Volume 21 Number 1, January-June 2016
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ISSN 0118-9034 Philippine Heart Center Journal Vol. 21 No. 1 January - June 2016 Editorial Lessons from Galapagos Gilbert C. Vilela, MD Consultant’s Corner Comparison of the New Mayo Clinic Risk Scores and Clinical SYNTAX Score in Predicting Adverse Cardiovascular Outcomes Following Percutaneous Coronary Intervention at the Philippine Heart Center Helenne Joie M. Brown, MD; James O. Ho Khe Sui, MD; Catherine C. Tan, MD; Vergel A. Quiogue, MD Original Articles Effectiveness of an Accelerated Phase II as Compared to the Comparison of the Clinical Outcome and Cost of Transcatheter Standard Cardiac Rehabilitation Program in Improving Exercise Device Occlusion and Surgical Closure of Isolated Ventricular Capacity and Quality of Life Septal Defect Benjamin Jose C. Quito, MD; Marcelo R. Esguerra, MD; Leandro Bernadette B. Valdez, MD; Juan C. Reganion, MD; Jean Antonio C. Bongosia, MD; Edgardo E. Ebba, MD G. Villareal, MD; Juliet J. Balderas, MD Association of Nutritional Status using Mini-Nutritional Assessment The Clinical and Procedural Outcome of Patients Undergoing Trans- ® Radial Approach vs. Trans-Femoral Approach in Percutaneous Short Form (MNA -SF) with Risk of Exacerbation Among Elderly Coronary Intervention COPD Patients Phillip C. Ines, MD; Norberto A. Tuaño, MD; James O. Ho Khe Sui, Peter Ian B. Tabar, MD; Aileen Guzman-Banzon, MD; Ma. Encarnita- MD; Noe A. Babilonia, MD Blanco-Limpin, MD A Cohort Study on the Use of Absorbable Sutures vs. Steel Wires in Association of Door-to-Balloon Time with Clinical Outcomes in Post- Sternal Closure in Pediatric Patients after Cardiovascular Surgery: Primary Percutaneous Coronary Intervention Patients a Philippine Heart Center experience Ed D. Gabitoya, MD; Jona Maria R. Mandap, MD Jay F. Alejandre, MD; Reynante T. Gamponia, MD; Karyn P. Luna, MD Outcome of Pediatric Patients Who Underwent Tetralogy of Fallot Correction in Relation to the Surgical Technique Used in Relieving The Correlation of Epicardial Adipose Tissue Thickness and Right Ventricular Outflow Obstruction Radiodensity with CT Coronary Artery Calcium Score Lorielyn G. Mandigma, MD; Bernadette Azcueta, MD; Juliet B. Kristine Ivy A. Riel, MD; Harold L. Tan, MD; Carolina A. Drilon, MD Balderas, MD; Corazon A. Estevanez, MD Prognostic Value of Coronary Flow Reserve by Dipyridamole SPECT Sestamibi Imaging in Predicting Future Cardiac Events Deverly D. Tumapon, MD; Jerry M. Obaldo, MD Case Report Hyperthrophic Cardiomyopathy with Absent Major Septal Perforator Intralobar and Extralobar Pulmonary Sequestration with Scimitar Coronary Artery Successfully Treated with Dual Chamber Pacing Syndrome: a complex variant as an Alternate Strategy to Alcohol Septal Ablation and Surgical Annalee de Leon-Manalo, MD; Dulce Requiron-Sy, MD; Ernesto Myectomy Z. Salvador, Jr., MD Bernard Benjamin P. Albano, MD; Erdie C. Fadreguilan, MD; Ed D. Gabitoya, MD; Jeffrey M. Chua, MD; James Ho Khe Sui, MD; Anesthesia for a Patient with Large Left Anterior Mediastinal Ana Beatrice Medrano, MD Tumor: a case report. Catherine Y. Gonzales-Duazo, MD Official Publication of the Philippine Heart Center PHILIPPINE HEART CENTER JOURNAL TABLE OF CONTENTS Volume 21 # 1 January-June, 2016 Editorial Lessons from Galapagos iii Gilbert C. Vilela, MD Consultant’s Corner Comparison of the New Mayo Clinic Risk Scores and : 1 Clinical SYNTAX Score in Predicting Adverse Cardiovascular Outcomes Following Percutaneous Coronary Intervention at the Philippine Heart Center Helenne Joie M. Brown, MD; James O. Ho Khe Sui, MD; Catherine C. Tan, MD; Vergel A. Quiogue, MD Original Articles Effectiveness of an Accelerated Phase II as Compared to the 10 Standard Cardiac Rehabilitation Program in Improving Exercise Capacity and Quality of Life Benjamin Jose C. Quito, MD; Marcelo R. Esguerra, MD; Leandro C. Bongosia, MD; Edgardo E. Ebba, MD The Clinical and Procedural Outcome of Patients 18 Undergoing Trans-Radial Approach vs. Trans-Femoral Approach in Percutaneous Coronary Intervention Phillip C. Ines, MD; Norberto A. Tuaño, MD; James O. Ho Khe Sui, MD; Noe A. Babilonia, MD Association of Door-to-Balloon Time with Clinical 26 Outcomes in Post-Primary Percutaneous Coronary Intervention Patients Ed D. Gabitoya, MD; Jona Maria R. Mandap, MD Outcome of Pediatric Patients Who Underwent Tetralogy of Fallot 33 Correction in relation to the Surgical Technique Used in Relieving Right Ventricular Outflow Obstruction Lorielyn G. Mandigma, MD; Bernadette Azcueta, MD; Juliet B. Balderas, MD; Corazon A. Estevanez, MD Comparison of the Clinical Outcome and Cost of Transcatheter 41 Device Occlusion and Surgical Closure of Isolated Ventricular Septal Defect Bernadette B. Valdez, MD; Juan C. Reganion, MD; Jean Antonio G. Villareal, MD; Juliet J. Balderas, MD Association of Nutritional Status using Mini-Nutritional 47 Assessment Short Form (MNA®-SF) with Risk of Exacerbation Among Elderly COPD Patients Peter Ian B. Tabar, MD; Aileen Guzman-Banzon, MD; Ma. Encarnita-Blanco-Limpin, MD i A Cohort Study on the Use of Absorbable Sutures 53 vs. Steel Wires in Sternal Closure in Pediatric Patients After Cardiovascular Surgery: a Philippine Heart Center experience Jay F. Alejandre, MD; Reynante T. Gamponia, MD; Karyn P. Luna, MD The Correlation of Epicardial Adipose Tissue Thickness 58 and Radiodensity with CT Coronary Artery Calcium Score Kristine Ivy A. Riel, MD; Harold L. Tan, MD; Carolina A. Drilon, MD Prognostic Value of Coronary Flow Reserve by Dipyridamole 63 SPECT Sestamibi Imaging in Predicting Future Cardiac Events Deverly D. Tumapon, MD; Jerry M. Obaldo, MD Case Reports Hyperthrophic Cardiomyopathy with Absent Major Septal 72 Perforator Coronary Artery Successfully Treated with Dual Chamber Pacing as an Alternate Strategy to Alcohol Septal Ablation and Surgical Myectomy Bernard Benjamin P. Albano, MD; Erdie C. Fadreguilan, MD; Ed D. Gabitoya, MD; Jeffrey M. Chua, MD; James Ho, MD; Ana Beatrice Medrano, MD Intralobar and Extralobar Pulmonary Sequestration 79 with Scimitar Syndrome: a complex variant Annalee de Leon-Manalo, MD; Dulce Requiron-Sy, MD; Ernesto Z. Salvador, Jr., MD Anesthesia for a Patient with Large Left Anterior Mediastinal 85 Tumor: a case report Catherine Y. Gonzales-Duazo, MD Information for subscribers iv Information for authors v ii Editorial “ Lessons from Galapagos ” Gilbert C. Vilela, MD Change, although painful to most, is always good. Constant change is an essen- tial part of nature. It is the foundation of moment to moment evolution. It is the gateway to progress. It defines life, and is the secret of existence. Change is the generator of evolution and dictates survival of the specie. Someone said that most things we learned from the school were wrong. Contextually, probably those things were correct then. As time ages us, we usually know better. We know better becaue of experience and studying the facts. In this context, research shapes our experienced then shapes our present truths. Ethics and the need to serve to the utmost usually drive medical practice. The papers of Benjamin C. Quito et al, Philip C. Ines et al, Ed D. Gabitoya et al, Bernadette B. Valdez et al, are fine examples. You’ll read that there is something better than what we used to do. For decades, our Percutaneous Coronary Interventions were done through Trans-Femoral Approach. The paper of Philip Ines et al, says that Trans-Radial Approach is better, outcomes-wise and cost-wise. Bernadette Valdez et al, showed in their paper that Trans- catheter Device Occlusion of Isolated Ventricular Septal Defect is a finer alternative as compared to surgical closure. Helenne Brown et al, revealed in their paper that the newer risk scoring system for predicting adverse cardiovascular outcomes after PCI is better than the SYNTAX Score. These few examples written in the pages of this journal declare that research is driving the improvement of our delivery of health solutions. The contents of this journal disclose that there is something better than what we used to do and there is evidence for it. This journal, the Philippine Heart Center, symbolizes the dreams and aspirations of the men and women who compose the institution. This journal is the proof that research is the driver to better management. Evidence-based medicine is the foundation of ethical and outstanding cardiovascular care. I hope you enjoy this issue. iii Consultant’s Corner Comparison of the New Mayo Clinic Risk Scores and Clinical SYNTAX Score in Predicting Adverse Cardiovascular Outcomes Following Percutaneous Coronary Intervention at the Philippine Heart Center Helenne Joie M. Brown, MD; James O. Ho Khe Sui, MD; Catherine C. Tan, MD; Vergel A. Ouiogue, MD Background --- Risk stratification of patients who will undergo percutaneous coronary intervention (PCI) can help physicians, patients and their families understand the risks of the procedure, thus providing an objective basis for decision-making. This study was done to compare the prognostic value of the Clinical SYNTAX Score (CSS) and New Mayo Clinic Risk Scores (NMCRS) for in-hospital and 30-day mortality and major adverse cardiovascular and cerebrovascular events (MACCE) following PCI. Method --- This is a prospective cohort study. The NMCRS for Predicting Mortality, NMCRS for Predicting MACE and CSS of all patients who underwent PCI at the Philippine Heart Center from April 1, 2011 to September 30, 2011 were computed. Patients were followed up for in-hospital and 30-day mortality and major adverse cardiovascular and cerebrovascular events (MACCE) following PCI. Results --- Of the 482 patients