G169(P) Exploring ethnic variation in infants with congenital heart defects undergoing paediatric cardiac surgery

Abstract

Conclusion Incidence of chest pain presenting to our ED was 1%. The commonest recorded cause was musculoskeletal. Fewer than 1% had a possible cardiac aetiology for chest pain. ECG is a useful test for children presenting with chest pain. Very few patients with mild ST elevation had cardiac enzyme levels checked. Aims The antenatal diagnosis of congenital heart diseases (CHD) is crucial for fetal and perinatal management; however, there is little in literature regarding the pharmacologic intervention for fetal CHD in Egypt. Therefore, we attempted to detect fetal cardiac structural or functional abnormalities using fetal echocardiography and plan fetal pharmacologic intervention without endangering the mother's life. Methods Cases fulfilled inclusion criteria were diagnosed using detailed fetal Echocardiographic examinations and antenatal treatment was described if indicated after a written consent. Cardiovascular profile score (CVPS) was used to assess the response to treatment. Postnatal transthoracic Echo was done to confirm diagnosis with follow up till the end of neonatal period to determine outcome. Results Fetuses fulfilled inclusion criteria were 143 with a mean gestational age at diagnosis 27.59 ± 5.41 weeks, mean maternal age at diagnosis was 26.64 ± 5.428 years, the most frequent cause of referral was family history of CHD (34.1%). Twenty fetuses (14%) received antenatal therapy. Fetuses with heart failure due to structural cardiac defects (n = 4) and functional non arrhythmic heart failure (n = 8) received digoxin while cases with fetal tachyarrhythmia (n = 6) received digoxin and/or sotalol or flecainide and fetuses with immune mediated fetal heart block (n = 2) received dexamethazone. Success in tachyarrhythmia was statistically significant regarding CVPS (p = 0.038) and heart rate changes (p = 0.002) but statistically insignificant regarding CVPS in structural defects (p = 0.102) and nonarrhythmic functional heart failure (p = 0.343). Conclusion Antenatal cardiac pharmacologic intervention is possible with hydrops fetalis reversal in fetal tachyarrhythmia and resolution of first degree immune mediated atrioventricular block. On the contrary, no response to antenatal digoxin use in fetal structural heart failure and limited response in non-arrhythmic functional heart failure. G168(P)ANTENATAL G169(P) EXPLORING ETHNIC VARIATION IN INFANTS WITHCONGENITAL HEART DEFECTS UNDERGOING PAEDIATRIC CARDIAC SURGERY Introduction North American researchers have reported ethnic differences in the prevalence and short-term outcomes of congenital heart defects (CHDs), which may reflect genetic variation, environmental exposures or healthcare access. It is unclear whether ethnic differences in CHD frequency and outcomes also exist in the UK population and healthcare system. Aim To examine national paediatric cardiac surgical audit data for ethnic differences in the frequency of different CHD subtypes, associated comorbidities and short-term outcomes for infants operated in the first year of life. Methods Individual...

G168(P) Antenatal management of fetal cardiac diseases, a single centre experience in egypt

“…CONGENITAL HEART DEFECTS UNDERGOING PAEDIATRIC CARDIAC SURGERY 1 RL Knowles, 1 D Ridout, 2 S Crowe, 3 J Tregay, 3 J Wray, 4 D Barron, 5 D Cunningham, 6 Introduction North American researchers have reported ethnic differences in the prevalence and short-term outcomes of congenital heart defects (CHDs), which may reflect genetic variation, environmental exposures or healthcare access. It is unclear whether ethnic differences in CHD frequency and outcomes also exist in the UK population and healthcare system.…”

G170(P) Improving antenatal detection rates of significant congenital cardiac lesions in a district general hospital

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