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Heart, Lung and Circulation Abstracts S1952008;17S:S1–S209

463Cardiac Magnetic Resonance Imaging (MRI) Prior toCompletion of Bidirectional Cavopulmonary Connection(BCPC) in Hypoplastic Left Heart Syndrome (HLHS)

Bryn Jones 1,2,3,∗, Daniel Penny 1,2,3, Yves d’Udekem 1,2,4,Christian Brizard 1,2,4, Michael Cheung 1,2,3

1 Australian and New Zealand Heart Research Centre, Mur-doch Children’s Research Institute, Melbourne, Australia;2 Department of Paediatrics, University of Melbourne, Mel-bourne, Australia; 3 Department of Cardiology, RoyalChildren’s Hospital, Melbourne, Australia; 4 Department ofCardiac Surgery, Royal Children’s Hospital, Melbourne, Aus-tralia

Introduction: Routine pre-operative assessment of chil-dren with HLHS undergoing BCPC has traditionallyconsisted of echocardiography and cardiac catheterisa-tion. Because elevated pulmonary vascular resistance inthis group is unusual and not predictive of mortalityour unit changed to echocardiography and cardiac MRIin 2006. We sought to analyse post-operative outcomesbefore and after this change.Methods: Children with HLHS who underwent BCPCbetween January 2004 and December 2007 were iden-tified from the cardiac surgical database. Data werecollected regarding pre-operative findings and post-operative course.Rcp9biiwiiMtaOHsCHtsctp

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464What Effect Does Prenatal Diagnosis of SignificantCongenital Heart Disease Have on Maternal–InfantAttachment and Infant Development?

Jenny Re 1,2, Amichay Rotstein 1,2,∗, Samuel Menahem 1,2,Andrew Cochrane 1,2, Suzanne Dean 1,2

1 Fetal Cardiac Unit, Monash Cardiovascular Research Cen-ter, MonahsHEART, Southern Health & Department ofMedicine(MMC), Monash University, Melbourne, Victoria,Australia; 2 Departments of Cardiology and Cardiac Surgery,Royal Children’s Hospital, Melbourne, Victoria, Australia

Background: Congenital heart defect (CHD) includes lifethreatening lesions, which may require ongoing treatmentand multiple surgical procedures. Advances in diagnostictechniques have led to significant CHD being increasinglydiagnosed prenatally. Most infants now survive the initialsurgery, carried out in early infancy with outcomes thatvary from complete ‘cure’, the need for further surgery, orlong-term palliation.Attachment theory has generated research measures forexamining the nature of the parent–infant relationship,and allows evaluation of the emotional impact of thetiming of the diagnosis of significant CHD upon this rela-tionshipStudy aims and design: This qualitative study aims to dis-cover patterns of lived experience in mothers and infantswetMaqvRpltaMTemss

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esults: Thirty-nine patients were identified—atheterisation (n = 21), MRI (n = 18). Catheterisationatients were older at BCPC (114.9 ± 22.7 days vs.4.8 ± 11 days; p-value 0.002), with no other difference inaseline data. Two patients required CPR during catheter-

sation; with no adverse events during MRI. Anatomicalnformation obtained in both groups correlated well

ith surgical findings. Perioperative course was similarncluding cardiopulmonary bypass time, ventilation time,notrope score, CVP and ICU stay. One patient in the

RI group required LVAD support post-operatively. Inhe catheter group two patients required further surgerynd three catheter intervention within 1 month of BCPC.ne patient required further surgery in the MRI group.ospital stay and discharge oxygen saturations were

imilar.onclusions: We have demonstrated that in patients withLHS cardiac MRI can safely provide detailed func-

ional and anatomical information prior to BCPC withimilar post-operative course and outcomes to cardiacatheterisation. Catheterisation has a continued role inhe management of residual obstructive lesions within theulmonary arteries and aortic arch.

oi:10.1016/j.hlc.2008.05.464

here there is a diagnosis of a significant CHD, and toxplore whether different patterns emerge in relation tohe timing of the diagnosis, prenatally versus postnatally.

aternal–infant attachment will be studied when infantsre 2 and 9 months of age with maternal interview anduestionnaires, and infant observation. The surgical inter-ention and medical outcome will be noted and analysed.esults: To date, 14 infants diagnosed prenatally and 13ostnatally, have been reviewed at age 2 months. Pre-

iminary data indicates that a prenatal diagnosis leadso anticipatory management of the pregnancy, deliverynd postnatal infant medical and surgical interventions.aternal anxiety and stress is high for both subgroups.

he maternal interviews suggest their lived experi-nce is infused with trauma, placing stresses on theother–infant relationship, with differences between the

ubgroups, which may influence the infant’s developmenttill to be determined.

oi:10.1016/j.hlc.2008.05.465

65itfalls and Limitations of Prenatal Cardiac Diagnosis and

ts Predictive Value on the Infant’s Outcome

michay Rotstein ∗, Samuel Menahem, Paul Shekleton

Fetal Cardiac Unit, Monash Cardiovascular Research Center,onash HEART, Southern Health & Department of Medicine

MMC), Monash University, Melbourne, Victoria, Australia

ntroduction: Advances in ultrasound have led to increas-ngly accurate cardiac prenatal diagnoses, allowing fornticipatory management of the pregnancy and infant.