Journal of the Egyptian Society of Cardio-Thoracic Surgery最新文献

{"title":"The fate of untreated moderate rheumatic aortic valve incompetence after mitral valve surgery: A one-year follow-up study","authors":"Ahmed A. Faragalla ,&nbsp;Azza Katta ,&nbsp;Hassan Ezeldien ,&nbsp;Hani A. Ibrahim","doi":"10.1016/j.jescts.2017.08.002","DOIUrl":"10.1016/j.jescts.2017.08.002","url":null,"abstract":"<div><h3>Background</h3><p>Most of the previous studies agreed that the moderate aortic Regurgitation (AR) has a slow progression over a very long period of time. There is no major consensus on how to deal with concomitant moderate rheumatic AR during mitral valve surgery. The current work evaluates the course of untreated moderate rheumatic AR following mitral valve surgery over a period of 1 year.</p></div><div><h3>Methods</h3><p>We prospectively enrolled 30 patients who had moderate rheumatic AR associated with pure rheumatic mitral stenosis in 15 patients (group S) and 15 patients with pure rheumatic mitral incompetence (group R). Quantification of the degree of the AR was done by echocardiography using the percentage of the width of the regurgitant get to the width of the left ventricular outflow tract (LVOT) method. Clinical and echocardiographic follow-up were done over 1 year.</p></div><div><h3>Results</h3><p>There were no early or late postoperative deaths and we achieved 100% follow-up. No patient had aortic valve replacement (AVR) after one year. Preoperatively, the width of the regurgitant jet was 34.67 ± 2.72% and 35.73 ± 1.87% in group S and group R respectively with no statistically significant difference (p = 0.22). Postoperatively after 1 year follow up the width of the regurgitant jet in group S increased significantly to 37.27 ± 4.67% (p = 0.005), while in group R almost remained unchanged 34.73 ± 4.13% (p = 0.3). However. both figures are still in the moderate category between (≥25 to ≤64%).</p></div><div><h3>Conclusions</h3><p>After 1-year follow-up, the moderate rheumatic AR didn't increase to the severe category necessitating AVR. Longer follow-up duration is recommended.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 236-241"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74046191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of ascorbic acid in reduction of the incidence of the atrial fibrillation in patients under B-blocker and undergoing coronary artery bypass graft operation in early post-operative period","authors":"Mohammed K. Alshafey MD ,&nbsp;Hany M. Elrakhawy MD ,&nbsp;Moataz E. Rezk MD ,&nbsp;Hani M. Moustafa MSC","doi":"10.1016/j.jescts.2017.04.003","DOIUrl":"10.1016/j.jescts.2017.04.003","url":null,"abstract":"<div><h3>Background</h3><p>The study was done to project the important role of the anti-inflammatory and anti –oxidant properties of Ascorbic acid (vitamin C) in reducing the incidence of atrial fibrillation (AF) in the early post-operative period after coronary artery bypass graft operation (CABG).</p></div><div><h3>Methods</h3><p>This prospective randomized study included 100 patients admitted to cardio-thoracic surgery department, Benha University Hospital, Benha, Egypt between 2011 and 2016. Those patients scheduled for CABG, were randomized into two groups of patients: the first; group 1: A fifty CABG patients were given β -blocker (bisoprolol 5 mg o.d.) &amp; ascorbic acid (2 g daily in divided doses qds) for at least three days pre-operatively. The second; group 2: A fifty CABG patients were given β -blocker (bisoprolol 5 mg o.d.) for at least three days pre-operatively. Patients were followed up for AF after (CABG) for the short term of 3 weeks.</p></div><div><h3>Results</h3><p>The incidence of AF after CABG in1st 48 h and after 1 month was statistically significantly lower in Group 1 than Group 2 with p value 0.022 and 0.025 respectively. Intensive care unit stay, need for inotropic support and ventilator stay were also significantly decreased in Group1 than Group 2 with p value 0.035, 0.045 and 0.048 respectively.</p></div><div><h3>Conclusions</h3><p>The incidence of post CABG AF, intensive care unit stay, need for inotropic support and ventilator stay were decreased by patients intake of vitamin C in combination with β -blockers pre-operatively.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 198-203"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87785132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of obesity on early cardiac surgical outcomes in Egypt׃ Early outcomes of coronary artery bypass graft surgery","authors":"Amany G. Abdallah,&nbsp;Mostafa A. Elnewihy,&nbsp;Alaa I. Brik,&nbsp;Abdel Megeed M. Salem","doi":"10.1016/j.jescts.2017.08.001","DOIUrl":"10.1016/j.jescts.2017.08.001","url":null,"abstract":"<div><h3>Background</h3><p>Obesity is a great burden in developing countries as Egypt due to limited resources of health care services. More than one third of Egyptians are obese. Coronary artery bypass graft surgery (CABG) is necessary for many of them. The objective of this study was to investigate the association between obesity and post-CABG morbidity and mortality in Egyptian patients.</p></div><div><h3>Methods</h3><p>This prospective study was conducted on 162 patients indicated for isolated CABG in Zagazig Univeristy Hospitals and El Ahrar Hospital. The patients were classified into two groups according to Body mass index (BMI) ≥ 30 (obese, group 1, n = 81) and BMI˂ &lt; 30 (non-obese, group 2, n = 81). In-hospital and after 6 months morbidity and mortality rates were compared between both groups.</p></div><div><h3>Results</h3><p>A total of 162 patients (35 females) with a mean age of 54 ± 8.5 years (range = 33–70 years), mean BMI of group 1 and group 2, (34.2 ± 3.9) and (26.5 ± 1.9) respectively with range = 23–44.4 were included. Saphenous vein harvest (SVH) site infection, intensive care unit (ICU) and in-hospital stay were significantly increased in patients with BMI ≥ 30 with (p value = 0.025, 0.02, 0.04) respectively.</p></div><div><h3>Conclusions</h3><p>Obesity is associated with SVH site infection and long ICU and in-hospital stays but not associated with other morbidity or mortality by the sixth post-operative month.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 192-197"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81774124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical valve at pulmonary site in adult TOF & absent pulmonary valve","authors":"Aayush Goyal,&nbsp;Rohit Shahapurkar,&nbsp;Balaji Aironi","doi":"10.1016/j.jescts.2017.06.002","DOIUrl":"10.1016/j.jescts.2017.06.002","url":null,"abstract":"<div><p>Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease. Tetralogy of Fallot (TOF) with APVS is a rare variation of TOF. These patients are commonly cyanotic at birth. Respiratory complaints predominate due to airway compression by dilated pulmonary arteries. Commonest age of presentation is infancy with anecdotal adult case-reports. Surgical treatment requires establishing unobstructed competent right ventricular outflow tract (RVOT) often with monocusp or conduits. We present a novel technique of rendering RVOT competent by implanting a tilting disc mechanical prosthesis in a rare adult TOF with APVS.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 259-261"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87425530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can complexity of coronary lesions and presence of poor targets jeopardize outcome in patients with poor systolic function undergoing coronary artery bypass grafting?","authors":"Alaa Omar ,&nbsp;Kareem Mahmoud ,&nbsp;Abdallah Nosair ,&nbsp;Mahmoud El-Degwy ,&nbsp;Mohamed Abdel-Raouf Khalil","doi":"10.1016/j.jescts.2017.07.004","DOIUrl":"10.1016/j.jescts.2017.07.004","url":null,"abstract":"<div><h3>Background</h3><p>SYNTAX score is an established angiographic scoring system for risk stratification of a patient undergoing coronary revascularization. There was always a theory between cardiac surgeons and interventional cardiologists that a good outcome after coronary artery bypass graft (CABG) operation needs at least one out of two limbs, either good contractility or good targets. If both are jeopardized the outcome will be suboptimal with considerable risky operation. We performed that study to confirm if vessels with poor distal run-off and high complexity of lesions might affect the outcome in those critical cohorts of patients with poor left ventricular function.</p></div><div><h3>Methods</h3><p>This was a prospective observational non-randomized study. The study included 100 patients with jeopardized left ventricular ejection fraction (EF) &lt;40%. The patients were divided into three groups per SYNTAX score. Group 1: (Score &lt;22), group 2: (Score 22–32) and group 3 (Score &gt;32). 30 days post-operative follow- up was done. The primary end point was the composite criteria of death, myocardial infarction (MI) and stroke.</p></div><div><h3>Results</h3><p>The mean SYNTAX score of the studied cases was 32.03 ± 9.62. Baseline clinical characteristics were similar among the three groups. The high SYNTAX score group showed more increase in total cardio-pulmonary bypass (CPB) time and cross-clamp time, ICU stay, mechanical ventilation, inotropic support and postoperative blood transfusion than the other two groups. High SYNTAX score showed high positive correlation with the number of grafts. No statistically significant difference was found for major adverse cardiac and cerebrovascular events (MACCE) among the three groups (p-value 0.12).</p></div><div><h3>Conclusions</h3><p>The complexity of coronary lesions and presence of poor targets were not associated with increased adverse outcomes in patients with low EF undergoing CABG. CABG is still the preferred method of revascularization in patients with complex multi-vessel disease and low EF.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 223-229"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74495905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of obesity on the results of cardiac surgery in Egypt: Early outcomes on heart valve surgery","authors":"Amr Tawfek,&nbsp;Khaled Abdelbary,&nbsp;Mostafa Kotb,&nbsp;Ali M. Refat","doi":"10.1016/j.jescts.2017.04.001","DOIUrl":"10.1016/j.jescts.2017.04.001","url":null,"abstract":"<div><h3>Background</h3><p>Rheumatic heart disease is endemic in developing countries, but obesity is worldwide increasing. The aim of this work was to evaluate impact of obesity on the results of heart valve surgery.</p></div><div><h3>Methods</h3><p>This cohort prospective study was conducted on 500 patients with heart valve diseases requiring valve surgery at two centers: Cardiothoracic Surgery Department, Zagazig University Hospitals and General hospital in El Ahrar, Zagazig, Egypt from August 2013 to August 2016. Heart valve surgery patients were subdivided according body mass index (BMI) into 5 groups: non-obese group: BMI &lt; 25; overweight group: BMI 25–29.9; class I obese group: BMI 30–34.9; class II obese group: BMI 35–39.9; and class III obese group: BMI ≥ 40.</p><p>Collected data were classified into: preoperative,operative, postoperative and follow up data.</p></div><div><h3>Results</h3><p>This study showed that there was no significant difference between the 5 groups regarding the following postoperative outcomes: exploration, arrhythmia, pacemaker insertion, tracheostomy and renal impairment.On the other hand, surgical site infection (SSI) had percentage in the 5 groups as follow: 0.9%, 5.4%, 7.4%, 9.1% and 50% respectively. A highly significant difference was found between non-obese group versus class III obese group, while there was significant difference between overweight group and class I obese group versus class III obese group.</p></div><div><h3>Conclusions</h3><p>This study found no obesity association with higher postoperative morbidity or mortality except for only SSI. So obesity had neutral effect on outcomes and the term Obesity paradox should be changed since the impact of obesity was just a parallax effect.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 185-191"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74652673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is bilateral internal thoracic artery grafting in poorly controlled diabetic obese patients a contraindication? A single center pilot study","authors":"Riyad Tarazi ,&nbsp;Amir Mohamed ,&nbsp;Mohamed Badawy ,&nbsp;Jean Tasrini ,&nbsp;Adel Maher ,&nbsp;Tarek Soliman","doi":"10.1016/j.jescts.2017.06.004","DOIUrl":"10.1016/j.jescts.2017.06.004","url":null,"abstract":"<div><h3>Background</h3><p>In spite of substantial evidence supporting a long-term survival benefit with bilateral internal mammary artery (BIMA) grafts in CABG, this technique remains grossly underutilized worldwide. The incidence of deep sternal wound infection (DSWI) following BIMA harvest ranges from 0.6% to 4.2%. The high incidence of obesity and diabetes among Kuwait population encouraged us to study the incidence of DSWI among our patients with BIMA.</p></div><div><h3>Methods</h3><p>101 patients who underwent CABG procedure with BIMA use in Al-Dabbous Cardiac center, Al-Adan Hospital, Kuwait. Between June 2014 and December 2016, were included and analyzed retrospectively.</p></div><div><h3>Results</h3><p>92 patients included in our study were males (91.1%) and were 9 females (8.9%). 86 patients had HbA1c &gt; 7% (85.2%). 20 patients (19.8%) had Body Mass Index (BMI) &gt; 30. Of all studied patients, 12 patients (11.9%) had both BMI &gt; 30 and HbA1c &gt; 7. DSWI occurred in 3 patients (3%) out of the studied 101 patients, 2 of them had BMI &gt; 30 and HbA1c &gt; 7. The multi-variable analysis showed a significant correlation between the occurrence of DSWI and female gender (p value = 0.001) as well as a combination of BMI &gt; 30 and level of HbA1c &gt; 7 (p value = 0.037). Age, HbA1c &gt; 7 with BMI &lt;30 and BMI &gt;30 with HbA1c &lt; 7, failed to show any statistically significant increase in the incidence of DSWI in our study group.</p></div><div><h3>Conclusions</h3><p>Based on our results, BIMA grafting in poorly controlled diabetic obese patients especially of female gender shouldn't be used to avoid the higher incidence of DSWI among them.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 217-222"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79926310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-expandable metal stent for palliation of malignant dysphagia & quality of life improvement in advanced cancer esophagus: Upper Egypt experience","authors":"Mohamed Abdelshafy ,&nbsp;Mohammed A. Omar ,&nbsp;Mohamed Abdel Bary ,&nbsp;Mohamed Mostafa Wahaman ,&nbsp;Rafaat Abd elaal Bakheet","doi":"10.1016/j.jescts.2017.06.003","DOIUrl":"10.1016/j.jescts.2017.06.003","url":null,"abstract":"<div><h3>Background</h3><p>In advanced cancer esophagus patients, self-expandable metallic stents (SEMS) are utilized to relieve malignant difficulty in swallowing and improve their quality of the life. Retrospectively, we evaluated the efficacy, feasibility, and outcomes of SEMS in palliation of malignant dysphagia in advanced cancer esophagus and its' complications.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed data of 350 patients with malignant dysphagia due to advanced cancer esophagus from December 2012 to April 2017. They were subjected to esophageal stenting with SEMS in our GIT endoscopy unit, General and Cardiothoracic Surgery departments at Qena and Sohag University Hospitals, Egypt.</p></div><div><h3>Results</h3><p>The mean age was 56.34 + 12.44 years ranging from 30 to 85 years, and 264 of them were males. Mean duration of dysphagia was 2.90 months. SEMSs were placed successfully in all cases without major complications; however minor bleeding and retrosternal discomfort were seen. The improvement in the dysphagia score was significant.</p></div><div><h3>Conclusions</h3><p>SEMSs were safe and effective in palliation of malignant dysphagia and improvement of the quality of life in advanced esophageal cancer patients without major complications.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 262-269"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"119278701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The affection of trans-valvular gradient on patient’s outcome in cases of severe aortic stenosis with impaired left ventricular function","authors":"I. Moursi MD,&nbsp;K. Al Fakharany MD","doi":"10.1016/j.jescts.2017.05.006","DOIUrl":"10.1016/j.jescts.2017.05.006","url":null,"abstract":"<div><h3>Background</h3><p>Severe Aortic stenosis (AS) is an advanced stage of the disease process. Underestimation of symptoms and delay of Aortic valve replacement (AVR) have a bad prognosis. The aim of this work was to study the results of AVR in patients with severe AS with impaired systolic left ventricle (LV) function.</p></div><div><h3>Methods</h3><p>This is retrospective study, from January 2007 to December 2014 at Zagazig University Hospital, Zagazig, Egypt. Group of 40 patients had severe AS with impaired the LV function. Patients were divided into 2 groups: <strong>Group 1</strong> with mean gradient &lt;40 mmHg (n = 17) and <strong>Group 2</strong> with average gradient ≥ 40 mmHg (n = 23). The patient's outcome was compared and statistically analyzed regarding the terms of the clinical features, associated comorbidities, mortality and 30 days follow-up.</p></div><div><h3>Results</h3><p>The aortic valve area was smaller in the Group 1 than in Group 2 (0.64 ± 0,2 cm² 0.66 vs ± 0 cm², p = 0.002). In-hospital mortality was comparable in both groups: Group 1: 11.1% vs Group 2 13.6% (p = 0.24). Group 1 had improved its ejection fraction (EF) by 17.8 units and in Group 2, the EF increased by 16.4 units. The average NYHA class increased from 2.71 ± 0.81 to 1.41 ± 0.50 in the Group 1 (p = 0.002) and 3.13 ± 0.63 to 1.33 ± 0.48 in the Group 2. (p = 0.0001).</p></div><div><h3>Conclusions</h3><p>The surgical outcome in cases with severe aortic stenosis with impaired ventricular function was limitedly affected by the value of the aortic valve mean gradient.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 204-209"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77326576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Senning procedure for the correction of the transposition of the great arteries: Mid-term results","authors":"Fatmaalzahraa Moustafa ,&nbsp;Mohamed Abdel-Raouf Khalil ,&nbsp;Dalia A. Saied ,&nbsp;Osama Abdelaziz ,&nbsp;Kefaya D. Moustafa","doi":"10.1016/j.jescts.2017.07.002","DOIUrl":"10.1016/j.jescts.2017.07.002","url":null,"abstract":"<div><h3>Background</h3><p>Many patients with Transposition of the great arteries (TGA) who underwent Senning procedure are in follow-up and approaching adulthood. This study aimed to assess the mid-term outcome after Senning procedure to disclose and manage subsequent complications.</p></div><div><h3>Methods</h3><p>Twenty five d-TGA patients, who underwent Modified Senning Procedure were enrolled in the study. Investigations done included 12- leads ECG and 24 h Holter monitoring for detection of cardiac arrhythmias. Two dimensional Echocardiography and 2-D Doppler ultrasound were done to evaluate the right ventricular function and detect any postoperative complications.</p></div><div><h3>Results</h3><p>The median age was 6.3 years (mean: 7.25 ± 3.2, range 4–16 years). The median follow-up duration was 5.5 years (mean: 6.04 ± 3.2, range: 1.5–14.6 years). There were no mortalities and no need for reoperations. All patients had good right ventricular function and baffle leaks were present in 12% of the cases. Significant tricuspid regurgitation was encountered in 36% of the patients. Ninety six percent of the patients maintained sinus rhythm. Tachyarrhythmias were present in 3 patients (12%) and one patient (4%) had complete heart block and required pacemaker insertion. Eighty eight percent of the patients were in NYHA class I-II and the event-free survival rate was 100%, 67.8% and 28.6% at 1, 5, and 10 years respectively.</p></div><div><h3>Conclusions</h3><p>Despite that data from our study revealed satisfactory outcome as regards mortality and functional status of d-TGA children, further studies are warranted to assess the long term outcome of these patients and for further assessment of their right ventricular function.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 252-258"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82216069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}