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PS262 Toxic Metals and Metalloids Role in Aorta Coarctation Ethiopathogenesis
PS261 Risk Stratification in Children With Heart Disease: M. García-Saldivia*1, H. Ilarraza-Lomelí1, J. Rojano-Castillo1, M.-D. Rius-Suárez1, E. Patiño2, I. Miranda2, A. Buendia2, R. Samuel2, A. Benita2, M. E. Franco1 1 Rehabilitación Cardiaca, 2Cardiopediatry, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico DF, Mexico Introduction: Health outcomes have been increasingly scrutinized as the best source of information about how to deliver optimal medical treatment. Indeed, evaluation of health care practice without outcome assessment can be readily criticized as lacking relevance. However, outcome evaluation, even for easily measured outcomes such mortality, requires data collection and complex analytical techniques for interpretation. On the other hand, before the technological advances of the modern world, including cardiovascular surgery, the patients with congenital heart disease had a desolate future. Today, an increasing number of patients who survive the cardiac-surgery can continue their lives for many years, however, in apparently simple diseases such as aortic coarctation, the prognostic is not as favorable as previously thought. Currently, there is not a tool that allows the pediatric cardiologist predict the incidence of complications or adverse outcomes in their patients. Objectives: Elaborate an instrument (clinical and paraclinical) able to predict cardiovascular risk in the medium and long term in the population of children with heart disease.
POSTER ABSTRACTS
Objectives: The objective is to discuss about a possible detection of large pericardial effusion on nuclear cardiac imaging. Thus far the “gold standard” for the diagnosis of pericardial effusion is the transthoracic echocardiogram. Large pericardial effusion may be diagnosed on nuclear cardiac imaging. Technitium-99m based MPI has a typical feature of diagnosing large pericardial effusion. Methods: A 39 years old gentle man was hospitalised after road traffic accident and sustained multiple injuries. A whole body scan revealed multipl injuries over anterior chest wall with large amount of fluid in pericardial space.Transthoracic echocardiogram confirms large pericardial effusion with cardiac tamponade and reduced ejection fraction. Pericardiocentesis was done and other injuries were taken care of accordingly. Subsequently, Technitium-99m scan was done to evaluate low ejection fraction and to look for any perfusion defect. However, finding on MPI ( Technitium-99m) scan revealed unusual “swinging movement” of heart with out any inducible ischemia. A lucent space around the heart suggestive of fluid collection. Results: An incidental finding of pericarial effusion can be diagnosed by myocardial perfusion imaging and is therefore important that physician be aware of this imaging modality, that is capable of diagnosing large pericardial effusion. However, It should not replace echocardiography because it remains the “gold standard” for diagnosing or ruling out pericardial effusion. Conclusion: Technitium-99m based MPI is a sensitivet tool for detection of large pericardial effusion, where as its usage is questionable for small size effusion. Based on limited available literature on myocardial perfusion imaging for diagnosis of pericardila effusion, it is pivotal fpr a physician to be aware of such a rare finding of “swinging heart” on myocardial perfusion imaging. Further studies are recommended in order to comment on cardiac tamponade. Disclosure of Interest: None Declared
Methods: In a formal a review process, a Risk Assessment Work Group was composed by an interdisciplinary group (figure 1). The Work Group was asked to examine the scientific evidence on risk assessment for initial classification of heart disease in children and to develop an approach for quantitative risk assessment that could be used in practice. Then, continued with the development of a “theoretical construct” for the design of a scale of risk stratification for various adverse outcomes. Once obtained these variables, a computer platform will be made and the process of validation of the risk scale. By completing the sample number calculated, the bivariate and multivariate analysis will be performed to determine the prognostic weight (b coefficient) and statistical power of the variables involved. Results: A classification comprehensive and practical of the various cardiovascular diseases (congenital, incidents or prevalent) in childhood was realized. Also, the selection of variables that have higher prognostic value were selected and the scale risk stratification was made (figure 2). Conclusion: A scale of risk stratification long term for children with heart disease is required, it will allow direct health resources on prevention, early detection, care and rehabilitation late complications in these patients. Disclosure of Interest: None Declared
PS262 Toxic Metals and Metalloids Role in Aorta Coarctation Ethiopathogenesis O. Koval*1, I. Mokryk2, O. Mukvich1, G. Dubova3 Government Institution “Institute of Pediatric, Obstetrics and Gynecology of National Academy of Medical Science of Ukraine”, 2“Institute of Urgent and Recovery Surgery named after V.K. Gusak National Academy of Medical Science of Ukraine”, Kiev, 3Donetsk National Medical University n.a. M.Gorkiy, Donetsk, Ukraine 1
Introduction: There are about 30 metals and metalloids that are potentially toxic to humans. Some of them, according to the experimental data, able to penetrate the placental barrier and violent cardiogenesis. Objectives: investigate toxic metals and metalloids content in the biopsies of cardiovascular tissues of patients with CHD and children without cardiogenesis violation. Methods: We had divided children in 2 groups. In first group we had included 55 children (aged from 14 days to 17 years) and 2 fetus with various cardiovascular malformations. The second group - 24 children and fetuses without CHD, died from different reasons. All patients were examined by the spectral analysis of Al, Cd, Pb, Hg, Be, Ba, Tl, Bi, As, Ni, Sb, Sn, Sr, Ti, W, Zr, Ag, Li, B, Co, Si, V in intraoperative and autopsy biopsies of aorta coarctation (CoAo) locus (n¼16), other areas of aorta in children with CoAo (n¼12), aorta of patients with other malformations (n¼2), aorta of children without CHD (n¼24). Results: In the locus of aorta coarctation had revealed presence 8 toxic metals and metalloids, in other areas of aorta of patients with CoAo – 5, in aorta of children with other CHD – 5, in aorta of children without cardiogenesis violation – 4. Such toxic substances, as tungsten, silver, titanium have been documented only in the coarctation locus. In area of coarctation was detected pathological concentrations of aluminum, nickel, barium and lithium. The average concentration of aluminum 20.57 6.5 mg/kg, nickel 1.67 0.50 mg/kg, lithium 0.83 0.27 mg/kg, strontium 3.17 1.04 mg/kg was the highest in the CoAo locus, than in other aortic biopsies and statistically higher than in the aorta of children without CHD, p0.05.
GHEART Vol 11/2S/2016
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June, 2016
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POSTER/WCC_2016-POSTERS
e57
POSTER ABSTRACTS
Conclusion: Our results indicate possible role of tungsten, silver, titanium, barium, aluminum, lithium, nickel, strontium in cardiogenesis violation and ethiopathogenesis of aortic coarctation in children. Disclosure of Interest: None Declared PS263 Dependence on CHD Variant of Toxic Substances Content in Children Cardiovascular Tissue O. Koval*1, I. Mokryk2, O. Mukvich1, G. Dubova3 1 Government Institution “Institute of Pediatric, Obstetrics and Gynecology of National Academy of Medical Science of Ukraine”, 2“Institute of Urgent and Recovery Surgery named after V.K. Gusak National Academy of Medical Science of Ukraine”, Kiev, 3Donetsk National Medical University n.a. M.Gorkiy, Donetsk, Ukraine Introduction: Etiology of congenital heart disease remains unsolved problem of pediatric cardiology. There are about 30 metals and metalloids that are potentially toxic to humans. Some of them, according to the experimental data, able to penetrate the placental barrier and violent cardiogenesis by retardation of cardiac hystiocyte differentiation tempo, myofibrillogenesis changing and other. Objectives: investigate toxic metals and metalloids content in the biopsies of cardiovascular tissues of patients with different CHD variants. Methods: We had determined content of toxic substances in 107 biosubstrates of heart and great vessels of 55 patients with CHD: 34 boys and 21 girls in age from 14 days till 17 years. Among 31 CHD variants 17,7 % of patients had heart malformations, 22,6 % – great vessels, the combination of heart and vascular malformations – 59,7 %; simple defects – 21,8 %, combined (2 to 8 variants) – 78,2 %. All patients were examined by the spectral analysis of Al, Cd, Pb, Hg, Be, Ba, Tl, Bi, As, Ni, Sb, Sn, Sr, Ti, W, Zr, Ag, Li, B, Co, Si, V content in heart and great vessels tissue by methods of the atomic emission spectrometry in the inductively coupled plasma and atomic absorption spectrometry with electrothermal atomization. Results: the presence of 12 toxic metals and metalloids (Al, Ba, Li, Ni, As, Sr, Pb, Zr, Sn, Ti, Ag, W) was documented in the cardiovascular tissues of patients with severe combined CHD, compared with children who had simple defects (9 substances). The average concentration of Ni, W, Ti and Ag (p0,05) was higher in patients with two or more malformations compared with children who had one. The presence of 3 and more toxic metals in pathological concentrations had 31.8 % patients of complex combinative CHD, which were statistically significantly more higher than in patients with simple defects (7.1%), p < 0.05. The greater amount of toxic metals in pathological concentration and a high concentration of Ba, As, Pb, Ag, Ti, Zr, Sn was revealed in patients with combined defects (heart and great vessels) compared with patients with isolated heart or great vessel defects. Conclusion: Our results had determinate dependence on CHD complexity of toxic metals and metalloids quantity and concentration in cardiovascular tissue, that may indicate possible pathological impact of toxic substances on cardiogenesis violation in children. Disclosure of Interest: None Declared PS264 Prevalence of Congenital Heart Diseases Among Primary School Children in the Niger Delta of Nigeria, West Africa B. E. Otaigbe*1, P. N. Tabansi1, S. A. Ujambi1 1 Paediatrics, University Of Portharcourt Teaching Hospital, Portharcourt, Nigeria Introduction: Congenital heart diseases (CHD) are leading causes of childhood morbidity and mortality especially in developing countries. Community-based studies are important in ascertaining the burden of the disease. Objectives: The study was set out to determine the prevalence and types of CHD among primary school children in Port Harcourt Local Government Area (PHALGA) of Rivers State, Nigeria. Methods: A total of 1,712 primary school pupils were selected by multistage sampling from twelve schools in PHALGA. A questionnaire was used to obtain information from pupil’s parents on their child’s biodata and symptoms suggestive of heart disease. General physical and cardiovascular system examinations were carried out on each selected pupil, following confirmation of their cardiac status. Results: The 1,712 subjects were aged 5-14 (mean 8.482.30) years. 874 (51.1%) were females while males were 838 (48.9%). The study revealed that 31 pupils had congenital heart diseases confirmed by echocardiography, giving a prevalence of 18.1 per 1,000 pupils (1.81%). The commonest cardiac defects seen were acyanotic CHD in 30 (96.8%) pupils while cyanotic CHD was seen in only one (3.2%) pupil. Among the acyanotic CHD, atrial septal defects (83.9%) followed by ventricular septal defects (9.7%) were the commonest. CHD occurred with higher frequency among females (64.5%) and among the younger age group of 5-9 years (61.3%) though these were not statistically significant (p>0.005). Conclusion: Cardiac examination as part of compulsory health screening at primary school entry and exit will help detect children with CHD, reduce delay in diagnosis for intervention, avert debilitating morbidity and assure a better quality of life. Disclosure of Interest: None Declared
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PS265 Analysis of Atrioventicular Septal Defect in Children in the Niger Delta Region of Nigeria, West Africa B. E. Otaigbe*1, P. N. Tabansi1, S. A. Ujambi1 1 Paediatrics, University of Portharcourt Teaching Hospital, Portharcourt, Nigeria Introduction: Atrio-ventricular canal defect (AVCD ) accounts for 0-19 per 1000 live births and 2.9% of congenital heart diseases. It is one of the congenital heart disease most frequently associated with extracardiac, chromosomal and genetic anomalies. Depending on the pathologic anatomy of the malformation, the symptoms vary from asymptomatic in infancy to severe symptoms of heart failure accounting for high morbidity and mortality. The association of AVCD with Down syndrome have been extensively reported and there are few reports on AVCD in non-Downs syndrome and other genetic syndromes and none from Africa. Objectives: This was to determine the echocardiographic and demographic characteristics of AVCD patients and analyse the types of defect associated with the presence or absence of obvious phenotypic syndromes in children of the Niger Delta of Nigeria. Methods: It is a prospective study of children with AVCD seen over a 5 year period. Data on age, sex, birth order, maternal age, parity of mother, mode of conception, marital .status and detailed echocardiographic description of the defect was analysed. Results: Of the 35 patients analysed 16 (45.7%) were syndromic. Complete AVCD with common A-V valve was the commonest presentation in about 80% of both syndromic and nonsyndromic patients. There was a male preponderance in both groups and 16 (46%) had other associated cardiac anomalies (exclusive of common atrium) . Maternal age was higher in syndromic patients while most of the mothers were multiparous. Conclusion: That more than 50% of the cases of AVCD seen were in non syndromic cases in the Niger Delta is worrisome and more so because this an oil exploratory area with lots of environmental pollution and possible pollutants. Disclosure of Interest: None Declared
PS266 Detection of Congenital Cardiac Diseases, by Fetal Echocardiography, in Azerbaijan A. Petropoulos*1, A. Xudiyeva2, Q. Valiyeva2, V. Behbudov2, M. Imyilova3 Peditric Cardiology, Azerbijan Medical University, Merkezi Klinika, 2Peditric Cardiology, 3 Obtentric, Merkei klinika, Baku, Azerbaijan
1
Introduction: The incidence of Congenital Heart Disease (CHD) in large series, in Fetal life has never been studied in Azerbaijan. Objectives: Describe the incidence of CHD, detected by fetal echocardiography. Over 3 year experience from 3 centers in Baku. Methods: From August 2012 until October 2015 we studied, 489 fetuses. They were referred with the following indications: 1Surrogate parents (32.47%) 2Abnormal cardiac screening examination during the 20th week scans (22.27%) 3IVF fetuses, (15.14%) 4 Arrhythmias (7.50%), 5.History of CHD in the family (7.1%), 6. Combination of maternal age and increased nuchal translucency (7.60%) 7. Maternal Diabetes Mellitus (5.29%), 8. Others, including multiple spontaneous abortions, un- explained intra uterus death, possible congenital rubella infection and mother suffering from SLE (2.63%).Initial scans were done after the 21st week of gestation, with mean gestational age 22+/-7 weeks. The assessment was done using color Doppler, 2D echocardiography, by General Electric Vivid 7 device, with appropriate fetal software and probe. Findings were verified with echocardiography and MRI studies were indicated, post-natal, and postmortem examination in pregnancies that were interrupted. Results: We detected 99 CHD, (20.25%). Complex CDH: (72/71.71%). The rest (27/28.28%) were simple. Complex CHD: Tetralogy of Fallot (11/10.89%), Complete AV channels (10/10.89%), Simple TGA’s (10/ 10.89%), Double Outlet RV(7/6.93%), Tricuspid valve atresia(7/6.93%), combination of (pm)VSD with Aortic arch hypoplasia(6/5.94% and/or coarctation (5/4.95%), hypoplastic LV Syndrome (6/5.94%), complex VSD’s with Bicuspid Aortic valves (6/5.94%), Ebstein Anomaly(2/1.98%),congenitally corrected TGA with additional VSD (1 /0.99%), Trancus Arteriosus with a criss - cross, heart(1/0.99%). Simple defects: VSD’s (16/15.84% muscular (12), perimembranus (4), pulmonary (7/6.93%), aortic valve stenosis (4/3.96%). We detected (6) Fetal Arrhythmias. (2/33.3%), transient tachycardia’s, (3/50%), SVT requiring treatment and (1/16.7%) permanent (complete A-V block). Conclusion: This preliminary study addresses the incidence of CHD in Fetal life In Azerbaijan. As surgical services are currently limited, fetal echocardiography under the appropriate indications can achieve primary diagnosis of CHD and help in delivering the best quality of care. Disclosure of Interest: None Declared
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS
POSTER ABSTRACTS
Objectives: The objective is to discuss about a possible detection of large pericardial effusion on nuclear cardiac imaging. Thus far the “gold standard” for the diagnosis of pericardial effusion is the transthoracic echocardiogram. Large pericardial effusion may be diagnosed on nuclear cardiac imaging. Technitium-99m based MPI has a typical feature of diagnosing large pericardial effusion. Methods: A 39 years old gentle man was hospitalised after road traffic accident and sustained multiple injuries. A whole body scan revealed multipl injuries over anterior chest wall with large amount of fluid in pericardial space.Transthoracic echocardiogram confirms large pericardial effusion with cardiac tamponade and reduced ejection fraction. Pericardiocentesis was done and other injuries were taken care of accordingly. Subsequently, Technitium-99m scan was done to evaluate low ejection fraction and to look for any perfusion defect. However, finding on MPI ( Technitium-99m) scan revealed unusual “swinging movement” of heart with out any inducible ischemia. A lucent space around the heart suggestive of fluid collection. Results: An incidental finding of pericarial effusion can be diagnosed by myocardial perfusion imaging and is therefore important that physician be aware of this imaging modality, that is capable of diagnosing large pericardial effusion. However, It should not replace echocardiography because it remains the “gold standard” for diagnosing or ruling out pericardial effusion. Conclusion: Technitium-99m based MPI is a sensitivet tool for detection of large pericardial effusion, where as its usage is questionable for small size effusion. Based on limited available literature on myocardial perfusion imaging for diagnosis of pericardila effusion, it is pivotal fpr a physician to be aware of such a rare finding of “swinging heart” on myocardial perfusion imaging. Further studies are recommended in order to comment on cardiac tamponade. Disclosure of Interest: None Declared
Methods: In a formal a review process, a Risk Assessment Work Group was composed by an interdisciplinary group (figure 1). The Work Group was asked to examine the scientific evidence on risk assessment for initial classification of heart disease in children and to develop an approach for quantitative risk assessment that could be used in practice. Then, continued with the development of a “theoretical construct” for the design of a scale of risk stratification for various adverse outcomes. Once obtained these variables, a computer platform will be made and the process of validation of the risk scale. By completing the sample number calculated, the bivariate and multivariate analysis will be performed to determine the prognostic weight (b coefficient) and statistical power of the variables involved. Results: A classification comprehensive and practical of the various cardiovascular diseases (congenital, incidents or prevalent) in childhood was realized. Also, the selection of variables that have higher prognostic value were selected and the scale risk stratification was made (figure 2). Conclusion: A scale of risk stratification long term for children with heart disease is required, it will allow direct health resources on prevention, early detection, care and rehabilitation late complications in these patients. Disclosure of Interest: None Declared
PS262 Toxic Metals and Metalloids Role in Aorta Coarctation Ethiopathogenesis O. Koval*1, I. Mokryk2, O. Mukvich1, G. Dubova3 Government Institution “Institute of Pediatric, Obstetrics and Gynecology of National Academy of Medical Science of Ukraine”, 2“Institute of Urgent and Recovery Surgery named after V.K. Gusak National Academy of Medical Science of Ukraine”, Kiev, 3Donetsk National Medical University n.a. M.Gorkiy, Donetsk, Ukraine 1
Introduction: There are about 30 metals and metalloids that are potentially toxic to humans. Some of them, according to the experimental data, able to penetrate the placental barrier and violent cardiogenesis. Objectives: investigate toxic metals and metalloids content in the biopsies of cardiovascular tissues of patients with CHD and children without cardiogenesis violation. Methods: We had divided children in 2 groups. In first group we had included 55 children (aged from 14 days to 17 years) and 2 fetus with various cardiovascular malformations. The second group - 24 children and fetuses without CHD, died from different reasons. All patients were examined by the spectral analysis of Al, Cd, Pb, Hg, Be, Ba, Tl, Bi, As, Ni, Sb, Sn, Sr, Ti, W, Zr, Ag, Li, B, Co, Si, V in intraoperative and autopsy biopsies of aorta coarctation (CoAo) locus (n¼16), other areas of aorta in children with CoAo (n¼12), aorta of patients with other malformations (n¼2), aorta of children without CHD (n¼24). Results: In the locus of aorta coarctation had revealed presence 8 toxic metals and metalloids, in other areas of aorta of patients with CoAo – 5, in aorta of children with other CHD – 5, in aorta of children without cardiogenesis violation – 4. Such toxic substances, as tungsten, silver, titanium have been documented only in the coarctation locus. In area of coarctation was detected pathological concentrations of aluminum, nickel, barium and lithium. The average concentration of aluminum 20.57 6.5 mg/kg, nickel 1.67 0.50 mg/kg, lithium 0.83 0.27 mg/kg, strontium 3.17 1.04 mg/kg was the highest in the CoAo locus, than in other aortic biopsies and statistically higher than in the aorta of children without CHD, p0.05.
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS
e57
POSTER ABSTRACTS
Conclusion: Our results indicate possible role of tungsten, silver, titanium, barium, aluminum, lithium, nickel, strontium in cardiogenesis violation and ethiopathogenesis of aortic coarctation in children. Disclosure of Interest: None Declared PS263 Dependence on CHD Variant of Toxic Substances Content in Children Cardiovascular Tissue O. Koval*1, I. Mokryk2, O. Mukvich1, G. Dubova3 1 Government Institution “Institute of Pediatric, Obstetrics and Gynecology of National Academy of Medical Science of Ukraine”, 2“Institute of Urgent and Recovery Surgery named after V.K. Gusak National Academy of Medical Science of Ukraine”, Kiev, 3Donetsk National Medical University n.a. M.Gorkiy, Donetsk, Ukraine Introduction: Etiology of congenital heart disease remains unsolved problem of pediatric cardiology. There are about 30 metals and metalloids that are potentially toxic to humans. Some of them, according to the experimental data, able to penetrate the placental barrier and violent cardiogenesis by retardation of cardiac hystiocyte differentiation tempo, myofibrillogenesis changing and other. Objectives: investigate toxic metals and metalloids content in the biopsies of cardiovascular tissues of patients with different CHD variants. Methods: We had determined content of toxic substances in 107 biosubstrates of heart and great vessels of 55 patients with CHD: 34 boys and 21 girls in age from 14 days till 17 years. Among 31 CHD variants 17,7 % of patients had heart malformations, 22,6 % – great vessels, the combination of heart and vascular malformations – 59,7 %; simple defects – 21,8 %, combined (2 to 8 variants) – 78,2 %. All patients were examined by the spectral analysis of Al, Cd, Pb, Hg, Be, Ba, Tl, Bi, As, Ni, Sb, Sn, Sr, Ti, W, Zr, Ag, Li, B, Co, Si, V content in heart and great vessels tissue by methods of the atomic emission spectrometry in the inductively coupled plasma and atomic absorption spectrometry with electrothermal atomization. Results: the presence of 12 toxic metals and metalloids (Al, Ba, Li, Ni, As, Sr, Pb, Zr, Sn, Ti, Ag, W) was documented in the cardiovascular tissues of patients with severe combined CHD, compared with children who had simple defects (9 substances). The average concentration of Ni, W, Ti and Ag (p0,05) was higher in patients with two or more malformations compared with children who had one. The presence of 3 and more toxic metals in pathological concentrations had 31.8 % patients of complex combinative CHD, which were statistically significantly more higher than in patients with simple defects (7.1%), p < 0.05. The greater amount of toxic metals in pathological concentration and a high concentration of Ba, As, Pb, Ag, Ti, Zr, Sn was revealed in patients with combined defects (heart and great vessels) compared with patients with isolated heart or great vessel defects. Conclusion: Our results had determinate dependence on CHD complexity of toxic metals and metalloids quantity and concentration in cardiovascular tissue, that may indicate possible pathological impact of toxic substances on cardiogenesis violation in children. Disclosure of Interest: None Declared PS264 Prevalence of Congenital Heart Diseases Among Primary School Children in the Niger Delta of Nigeria, West Africa B. E. Otaigbe*1, P. N. Tabansi1, S. A. Ujambi1 1 Paediatrics, University Of Portharcourt Teaching Hospital, Portharcourt, Nigeria Introduction: Congenital heart diseases (CHD) are leading causes of childhood morbidity and mortality especially in developing countries. Community-based studies are important in ascertaining the burden of the disease. Objectives: The study was set out to determine the prevalence and types of CHD among primary school children in Port Harcourt Local Government Area (PHALGA) of Rivers State, Nigeria. Methods: A total of 1,712 primary school pupils were selected by multistage sampling from twelve schools in PHALGA. A questionnaire was used to obtain information from pupil’s parents on their child’s biodata and symptoms suggestive of heart disease. General physical and cardiovascular system examinations were carried out on each selected pupil, following confirmation of their cardiac status. Results: The 1,712 subjects were aged 5-14 (mean 8.482.30) years. 874 (51.1%) were females while males were 838 (48.9%). The study revealed that 31 pupils had congenital heart diseases confirmed by echocardiography, giving a prevalence of 18.1 per 1,000 pupils (1.81%). The commonest cardiac defects seen were acyanotic CHD in 30 (96.8%) pupils while cyanotic CHD was seen in only one (3.2%) pupil. Among the acyanotic CHD, atrial septal defects (83.9%) followed by ventricular septal defects (9.7%) were the commonest. CHD occurred with higher frequency among females (64.5%) and among the younger age group of 5-9 years (61.3%) though these were not statistically significant (p>0.005). Conclusion: Cardiac examination as part of compulsory health screening at primary school entry and exit will help detect children with CHD, reduce delay in diagnosis for intervention, avert debilitating morbidity and assure a better quality of life. Disclosure of Interest: None Declared
e58
PS265 Analysis of Atrioventicular Septal Defect in Children in the Niger Delta Region of Nigeria, West Africa B. E. Otaigbe*1, P. N. Tabansi1, S. A. Ujambi1 1 Paediatrics, University of Portharcourt Teaching Hospital, Portharcourt, Nigeria Introduction: Atrio-ventricular canal defect (AVCD ) accounts for 0-19 per 1000 live births and 2.9% of congenital heart diseases. It is one of the congenital heart disease most frequently associated with extracardiac, chromosomal and genetic anomalies. Depending on the pathologic anatomy of the malformation, the symptoms vary from asymptomatic in infancy to severe symptoms of heart failure accounting for high morbidity and mortality. The association of AVCD with Down syndrome have been extensively reported and there are few reports on AVCD in non-Downs syndrome and other genetic syndromes and none from Africa. Objectives: This was to determine the echocardiographic and demographic characteristics of AVCD patients and analyse the types of defect associated with the presence or absence of obvious phenotypic syndromes in children of the Niger Delta of Nigeria. Methods: It is a prospective study of children with AVCD seen over a 5 year period. Data on age, sex, birth order, maternal age, parity of mother, mode of conception, marital .status and detailed echocardiographic description of the defect was analysed. Results: Of the 35 patients analysed 16 (45.7%) were syndromic. Complete AVCD with common A-V valve was the commonest presentation in about 80% of both syndromic and nonsyndromic patients. There was a male preponderance in both groups and 16 (46%) had other associated cardiac anomalies (exclusive of common atrium) . Maternal age was higher in syndromic patients while most of the mothers were multiparous. Conclusion: That more than 50% of the cases of AVCD seen were in non syndromic cases in the Niger Delta is worrisome and more so because this an oil exploratory area with lots of environmental pollution and possible pollutants. Disclosure of Interest: None Declared
PS266 Detection of Congenital Cardiac Diseases, by Fetal Echocardiography, in Azerbaijan A. Petropoulos*1, A. Xudiyeva2, Q. Valiyeva2, V. Behbudov2, M. Imyilova3 Peditric Cardiology, Azerbijan Medical University, Merkezi Klinika, 2Peditric Cardiology, 3 Obtentric, Merkei klinika, Baku, Azerbaijan
1
Introduction: The incidence of Congenital Heart Disease (CHD) in large series, in Fetal life has never been studied in Azerbaijan. Objectives: Describe the incidence of CHD, detected by fetal echocardiography. Over 3 year experience from 3 centers in Baku. Methods: From August 2012 until October 2015 we studied, 489 fetuses. They were referred with the following indications: 1Surrogate parents (32.47%) 2Abnormal cardiac screening examination during the 20th week scans (22.27%) 3IVF fetuses, (15.14%) 4 Arrhythmias (7.50%), 5.History of CHD in the family (7.1%), 6. Combination of maternal age and increased nuchal translucency (7.60%) 7. Maternal Diabetes Mellitus (5.29%), 8. Others, including multiple spontaneous abortions, un- explained intra uterus death, possible congenital rubella infection and mother suffering from SLE (2.63%).Initial scans were done after the 21st week of gestation, with mean gestational age 22+/-7 weeks. The assessment was done using color Doppler, 2D echocardiography, by General Electric Vivid 7 device, with appropriate fetal software and probe. Findings were verified with echocardiography and MRI studies were indicated, post-natal, and postmortem examination in pregnancies that were interrupted. Results: We detected 99 CHD, (20.25%). Complex CDH: (72/71.71%). The rest (27/28.28%) were simple. Complex CHD: Tetralogy of Fallot (11/10.89%), Complete AV channels (10/10.89%), Simple TGA’s (10/ 10.89%), Double Outlet RV(7/6.93%), Tricuspid valve atresia(7/6.93%), combination of (pm)VSD with Aortic arch hypoplasia(6/5.94% and/or coarctation (5/4.95%), hypoplastic LV Syndrome (6/5.94%), complex VSD’s with Bicuspid Aortic valves (6/5.94%), Ebstein Anomaly(2/1.98%),congenitally corrected TGA with additional VSD (1 /0.99%), Trancus Arteriosus with a criss - cross, heart(1/0.99%). Simple defects: VSD’s (16/15.84% muscular (12), perimembranus (4), pulmonary (7/6.93%), aortic valve stenosis (4/3.96%). We detected (6) Fetal Arrhythmias. (2/33.3%), transient tachycardia’s, (3/50%), SVT requiring treatment and (1/16.7%) permanent (complete A-V block). Conclusion: This preliminary study addresses the incidence of CHD in Fetal life In Azerbaijan. As surgical services are currently limited, fetal echocardiography under the appropriate indications can achieve primary diagnosis of CHD and help in delivering the best quality of care. Disclosure of Interest: None Declared
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS