Cardiac Surgery—A Major Stress for Infants, Parents and Families

Paediatrics – Posters 217 CMRI Measurement of Values and Ranges of Ventricular Function in Normal Children Aged 8–12 Years L. Altamirano ∗ , W. Strugnell, R. Slaughter, J. Morwood, R. Justo The Prince Charles Hospital, Rode Road, Brisbane, Queensland, Australia Objectives: To establish normal values for right and left ventricular volumes and function in normal children using cardiac magnetic resonance imaging (CMRI). Background: CMRI is increasingly recognised as the reference standard for the non-invasive assessment of right ventricular function. Whilst these values have been established in an adult population, there is a paucity of published values in children. Methods: Eighty-nine normal children were studied: 44 males (median age 9.9 years; range 8.0–12.1 years) and 45 females (median age 9.6 years; range: 8.2–12.0 years). CMRI imaging was performed on a 1.5T GE Twinspeed without sedation using ECG-gating and suspended respiration. Steady state free precession cine MR images were acquired and analysis was performed off-line using Mass Analysis software. Left and right ventricular end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were calculated. Results: RVEDV was 114 ± 41.9 ml for males and 94 ± 29.6 ml for females. Adjusted for BSA this was 93 ± 31.1 ml/m2 and 81 ± 19.7 ml/m2 , respectively. RVEF was 55 ± 7.9% for males and 57 ± 7.2% for females. LVEDV was 106 ± 33.8 ml for males and 93 ± 26 ml for females. Adjusted for BSA this was 86 ± 22.4 ml/m2 and 80 ± 16.1 ml/m2 , respectively. LVEF was 57 ± 4.4% for males and 57 ± 6.0% for females. Conclusion: Normal values for right and left ventricular volume and function in normal 8–11 years old children were established using CMRI. doi:10.1016/j.hlc.2007.06.222 218 Cardiac Surgery—A Major Stress for Infants, Parents and Families B. Jordan 1,2,3 , C. Franich-Ray 1,2,3 , A. Al Farquani 1,2,3 , S. Menahem 1,2,3,∗ , A. Cochrane 1,2,3 , V. Anderson 1,2,3 , E. Northam 1,2,3 1 Royal Children’s Hospital, Flemington Road, Melbourne, Aus-

tralia; 2 Murdoch Children’s Research Institute, Parkville, Victoria, Australia; 3 The University of Melbourne, Australia Background: Most surgery for congenital heart disease is performed on the newborn and young infants, and has a profound impact on the affected parents and families. The aim of this study was to review the nature and extent of the stresses experienced.

Abstracts

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Methods: Infants who had cardiac surgery before three months of age were reviewed one month following hospital discharge. Infants’ medical and developmental outcomes, feeding and crying patterns, infant–parent attachment and parental mental well being was assessed using questionnaires and a structured interview. Results: One hundred and nine infants completed the assessment. Surgery included the full gamut of congenital heart disease ranging from a hypoplastic left heart syndrome to duct ligation. Seventy percent had bypass surgery. Nine percent of mothers regarded their infants’ cardiac disease as severe and 48% as moderate. The majority viewed their baby’s progress as good. Most considered that surgery and hospitalization had affected their relationship with their baby, some experiencing a stronger bond, whilst others felt somewhat alienated. Study mothers had higher levels of depression and physical and emotional stress symptoms than community samples. A quarter of the infants had ongoing feeding difficulties and slightly fewer had crying problems. Conclusion: Infant cardiac surgery has a major impact on the infants and their parents confirming the need for acute supportive and directed intervention at the time of surgery. doi:10.1016/j.hlc.2007.06.223 219 Echocardiographic (Echo) Assessment of Early Changes of Left Heart Function in Patients Receiving Prednisone (Pred) for Acute Rheumatic Fever (ARF) S. Long ∗ , D. Fong, R. Webb, T.L. Gentles, J.R. Skinner, C. O’Donnell, T. Hornung, MRCP, N.J. Wilson Starship Children’s Hospital and Green Lane Cardiovascular Service, Auckland, New Zealand Background: Well-performed RCTs using corticosteroids for ARF performed in the 1950–1960s did not show a benefit after 1 and 5 years for the severity of carditis. Never the less many clinicians advocate their use as do most standard texts. The role of prednisone for controlling ongoing inflammation in those patients who have required early mitral valve repair for fulminate RF has also not been studied. The aim was to use echo to study possible mechanisms of cardiac improvement observing serial short-term changes of LV function and left sided valve regurgitation. Methods: Echo data included standard assessment for grading of mitral regurgitation (MR) and aortic regurgitation (AR). LV function was assessed by LVEDD, LVEDS, LV volumes by area/length methods all related to BSA expressed as Z scores. Assessment times were pre- and 2, 4 and 6 weeks after starting a tapering schedule of prednisone. Results: Five pts, three preoperatively, two postoperatively (age range 8–13 years), received prednisone. Severe MR was present n = 4, mild in 1. AR ranged from 0 to mild overall LVED Z volumes decreased from +3.7 ± 3.5 to +2.6 ± 4 (p = 0.7). There was no change in grading of valve regurgitation except in 1 pt with decreased volumes where

ABSTRACTS

Heart, Lung and Circulation 2007;16:S1–S201