CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 1, January/February 2013
240
AFRICA
1421: ASSOCIATION OF TEMPORARY COMPLETE AV
BLOCK AND JUNCTIONAL ECTOPIC TACHYCARDIA
AFTER SURGERY FOR CONGENITAL HEART DISEASE
Christian Paech
1
, Patrick Flosdorff
1
, Ingo Dähnert
1
, Martin Kostelka
2
,
Meinhardt Mende
3
, Roman Antonin Gebauer
1
1
Department of Paediatric Cardiology, Heart Centre, University of
Leipzig, Germany
2
Departement of Cardiac Surgery, Heart Centre, University of
Leipzig, Germany
3
Insitute for Medical Biometry, University of Leipzig, Germany
Junctional ectopic tachycardia (JET) is a postoperative complica-
tion with a mortality rate of up to 14% in patients after surgery for
congenital heart disease. This study evaluated the association of
intra- and/or postoperative temporary third-degree AV block and the
occurance of junctional ectopic tachycardia.
Methods:
Data were collected retrospectively from 1 158 consecu-
tive patients who underwent surgery for congenital heart disease in
the period 2006 to 2010.
Results:
The overall JET incidence was 2.8%. Temporary third-
degree AV block occured in 2.8% of cases. Ongoing third-degree AV
block requiring pacemaker implantation occured in 1.2% of cases.
Postoperative JET was significantly correlated with temporary AV
block (
p
<
0.001), occuring in 56% of patients with temporary AV
block. No case of postoperative JET was reported in a patient with
ongoing AV block. Furthermore, bivariate regression analysis showed
a statistically significant correlation between postoperative JET and
age at operation (
p
<
0.001), cardiopulmonary bypass time (
p
<
0.001) and aortic cross-clamping time (
p
<
0.004).
Conclusion:
There was an association between temporary complete
AV block and postoperative JET. In addition, ongoing complete AV
block seemed to be negatively correlated with postoperative JET.
1426: QUALITY OF LIFE IN FAMILIES WITH A CHILD
AFTER STAGED TREATMENT FOR HYPOPLASTIC LEFT
HEART SYNDROME (HLHS)
Anna Mazurek-Kula, Barbara Wisniewska, Katarzyna Ostrowska,
Tomasz Moszura, Pawel Dryzek, Jadwiga A Moll, Andrzej Sysa,
Jacek J Moll
Polish Mother’s Memorial Hospital, Poland
Background:
In spite of increasing numbers of survivors with HLHS
after a staged Norwood operation, data on quality of life in this group
of patients and their families are limited.
Aim:
The aim of the study was to assess the quality of life of children
with HLHS and their families.
Methods:
Mothers of 54 children with HLHS completed the ques-
tionnaire to assess subjectively quality of their children’s life and
impact of the child’s illness on the family. All children (age 4–16
years) were operated on at our institution. In 35%, the child with
HLHS was the only child in the family.
Results:
Problems with physical activity in HLHS patients were
reported in 79%, emotional problems in 25%, and educational in 9%.
Development estimated as normal was reported in 89% of patients;
79% of patients attended normal schools or kindergartens. Good
tolerance of frequent hospitalisations was reported in 75% of cases.
Childhood illness is connected with strong parental stress (73%),
and negative emotions such as sadness (41%), fear and helplessness
(42%). Own family support, support groups of parents and religious
faith were considered most helpful. Only 13% of mothers looked
for professional psychological care; 94% of responders assessed the
familial atmosphere as good, and in 67% the child’s illness strength-
ened the parental marriage. The impact of the child’s illness on the
family’s material situation was assessed as significantly negative in
79% . In 59% of families the father was the only working parent.
Conclusion:
Patients with HLHS are active members of the soci-
ety, they attend normal schools and kindergartens although their
physical activity is limited. The family functioning is good but the
child’s illness is a cause of parental stress and indicates material
problems. Increasing numbers of HLHS survivors indicates the need
for a continuation of these studies concerning neurodevelopmental
outcome, quality of life and family functioning in this group of
patients.
1427:
PAEDIATRIC
CARDIAC
INTERVENTION
PROGRAMME IN UPPER EGYPT: MORE BENEFITS AND
FEWER RISKS
Alaa Roushdy
1,2
, Maiy El sayed
1,2
, Mohamed Gazi
1,2
, Sherien
Abdelsalam
1
, Magdi Yacoub
1,3
1
Aswan Heart Centre, Magdi Yacoub Heart Foundation, Egypt
2
Cardiology Department, Ain shams University, Cairo, Egypt
3
Cardiothoracic Surgery, Harefield Heart Science Centre, London,
UK
Background:
The high prevalence of congenital heart disease among
developing nations due to their high birth rate and the highly quali-
fied medical staff needed to deal with such patients makes the devel-
opment of sustainable cardiac centres for the treatment of children
and young people with heart diseases, in countries where the facili-
ties for such treatments are unavailable, a top priority.
Methods:
The study included all children suffering from congenital
heart disease who were referred for elective percutaneous cardiac
intervention in Aswan Heart Centre over a period of six months.
Patients and procedural data were recorded, including age, gender,
weight, height, underlying heart disease, type of the procedure,
procedure duration, outcome as well as any intra- or postprocedural
complications and the severity level of these complications.
Results:
Eighty-four children were included in the study; their mean
age was 4.4
±
4.3 years; the youngest patient was two months old
while the oldest was 18 years. Patients underwent a wide range of
percutaneous interventional procedures, most of which were balloon
pulmonary valvuloplasty (
n
=
18), ASD device closure (
n
=
18), and
PDA device closure (
n
=
32). Five patients underwent two interven-
tional procedures in the same setting. The mean procedure duration
was 52.7
±
32.7 minutes and the maximum hospitalisation period
was less than 48 hours. The success rate was 97.6% (
n
=
82) and the
mortality rate was 0%. Periprocedural complications occurred in 19
patients, none of which were life threatening and the majority were
self limiting intra-procedural arrhythmias.
Conclusion:
The development of a specialised paediatric cardiac
interventional centre in remote area that lacks this service is very
cost effective. Such a centre will not only provide excellent medical
service to children in need but will also free up the available surgi-
cal theatres, allowing these centres to deal with more complex and
challenging cases.
1430: QUALITY OF CAREAND OUTCOMES AMONG CHIL-
DREN UNDERGOING CARDIAC CATHETERISATION: A
CHARITY-BASED PROGRAMME IN UPPER EGYPT
Maiy El Sayed
1,2
, Alaa Roushdy
1,2
, Mohamed Gazi
1,2
, Sherien
Abdelsalam
1
, Baher Matta Hanna
1
, Joaquim Miro
1,3
, Magdi Yacoub
1,4
1.
Aswan Hear Centre, Magdi Yacoub Heart Foundation, Egypt
2
Cardiology Department, Ain shams University, Cairo, Egypt
3
Centre Hospitalier Universitaire, Sainte-Justine, Montreal, QC,
Canada
4
Cardiothoracic Sugery, Harefield Heart Science Centre, London,
UK
Background:
The inhabitants of Aswan and neighboring Upper
Egypt amount to approximately 24 million people. Currently there
are no local specialised cardiac services for this large population.
This tremendous need motivated Prof Yacoub and the Chain of Hope
team to stimulate the development of a new unit to offer cardiac
facilities at the highest level.
Methods:
All children with congenital heart disease who were
referred for elective cardiac catheterisation in Aswan Heart Centre
over a period of two years were subjected to a baseline 2D echocar-
