58. Double coronary balloon angioplasty of the aorta in an infant Al-Dhahri, Khalid We are reporting the first case of double coronary bal- loon usage in infants. A 10 weeks old male infant under- went successful surgical repair for severe coarctation of the aorta at the age of 14 days with end to end anastamo- sis. Later on, developed significant symptomatic recoarc- tation. During cardiac catheterization, the narrowed segment appeared long. He did not respond to a pliable low pressure balloon dilatation. Because of the weight of the infant (4.0 kg) and to avoid vascular injury we elected to use 2 high pressure coronary balloons through one 4F sheath. The procedure was successful with drop in pres- sure gradient from 30 mmHg to 3 mmHg, and significant angiographic improvement. Nine months post procedure there was no recoarctation and the infant is stable, asymptomatic and thriving well. Conclusion: high pressure coronary balloons can be used safely and effectively in small infants to avoid the use of larger introducers and hence avoid arterial vascu- lar injury. http://dx.doi:10.1016/j.jsha.2015.05.239 59. Urinary tract infection in children after cardiac surgery: Incidence, risk factors and outcome Rehana Shafi, Anis Fatima, Julinar Idris, Akhter Mehmood, Sameh Ismail, Omar Hijazi, Mohamed Kabbani, Reetam Singh, Huthaim Al Muhaidib Background/Aim: Urinary tract infection (UTI) can prolong hospitalization, and increase morbidity. Catheter associ- ated UTI (CAUTI) is a major cause of UTI. The aim of this study is to determine the incidence, risk factors, etiology and outcome of UTI in postoperative cardiac children. Methods: This is retrospective cohort study. All post- operative patients admitted to PCICU during 2012 were included. Patients were divided into: group (1) Patients who developed and group (2) patients who did not develop UTI. The two groups were compared for demo- graphic and other variable predictors for UTI. Results: 413 post-cardiac surgical children were included. Group 1 had 29 patients (7%) all had CAUTI. Foley cathe- ter utilization ratio was 44%. CAUTI density rate was 18 per 1000 catheter days. Logistic regression analysis demonstrated that risk factors for developing UTI were: duration of Foley (P < 0.002), associated syndrome (P = 0.01) and prolonged PCICU and hospital stay (P < 0.05). Gram-negative were responsible for 63% and Candida for (24%) of the CAUTI. ESBL caused 30% and MDRO caused 10% of our patients CAUTI. Conclusions: Foley catheter duration, presence of syn- drome and prolonged PCICU and hospital stay were the main risk factors for CAUTI in postoperative pedi- atric cardiac patients. Resistant Gram-negative were the main cause for BSI with one third of CAUTI cases caused by MDRO or ESBL organisms. The cases with CAUTI were generally sicker and with more morbidity. The study will establish a baseline clinical indicator for monitoring quality improvement and the future measures to minimize CAUTI incidence, and its co-morbidity. http://dx.doi:10.1016/j.jsha.2015.05.240 60. A three years old girl with atrial septal defect associated with multiple coronary artery micro- fistulas to the left ventricle Shehla Jadoon, Milad El Segaier, M.O. Galal Congenital coronary artery fistulas are rare anomalies. Most of these fistulas drain to the right side of the heart. They seldom connect to either left atrium or left ventricle. We report a three years old girl in whom an atrial sep- tal defect (ASD) was diagnosed. Echocardiography sug- gested a possible additional coronary artery fistula to the left ventricle (LV). Before closing the ASD, coronary angiography identified multiple coronary artery fistulas to the left ventricle. Transcatheter closure of the ASD was done successfully. The hemodynamic effect of coronary artery fistula to LV after ASD closure is discussed along with literature review of this extremely rare association. http://dx.doi:10.1016/j.jsha.2015.05.241 61. Recanalization of patent ductus arteriosus after spontaneous closure El-Segaier Milad, M.O. Galal, Shiekh Eldin Ghada, Momenah Tarek Background: Patency of the arterial duct (AD) needs to be preserved for a certain time in patients with duct depen- dent circulation. Recanalization of arterial duct might be a needed option in certain conditions. Objective: To report our experience regarding the feasi- bility and effectiveness of arterial duct (AD) recanaliza- tion in three infants. Methods and results: We report on three patients with decreased pulmonary blood flow after initial palliation. The first patient had pulmonary atresia (PA) and intact ventricular septum. The infant underwent pulmonary valve perforation and balloon valvuloplasty. He devel- oped desaturation and needed further intervention and recanalization of the AD. The second patient had PA and ventricular septal defect (VSD). His AD origi- nated from left subclavian artery. He had initially ABSTRACTS 322 ABSTRACTS J Saudi Heart Assoc 2015;27:299–330 brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by Elsevier - Publisher Connector