CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 1, January/February 2013
AFRICA
135
types of malformations and their haemodynamic repercussion, so as
to be able to propose precise and timely treatment for these patients.
46: ANATOMICAL–ECHOCARDIOGRAPHIC CORRELA-
TION IN COMPLEX CONGENITAL HEART DISEASE
Nilda Espinola-Zavaleta, Luis Mua ’Oz-Castellanos, Maria Elena
Soto, Eulo Lupi
Instituto Nacional de Cardiología Ignacio Chávez, Mexico City,
Mexico
Background:
Echocardiography is a valuable non-invasive tech-
nique to identify the anantomy and function of complex congenital
heart disease. Knowledge of the morphological details of each type
of complex congenital heart disease is the basis for the correct inter-
pretation of diagnostic images and clinical decisions.
Objective:
The objective of this study was to establish the anatom-
ical–echocardiographic correlation in complex congenital heart
disease from heart samples with equivalent findings to those of
echocardiographic images.
Methods:
Thirty hearts and 50 patients with Ebstein’s anomaly, 60
hearts and 24 patients with atrio-ventricular septal defect, 15 hearts
and 24 patients with absence of right atrio-ventricular connec-
tion were studied. The samples correspond to the collection of the
Embryology Department.
Results and Conclusions:
The anantomical–echocardiographic
correlation clearly showed that the anatomical findings of the
hearts corresponded with the echocardiographic images of complex
congenital heart disease and provided an adequate understanding
of the echocardiographic images in terms of an accurate diagnosis,
treatment, therapeutic decisions and prognosis.
50: CONTRIBUTION OF MRI AND CT SCAN IN DIAGNOSIS
AND MANAGEMENT OF CONGENITAL HEART DISEASE:
ABOUT 18 CASES IN THE DEPARTMENT OF CARDIOL-
OGY, FANN UNVERSITY HOSPITAL, DAKAR, SENEGAL
Arame Diagne Diallo
1
, Ibrahima Bara Diop
2
, Ababacar Mbengue
3
,
Abdoulaye Ndoye Diop, Mohamed Leye, E Hadji Mbackã Sarr,
Simon Manga, Lucien Leopold Diene
1
Department of Cardiology, Fann University Hospital, Dakar, Senegal
2
Medical Imaging Department, Principal Hospital, Dakar, Senegal
3
Medical Imaging Department, Fann University Hospital, Dakar,
Senegal
Introduction:
For diagnosis of congenital heart disease (CHD),
cardiovascular magnetic resonance imaging (MRI) and cardiac angi-
oscan (CT) can provide additional useful information for therapeutic
decisions. The objective of this study was to identify the indications
for MRI and CT and to determine their contribution to diagnosis and
management of CHD.
Methods:
This was a descriptive study from January 2008 to March
2011 including patients with CHD who underwent trans-thoracic
echocardiography (TTE) and in whom MRI or CT was performed.
Results:
We identified 10 patients who underwent MRI and eight
cases CT scan. Patients’ average age was 10 years.The indications
for MRI were always pre-operative assessment of: tetralogy of Fallot;
coarctation of the aorta; patent ductus arteriosus with a right aortic
arch; congenital aneurysm of the left ventricle (LV); and migration
of pulmonary banding.
The MRI allowed precise anatomical diagnosis of: hypoplastic
left pulmonary artery (LPA); tight coarctation of the aorta; a bi-carot-
id trunk; rupture of a LV aneurysm within the pericardium; distal
migration of a pulmonary banding. CT was indicated for: stenosis
at the origin of the pulmonary branches after ligation of the ductus
arteriosus; tetralogy of Fallot with pulmonary hypoplasia. A CT scan
provided a better description of the aorta, but also the pulmonary
arteries and their abnormalities.
Conclusion:
MRI and CT scans can be very useful in pre-operative
assessment of congenital heart defects. They can be indicated for
more accurate anatomical diagnosis prior to surgery and may avoid
the use of invasive cardiac catheterisation.
54: INTRA-ATRIAL RHABDOMYOMA IN A NEWBORN
PRODUCING PSEUDO PRE-EXCITATION
Gebauer Roman, Richter Sergio, Paech Christian
Heart Centre, University of Leipzig, Germany
Pre-excitation is a common phenomenon in paediatric patients with
an accessory pathway. We present a term newborn, male patient with
one giant atrial rhabdomyoma and multiple ventricular rhabdomyo-
mas that showed pseudo pre-excitation in the 12-lead surface ECG
due to tumour caused atrial depolarisation and repolarisation distur-
bances. First presentation to our clinic was for further diagnosis and
therapy. Except for the cardiac tumours, other physical findings were
unremarkable for his age and gender.
Initial ECG showed atrial fibrillation with ventricular rate of
230/min, which was terminated by a single direct current shock of
6 Joule. After cardioversion, ECG showed slow atrial rhythm with
frequent premature atrial contractions (PAC) and deformation of the
PR interval posing as pseudo-pre-excitation, followed by a normal
QRS complex with seemingly abnormal ventricular repolarisation.
We suspected the origin of this pseudo pre-excitation was isolated
atrial depolarisation disturbances due to the tumour, which caused
heterogenous endocardial activation. Also the seemingly abnormal
ventricular repolarisation represented excessive delay in atrial repo-
larisation superimposed on the ventricular repolarisation. Due to the
developement of inflow congestion, the atrial tumour was resected
with consequent vast atrial reconstruction using patch plastic, where-
as the ventricular tumours were left without manipulation. After
surgery pre-excitation and repolarisation abnormalities vanished
entirely, with development of an alternans between sinus rhythm and
ectopic atrial rhythm.
The QRS complex before and after surgical resection of the rhab-
domyoma were identical, underlining the atrial origin of the repolari-
sation abnormalities before surgery.
57: CONGENITAL JUNCTIONAL ECTOPIC TACHYCAR-
DIA: CLINICAL PRESENTATION, RESPONSE TO TREAT-
MENT AND LONG-TERM EVOLUTION
Alberto Sciegata, Maria Victoria Lafuente, Juan Pablo Fabris, Julieta
Irman, Claudia Villalba, Horacio Capelli
Dicision of Paediatric Cardiology, Hospital JP Garrahan, Argentina
Objective:
To examine the clinical presentation, response to phar-
macological treatment and evolution of congenital JET treated in
our hospital.
Methods
: Twenty patients were seen in our practice in arrhyth-
mias with congenital JET during the period 2001–2010, with a mean
follow up of 5.9 years (
±
5.3). All were evaluated with physical
evaluation, ECG and Holter periodically. The diagnosis was based
on ECG: tachycardia with normal QRS morphology, atrioventricular
dissociation and ventricular rate higher than sinus rhythm. Patients
were subdivided according to the age of presentation into group I:
younger than one year old: 16 patients, with a mean age at diagnosis
of 38 days old (1–90 days) and group II: older than one year: four
patients with a mean age of 8.7 years (7–11 years).
Results:
Group I: median HR at diagnosis was of 182
±
32 beats/min,
and it was constant in all our patients (
p
=
0.002); 87.5% (
p
=
0.006)
showed signs of heart failure and ventricular dysfunction, and 81% (
p
=
0.02) needed to be admitted. In all cases HR (mean 122 beats/min,
range 90–157) was controlled by 45 days (15–120). Only one patient
had a positive family history.
Group II: median HR of the JET patients was 127
±
38 beats/
min and in two patients, it was paroxismic (
p
=
0.09). All of them
referred because of palpitations (
p
=
0.0002) and one patient required
admission. In all cases the HR (mean 81 beats/min, range 69–98) was
controlled by 35 days (5–120). In all cases there was partial control of
