geoff Lane 3

Royal Adelaide Hospital and Adelaide University, Adelaide,outh Australia, Australia; 2 Monash Medical Centre andonash University, Clayton, Victoria, Australia; 3 Royal Chil-

ren’s Hospital, Melbourne, Victoria, Australia

ntroduction: Aortic coarctation stenting has emerged asn alternative treatment to surgery. From 2005 to 2006, fouratients with aortic coarctation had stent placement per-

onclusions: In this cohort, aortic coarctation stenting hadigh procedural success and safety with short hospitaltay. The medium-term outcome appears equivalent tourgical repair.

oi:10.1016/j.hlc.2008.05.440

40Multi-centre Study of the Impact of Delayed STEMI

iagnosis in Emergency Departments on Door to Balloonimes

ernadette Hoffmann ∗, Wai Chan, Aaron Sverdlov,athryn Hines, Sharon Taylor, Margaret Arstall, Christo-her Zeitz

Lyell McEwin Hospital, Elizabeth Vale, Australia

ercutaneous coronary intervention (PCI) is the preferredtrategy for treating ST elevation myocardial infarctionSTEMI) but must be delivered in a timely fashion toe superior to fibrinolysis. Published strategies to reduceoor to balloon (DB) times have focused on processes toapidly activate the catheterization laboratory (CL) team.

e service STEMI patients at two sites (A and B). Dataver 27 months are presented.