CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 1, January/February 2013
154
AFRICA
structural cardiac cause of syncope, yielding high sensitivity (90.9%)
and specificity (94.4%) in distinguishing structural cardiac syncope
from non-cardiac syncope.
Conclusion:
Plasma BNP was helpful in differentiating structural
cardiac syncope from non-cardiac syncope, but it had a limited value
in the differential diagnosis of arrhythmic cardiac syncope and non-
cardiac syncope in children and adolescents.
274: WORLDWIDE EXPERIENCE WITH PORCINE
SMALL INTESTINE SUB-MUCOSAL EXTRACELLULAR
MATRIX GRAFT (CORMATRIX) IN CONGENITAL HEART
SURGERY: A SINGLE-INSTITUTIONAL EXPERIENCE
Christian Gilbert
1
, Robert Matheny
2
, Sanjay Kaushal
3
, John
Iguidbashian
5
, Kathleen Fenton
1
, Jorge Ochoa
4
, William Novick
1
1
International Children’s Heart Foundation, Memphis, Tennessee,
USA
2
Cormatrix Cardiovascular Inc, Alpharetta, Georgia, USA
3
Northwestern University, Chicago, Illinois, USA
4
Instituto Nacional Cardiopulmonar, Tegucigalpa, Honduras
5
Legacy Emanuel Children’s Hospital, Portland, Oregon, USA
Methods:
All patients receiving SIS-ECM implants were entered
into the ICHF database. This report is a retrospective review of
this database. The patients were from Iraq, India, Egypt, Ukraine,
Honduras and Ecuador.
Results
: There were 174 patients who received 176 implants,
including 33 pulmonary valved conduit procedures (14 Ross, six
tetralogy with absent pulmonary valve, four truncus arteriosus, four
Rastelli, three DORV with RV to PA conduit, two TOF redo RV to
PA conduit), 39 primary tetralogy repairs, 34 valve leaflet repairs
(included with primary repair), 65 septal patches, seven arterial
switch repairs, five AVSD repairs and five Glenn procedures with
pericardial closure. Overall mortality was 19/174 or 10.9%. There
was no mortality, which could be directly attributed to the ECM. Two
patients required early replacement of an ECM pulmonary valved
conduit for obstruction distal to the conduit. Two patients receiving
aortic leaflet augmentation required aortic valve replacement. All
patients having the Ross procedure have had excellent early and
midterm results with no mortality or re-operations.
Conclusions
: The SIS-ECM (Cormatrix) is an easy-to-use haemo-
static alternative to traditional materials. It can be used to fashion
valve conduits for right-sided reconstructions and establish compe-
tent pulmonary valves in tetralogy repairs needing trans-annular
patch. The valve constructs demonstrate excellent results in short-
and mid-term follow up. Complete freedom from calcification is an
added benefit.
282: MODIFIED CALGARY SCORE IN DIFFERENTIAL
DIAGNOSIS BETWEEN CARDIAC SYNCOPEAND POSTUR-
AL ORTHOSTATIC TACHYCARDIA SYNDROME-ASSOCI-
ATED SYNCOPE IN CHILDREN
Jinyan Yang
1
, Lulu Zhu
1
, Stella Chen
2
, Xueying Li
3
, Qingyou Zhang
1
,
Fengwen Zhang
1
, Li Chen
1
, Chaoshu Tang
4
, Junbao Du
1
, Hongfang
Jin
1
1
Department of Paediatrics, Peking University First Hospital, Beijing,
PR China
2
Department of Biological Sciences, University of California, San
Diego, La Jolla CA, USA
3
Department of Medical Statistics, Peking University First Hospital,
Beijing, PR China
4
Department of Physiology and Pathophysiology, Peking University
Health Science Centre, Beijing, PR China
Objectives:
The present study was designed to analyse the useful-
ness of a modified Calgary scoring system during differential diag-
nosis between cardiac syncope and postural orthostatic tachycardia
syndrome-associated syncope through a large-sample sized clinical
investigation.
Methods:
The study included 213 children with cardiac syncope
or postural orthostatic tachycardia syndrome-associated syncope
(101 male and 112 female children), aged between two and 19 years
(mean 11.8
±
2.9). A modified Calgary score was created, which was
analysed to predict differential diagnoses between cardiac syncope
and postural orthostatic tachycardia syndrome-associated syncope
using a receiver operating characteristic curve.
Results:
The median of modified Calgary scores for cardiac syncope
was –5.0, which significantly differed from that of postural orthos-
tatic tachycardia syndrome (0.0) (
p
<
0.01). The sensitivity and speci-
ficity of a differentiation score of less than –2.5 was 96.3 and 72.7%,
respectively. Since the modified Calgary score was an integer, when
less than –3.0, the diagnosis could be considered as cardiac syncope.
Conclusion:
The modified Calgary score could be used to make an
initial differential diagnosis between cardiac syncope and postural
orthostatic tachycardia syndrome-associated syncope in the clinic.
290: DOES QUALITY OF CONGENITAL HEART SURGERY
VARYWITH MOON PHASES?
Ute Hirsch, Nicodeme Sinzobahamvya, Sojiro Sata, Viktor Hraska,
Boulos Asfour, Joachim Photiadis
German Paediatric Heart Centre, Sankt Augustin, Germany
Background
: Popular belief bestows to some moon phases adverse
effects on human activities. Accordingly, worried parents refuse
operations for their children during these ‘critical’ periods. Is quality
of congenital heart surgery affected by lunar phases?
Methods
: Quality was measured by observed postoperative mortal-
ity and morbidity. Lengths of stay at the intensive care unit (ICU)
and in hospital were used as morbidity surrogates. Morbidity scores
were attributed to each hospital stay according to complications and
adverse events occurring after surgery, in conformity with Sata’s
methodology. Two groups of patients with similar age who underwent
similar types of procedures, with the same Aristotle complexity score
(8 points) from January 2006 to June 2012 were compared, using the
Mann-Whitney test, unpaired
t
-test and Fischer’s exact test. Group 1 (
n
=
75) consisted of patients operated upon during so-called unfavour-
able periods (full moon and moon in Leo). Patients in group 2 (
n
=
79) underwent surgery during presumed favourable moon phases (last
week before new moon). The difference was considered not significant
at a
p
-value above 0.05.
Results
: No patient died: a mortality of 0% for both groups. ICU and
in-hospital lengths of stay were 3.85
±
3.91 and 13.19
±
7.31 days for
group 1, versus 4.21
±
4.96 and 14.53
±
8.51 days for group 2:
p
=
0.62 and 0.30, respectively; 57.3% (43/75) of patients in group 1 and
57.0% (45/79) in group 2 had an uneventful postoperative course;
p
=
1. The severity of complications that occurred in the other patients
was similar for both groups;
p
=
1. The morbidity score reached 1.55
±
1.72 points for group 1 and 1.50
±
1.58 points for group 2;
p
=
0.85.
Conclusions:
Quality of results did not vary with moon phases.
One should not worry at all about lunar phases when planning and
performing congenital heart surgery.
295: PERMANENT PACEMAKER IN PREGNANCY: ANALY-
SIS OF SIX CASES
Mamie Watanabe
1
, Kunitaka Joo
1
, Jun Muneuchi
1
, Ayako Kuraoka
1
,
Yoko Horibata
2
, Takeshi Kawakami
3
, Hiromasa Nakahara
3
, Yoshie
Ochiai
3
, Toshiro Iwai
4
1
Department of Paediatric Cardiology, Kyushu Koseinenkin Hospital,
Japan
2
Department of Cardiology, Kyushu Koseinenkin Hospital, Japan
3
Department of Obstetrics and Gynecology, Kyushu Koseinenkin
Hospital, Japan
4
Department of Cardiovascular Surgery, Kyushu Koseinenkin
Hospital, Japan
Background:
Outcome of pregnancy in patients with a pacemaker is
not fully understood because of limited numbers of cases. We present
