Report
Report from the 12th Conference of the Pediatric Cardiology Section of the Polish Cardiac Society (Zabrze 7–8.06.2013) – “Progress in interventional treatment of congenital heart diseases”

The 12th annual Conference of Pediatric Cardiology Section organized in Zabrze in 7–8.06.2013 was a very important medical event for cardiologists and doctors looking after patients with congenital heart diseases (CHD). The symposium was part of the 20th Jubilee of the International Cardiology Conference traditionally taking place in Zabrze in spring. Almost 2000 doctors including 300 pediatricians from all parts of Poland participated in this event. The main topic of our conference was advances in interventional cardiology of CHD and was presented in the 5 following sessions. In the opening session interesting introductory lectures were presented by professors W. Ka­walec, B. Brzezińska-Rajszys and B. Maruszewski from IPCZD in Warsaw. The second session concerned standard per­cutaneous interventions in treatment of selected CHD. Angioplasty and stent implantations in coarctation of aorta (CoA) were excellently described by Dr. M. Zubrzycka, closure of atrial septal defects by Prof. M. Szkutnik, closure of patent arterial ducts (PDA) by Dr. K. Godlewski, pul­monary balloon valvuloplasty by Dr. P. Weryński and balloon aortic valvuloplasty (BAV) by Prof. J. Białkowski. In the third session titled “New challenge for interventional cardiology” lectures were presented by Prof. J. Szymkiewicz-Dangel (fetal interventions), Dr. P. Dryżek (neonatal interventions), Dr. I. Haponiuk (hybrid procedures), Dr. R. Fiszer (per­cu­taneous pulmonary valve implantation), Dr. T. Moszura (interventions in univentricular heart) and Dr. R. Sabiniewicz (closure of vascular malformations). In the next session Prof. K. Bieganowska, Prof. W. Bobkowski and Dr. R. Le­narczyk presented in their lectures summaries concerning advances in electrotherapy of rhythm and conduction disturbances in children (pacemaker and cardioverter implantations as well as radiofrequency ablation and electroanatomical 3D mapping).

The last, probably the most interesting session was entitled “What is new in the world? Invited experts lectures”. The first speaker was Prof. Shiliang Jiang, leader of the biggest cardiological center in China (Fuwai Hospital, Beijing). This hospital was visited recently by a Polish go­vernment delegation with Marshall Ewa Kopacz. Prof Jiang presented Chinese experience in percutaneous closure of ventricular septal defects (VSD). There were more than

20 000 patients with VSD treated percutaneously in all over China (for comparison the biggest multicenter studies in Europe published by M. Carminati [1] enrolled 450 cases). In the Chinese study perimembranous VSDs were closed initially by US implants (asymmetric Amplatzer devices), and later by Chinese, domestic occluders modified by Prof. Qin from Shanghai [2]. The results presented by Prof. Jiang indicated that the procedures were highly successful with no major complications. Complete AV block in follow-up was noted in less than 1% of cases – in comparison to 5% of cases in M. Carrminati’s study [1]. Some doubts were expressed by the chairmen (Prof. W. Rużyłło and Prof. G. Brzezińska) and concerned age of the percutaneously treated patients (median – 8 years). It was surprising as indications for VSD closure are usually much earlier. The second speaker was Prof. Felix Berger – head of the Pediatric Cardiology Ward in Charite Hospital in Berlin. He gave an outstanding lecture concerning indications, effectiveness and long-term follow-up of BAV in children and teenagers. His conclusions were similar to my earlier presentation in the previous session. The main conclusion was the statement that BAV in children although palliative in nature was the treatment of choice in selected patients, helping to delay aortic valve replacement. Prof. Berger mainly referred to the recently published BAV results of 20 pediatric cardiology centers from Germany, Austria, and Switzerland [3]. According to that study performed in a group of 1004 patients treated with BAV, 70% did not require cardiac surgery up to

10 years after the initial procedure. The next lecturer, Dr. Gejun Zhang – head of the Hemodynamic Laboratory in Fuwai Hospital in Beijing – showed us his experience of 23 procedures of percuta­neous closure of ruptured Valsalva aneurysm (our own material unique in Europe enrolled 13 patients treated by that method). The next speaker was Dr. Christian Juxt (head of the cath lab in Munster – Germany). He presented new stents for dilation of great vessels (mostly CoA), mentioned the encouraging results of applications of cobalt–chromium stents (namely An­drastents) and expressed his negative opinion about the Advanta V12 stent (similar to the impressions of Dr. L. Ben­son and Dr. J. Di Giovanni). According to their opinion, the Advanta V12 stent although doubly covered has minor radial strength which can be responsible for stent deformation and dislocation. There were also two very interesting lectures of guests from Spain. Dr Fernando Ballesteros (from Gregorio Maranon Hospital in Madrid) talked about his center experience in closing PDA in preterm neonates (biggest material in the world) and Dr Fernando Rueda (from La Coruna Hospital) presented new opportunities in application of rotational angiography in diagnostics and treatment of CHD.

On the next day in two stimulating sessions there were presented and discussed 22 casuistic cases almost from all pediatric cardiology centers from Poland. Two of them traditionally were chosen as the most interesting: the first case from Poznan (presenter – R. Surmacz): “Percutaneous closure of vascular fistula between right ventricle and right atrium” and the second from Zabrze (presenter – J. Rycaj): “Effectiveness of corticoids in fulminant myocarditis – case report”.

In summary, in my opinion the conference was very successful. The vivid discussions were particularly important but they were limited because of the shortage of time caused by the rich program.

References

1. Carminati M, Butera G, Chessa M, et al. Transcatheter closure of congenital ventricular septal defects: results of the European registry. Eur Heart J 2007; 28: 2361–2368.

2. Qin Y, Chen J, Zhao X,et al. Transcatheter closure of perimem­branosus ventricular septal defect using a modified double-disc occluder. Am J Cardiol 2008; 101: 1781–1786.

3. Ewert P, Bertram H, Brener J, et al. Balloon valvuloplasty in the treatment of congenital aortic stenosis. A multicenter retrospective survey of more than 1000 pts. Int J Cardiol 2011; 149: 182–191.