Cardiovascular Journal of Africa: Vol 24 No 1 (February 2013) - page 207

CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 1, January/February 2013 AFRICA 205
technique today because the Takeuchi procedure is associated with a
higher rate of re-operations and residual lesions.
1006: ANOMALOUS ORIGIN OF CORONARY ARTERIES
FROM RIGHT PULMONARY ARTERY
Nawal AlAbdulkarim, Tarek Momenah, Saleh AlGhamdi
Prince Sultan Cardiac Centre, Riyadh, Saudi Arabia
Background: Anomalous origin of coronary arteries from the right
pulmonary artery AOCARPA is a rare variant of anomalous left
coronary artery from the pulmonary artery AlCAPA. It is essential to
recognise this anomaly since it causes higher morbidity/mortality of
the associated congenital cardiac lesions; also correction of the associ-
ated congenital cardiac defect could reduce left coronary artery flow.
Methods: We describe the cases of AOCARPA that were diagnosed
at a tertiary care referral cardiac centre during 1990–2012.
Results: Forty-five patients had ALCAPA, three patients (7%) were
diagnosed with AOCARPA. All underwent surgical re-implantation
of AOCARPA; patient two had uneventful convalescence in spite of
being diagnosed late postcoarctation repair, patient three died due to
sepsis postoperatively, and patient one with a single coronary from
RPA died during surgery.
Conclusions: AOCARPA is a rare subset of ALCAPA where diagno-
sis is suspected by clinical/echocardiographic findings and confirma-
tion requires cardiac angiography. It is usually associated with other
congenital heart disease and carries higher mortality rates.
1016: EXERCISE TRAINING IN CHILDREN AND YOUNG
ADULTS WITH A CORRECTED TETRALOGY OF FALLOT:
PRELIMINARY RESULTS OF THE TOFFIT STUDY
Nienke Duppen1, Michiel Schokking2 , Irene Kuipers3, Christiaan
Blank4, Nico Blom 5, Arie van Dijk2, Jolien Roos-hesselink1, Tim
Takken6, Maria Hopman2 , Wim Helbing1
1Erasmus Medical Centre, Sophia, Rotterdam, The Netherlands
2Radboud University Nijmegen Medical Centre, Nijmegen, The
Netherlands
3Academic Medical Centre, Amsterdam, The Netherlands
4Wilhelmina Children’s Hospital, Utrecht, The Netherlands
5Leiden University Medical Centre, Leiden, The Netherlands
6Child Development and Exercise Centre, Wilhelmina Children’s
Hospital, Utrecht, The Netherlands
Objective: To study whether exercise training in children and young
adults with corrected tetralogy of Fallot can improve exercise capac-
ity, physical activity and ECG markers.
Methods and Results: The study is a multicenter, randomised,
controlled trial. After randomisation the participants were assigned
to an interventional or control group. In total, 92 participants were
recruited from five participating university medical centres. All
participants underwent a cardiopulmonary exercise test, an elec-
trocardiogram and wore a five-day activity monitoring device. The
interventional group followed 12 consecutive weeks of supervised
aerobic exercise training, three times a week, for an hour at the level
of 60–70% of heart rate reserve. The results of the first 26 partici-
pants were included in an interim analysis. Baseline characteristics
of the intervention group consisting of 14 participants were: age 16.1
± 2.4 years, BMI 21.3 ± 3 kg.m2, 10 males; baseline characteristics
of the control group consisting of 12 participants were: age 17.6 ±
3.0, BMI 20.6 ± 3.2 kg/m2, nine males. VO2peak/kg of the intervention
group improved significantly (34 ± 6 vs 38 ± 8 ml/kg/min, p < 0.03)
whereas the control group did not show any change (35 ± 7 vs 34 ± 5
ml/kg/min). Activity levels did not change in either group. No signif-
icant ECG changes were seen (QRS duration intervention group 128
± 27 vs 127 ± 26 ms; control group 128 ± 24 vs 125 ± 27 ms, QTc
duration intervention group 432 ± 29 vs 427 ± 27 ms, control group
431 ± 19 vs 425 ± 22 ms). Moderate to vigorous activity levels in
percentage of total recorded time did not change in either group
(intervention group: 15 ± 6 vs 15 ± 5; control group 14 ± 6 vs 14 ± 6).
Conclusion: Exercise training did improve VO2peak/kg of children and
young adults with a corrected tetralogy of Fallot without changing
ECG markers and physical activity.
1021: NORMAL VALUES OF ARTERIAL VALVE DIAME-
TERS IN NEONATES
Krzysztof Michalak, Jolanta Binikowska, Katarzyna Ostrowska,
Barbara Stanek, Jadwiga Moll
Department of Cardiology, Polish Mother’s Memorial Hospital,
Research Institute, Poland
Background: Normal values of various cardiovascular diameters are
needed to facilitate proper diagnosis and decision making on treat-
ment of children with congenital heart defects. The larger the group
analysed, the more accurate and useful the conclusions and norms
are. The aim of this study was to assess the normal values of aortic
and pulmonary valves in healthy, term neonates and to correlate this
with age (1–30 days), weight and body surface area.
Methods: We reviewed 771 transthoracic echocardiographic exami-
nations performed between 2002 and 2008, and data were collected
retrospectively. All examinations were performed on healthy, term
neonates without any structural heart defect. Measurements were
taken from the short (pulmonary valve) and long (aortic valve)
parasternal axis in diastole. Statistical analysis was performed using
Statistica 10 software.
Results: The average age at examination was 10.6 days (SD 7.8) and
weight was 2.6 kg (SD 0.7). Aortic valve diameter [average 7 68 mm
(SD 0.95)] was statistically significantly correlated with age (p <
0.001, r = 0.29), BSA (p < 0.001, r = 0.47) and weight (p < 0.001, r
= 0.54). In the case of the pulmonary valve, the average diameter was
9.05 mm (SD 1.24). It was also significantly correllated with age (p
< 0.001, r = 0.4), BSA (p < 0.001, r = 0.58) and weight (p < 0.001, r
= 0.62). In both of the valve diameters, the strongest correlation and
clinical significance was observed with weight. Because all observed
correlations were medium or weak, we calculated the normal values
of aortic (6.3–9.7 mm) and pulmonary (7–11.4 mm) valves for the
whole study group, which gave values between the fifth and 95th
percentile.
Conclusion: The diameters of the aortic and pulmonary valves in
the neonatal period did not correlate strongly with age, weight or
BSA, despite the fact that it was statistically significant in all cases.
This allows us to use the common normal value range for the whole
neonatal period. In case of borderline values, weight should be taken
into consideration, because it has the strongest correlation with arte-
rial valve diameters.
1028: PULMONARY HAEMOSIDEROSIS SECONDARY TO
SEVERE MITRAL STENOSIS IN PATIENTS UNDERGOING
VALVULOPLASTY AT TYGERBERG HOSPITAL
Jacques Doubell1, Philip Herbst1, Alfonso Pecoraro1 , Conraad
Koeglenberg2, Anton Doubell1
1Division of Cardiology, Department of Medicine, Stellenbosch
University, South Africa
2Division of Pulmonology, Department of Medicine, Stellenbosch
University, South Africa
Aim: ulmonary haemosiderosis (PH) secondary to mitral stenosis
(MS) is considered rare. This study aimed to determine if PH is
more common than currently thought, as well as determining factors
contributing to its development, impact on lung function and revers-
ibility.
Methods: Chest X-rays (CXRs) of patients who underwent mitral
valvuloplasy (17/01/1997–10/02/2012) were reviewed for PH. Data
collected included date of birth, date of valvuloplasty and pre-
procedural echocardiography reports. Patients with PH on CXR were
invited to participate in a prospective trial. Patients without PH were
selected as controls. In the prospective trial a clinical evaluation,
ECG, echocardiography, CXR and lung functions were performed.