scholarly journals The effect of Surgical Technique, Age and Trisomy 21 on early outcome of Surgical Management of Complete Atrioventricular Canal Defect

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sherief Azzab ◽  
Ahmed Samy ◽  
Hamdy Singab ◽  
Mohamed EL Ghanam ◽  
Ahmed Tarek
Keyword(s):  
Down Syndrome ◽  
Early Intervention ◽  
Surgical Technique ◽  
Surgical Repair ◽  
P Value ◽  
Atrioventricular Canal ◽  
End Point ◽  
Atrioventricular Canal Defect ◽  
Significant Difference ◽  
Patch Technique

Abstract Background The optimal timing, surgical technique and the influence of Down syndrome on outcome of surgical repair of Complete Atrio-Ventricular Canal Defect (CAVC) remains uncertain. We reviewed our experience in repair of CAVC to identify the influence of these factors on operative outcome. Methods A prospective study included 70 patients who underwent repair of CAVC at Ain Shams university hospitals, academy of cardiothoracic surgery during the period from July 2016 to October 2019. Age at surgery (less than 6 months old versus later), surgical technique used [(modified single patch versus double patch technique), (use of posterior annuloplasty for repair of left AV valve or not)] and association of Down syndrome were evaluated for their impact on the outcome of surgical repair using multivariate analysis. Patients were followed up for 6 months; primary end point was mortality and secondary end point was reappearance of LAVV regurgitation. Results No significant difference between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Down patients showed significant difference in the occurrence of postoperative compared to non-Down patients (LAVVR grade 2 + = 8.9% vs 24%, P value =0.005) respectively. Surgical repair by Modified single patch technique showed significant reduction in cross clamp time (mean = 47.6 ± 9.227 min vs 73.55 ± 21.087 min, P value 0.00), shorter bypass time (mean = 71.13 ± 13.507 min vs 99.19 ± 27.092 min, P value =0.00) and shorter duration of ICU stay (mean =3.2 ± 1.657 days vs 5.3 ± 2.761 days, P value=0.01) as compared to double patch technique. Posterior annuloplasty used for repair of LAVV compared to closure of cleft only resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVVR 2+ 43% vs 7%, P value=0.03) and at 6 months of follow up. (LAVVR 2+ 35.4% vs 0%, P value=0.01) respectively. Conclusion early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair, Down syndrome was not found to be a risk factor for early intervention. Modified single patch and double patch techniques for repair, can be used both with comparable results even in large VSD component (8mm and larger), finally, repair of common AV valve by cleft closure with posterior LAV annulplasty showed better results with significant decrease in postoperative LAV regurgitation and early mortality in comparison to closure of cleft only.

scholarly journals The Effect of Surgical Technique, Age and Trisomy 21 on Early Outcome of Surgical Management of Complete Atrioventricular Canal Defect

2021 ◽  
Author(s):  
Sherief Azzab ◽  
Ahmed Samy ◽  
Hamdy Singab ◽  
Mohamed Zeinah ◽  
Gledisa Musollari ◽  
...  
Keyword(s):  
Early Intervention ◽  
Surgical Technique ◽  
Trisomy 21 ◽  
Surgical Repair ◽  
Early Period ◽  
Optimal Timing ◽  
P Value ◽  
Atrioventricular Canal ◽  
Atrioventricular Canal Defect ◽  
Significant Difference

Abstract Background: The optimal timing, surgical technique and the influence of Trisomy 21 on outcome of surgical repair of Complete Atrio-Ventricular Canal Defect (CAVC) remain uncertain. We reviewed our experience in repair of CAVC to identify the influence of these factors on operative outcome. Methods: A prospective study included 70 patients who underwent repair of CAVC at our institute between July 2016 to October 2019. Primary endpoint was mortality and secondary endpoint was degree of left atrio‐ventricular valve (LAVV) regurgitation.Results: No significant difference noted between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Surgical repair by modified single patch technique showed significant reduction in bypass time (71.13 ± 13.507 min vs 99.19 ± 27.092 min, P value =0.001). Comparison to closure of cleft only, posterior annuloplasty used for repair of LAVV resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVV 2+ 43 % vs 7 %, P value=0.03) and at 6 months of follow up (LAVV 2+ 35.4 % vs 0 %, P value=0.01) respectively.Conclusion: Early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair; Trisomy 21 was not found to be a risk factor for early intervention. Repair of common AV valve by cleft closure with posterior LAVV annuloplasty showed better results with significant decrease in postoperative LAVV regurgitation and early mortality in comparison to closure of cleft only.

scholarly journals The effect of surgical technique, age, and Trisomy 21 on early outcome of surgical management of complete atrioventricular canal defect

2021 ◽  
pp. 1-5
Author(s):  
Sherief Azzab ◽  
Ahmed Samy ◽  
Hamdy Singab ◽  
Mohamed Zeinah ◽  
Gledisa Musollari ◽  
...  
Keyword(s):  
Early Intervention ◽  
Surgical Technique ◽  
Trisomy 21 ◽  
Surgical Repair ◽  
P Value ◽  
Valve Regurgitation ◽  
Atrioventricular Canal ◽  
Atrioventricular Canal Defect ◽  
Significant Difference ◽  
Complete Atrioventricular

Abstract Background: The optimal timing, surgical technique, and the influence of Trisomy 21 on the outcome of surgical repair of Complete Atrioventricular Canal Defect remains uncertain. We reviewed our experience in the repair of CAVC to identify the influence of these factors on operative outcomes. Methods: A prospective study included 70 patients, who underwent repair of CAVC at our institute between July, 2016 and October, 2019. Primary endpoint was mortality and the secondary endpoint was a degree of left atrioventricular valve regurgitation. Results: No significant difference was noted between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Surgical repair by modified single-patch technique showed a significant reduction in bypass time (71.13 ± 13.507 min versus 99.19 ± 27.092 min, p-value = 0.001). Compared to closure of cleft only, posterior annuloplasty used for repair of LAVV resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVV 2 + 43 versus 7 %, p-value = 0.03) and at 6 months of follow-up (LAVV 2 + 35.4 versus 0 %, p-value = 0.01), respectively. Conclusions: Early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair; Trisomy 21 was not found to be a risk factor for early intervention. Repair of common AV valve by cleft closure with posterior LAVV annuloplasty showed better results with a significant decrease in post-operative LAVV regurgitation and early mortality in comparison to the closure of cleft only.

scholarly journals Speech profile in Down syndrome: speech apraxia x speech disorder of musculoskeletal origin

Revista CEFAC ◽  
2020 ◽  
Vol 22 (5) ◽  
Author(s):  
Julyane Feitoza Coêlho ◽  
Isabelle Cahino Delgado ◽  
Marine Raquel Diniz da Rosa ◽  
Giorvan Ânderson dos Santos Alves
Keyword(s):  
Differential Diagnosis ◽  
Down Syndrome ◽  
Clinical Intervention ◽  
Speech Disorders ◽  
Study Data ◽  
P Value ◽  
Phonetic Transcription ◽  
Word Repetition ◽  
Syllable Repetition ◽  
Significant Difference

ABSTRACT This study presents an analysis of linguistic aspects at the segmental and suprasegmental levels in individuals with Down syndrome with or without a diagnosis of speech apraxia. Ten individuals of both sexes, aged between 13 and 32 years, participated in the study. Data collection was performed, individually and separately, in a video recorded therapeutic session. Speech tasks consisted of word repetition, repetition of sentences and automatic speech. The speech samples were submitted to phonetic transcription with a description and analysis of phonoarticulatory alterations, typology of disfluencies and prosodic alterations. The data were submitted to descriptive and inferential statistical analysis, using the Mann-Whitney test for independent samples and considering p-value≤0.05 as significant. Individuals with speech apraxia (n=6), compared with those without it (n=4), presented a higher occurrence of phonoarticulatory alterations, with a statistically significant difference between the two groups in omission (p=0.018) and articulatory inaccuracy (p=0.030) alterations; a higher occurrence of disfluencies, mainly of the syllable repetition type; and the occurrence of prosodic alterations (83.3%), which was not found in the group without speech apraxia. The importance of the differential diagnosis of speech disorders in Down syndrome is revealed with an evaluation that considers the different linguistic aspects resulting from the differentiation of the characteristics of speech. Clinical intervention should be early and guided by specific parameters.

Atrioventricular canal defect without Down syndrome: A heterogeneous malformation

1999 ◽  
Vol 85 (2) ◽  
pp. 140-146 ◽  
Author(s):  
Maria Cristina Digilio ◽  
Bruno Marino ◽  
Alessandra Toscano ◽  
Aldo Giannotti ◽  
Bruno Dallapiccola
Keyword(s):  
Down Syndrome ◽  
Atrioventricular Canal ◽  
Atrioventricular Canal Defect

scholarly journals Outcomes of surgical repair of complete atrioventricular canal defect in patients younger than 2 years of age

2019 ◽  
Vol 39 (6) ◽  
pp. 422-425
Author(s):  
Mohannad Ali Dawary ◽  
Faisal Dkhalallah Alshamdin ◽  
Louai Hassan Alkhalaf ◽  
Ahmed Othman Alkhamis ◽  
Fareed Ahmed Khouqeer
Keyword(s):  
Surgical Repair ◽  
Atrioventricular Canal ◽  
Atrioventricular Canal Defect ◽  
Complete Atrioventricular

COMPLETE ATRIOVENTRICULAR CANAL DEFECT IN PRESENCE OF DOWN SYNDROME

The Lancet ◽  
1985 ◽  
Vol 326 (8459) ◽  
pp. 834-835 ◽  
Author(s):  
N.J. Wilson ◽  
E. Gavalaki ◽  
C.G.H. Newman ◽  
Samuel Menahem ◽  
RogerB.B. Mee
Keyword(s):  
Down Syndrome ◽  
Atrioventricular Canal ◽  
Atrioventricular Canal Defect ◽  
Complete Atrioventricular

Cyanoacrylate Based Products as Interpositioning Substance versus Reintervention Alone for Urethrocutaneous Fistula Repair after Hypospadias

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M Abdallah ◽  
A M Tawfeek ◽  
A M W Mohareb
Keyword(s):  
Success Rate ◽  
Surgical Repair ◽  
Fistula Formation ◽  
P Value ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Cyanoacrylate Glue ◽  
Recurrent Fistula ◽  
Significant Difference ◽  
Basis Method

Abstract Background urethrocutaneous fistula (UCF) is still the commonest complication after hypospadias repair. Although recent advances in the surgical procedures of hypospadias repair have reduced the rate of urethrocutaneous fistula formation, it remains a real complication of hypospadias and frustrating problem for surgeons. Aim of the Work evaluation of success and failure rates of using cyanoacrylate based productes as an interpositioning substance in surgical repair of fistula after hypospadias in comparison to the classic surgical repair technique. Patients and Methods this is a prospective, randomized-controled study, conducted on 40 patients from the date of the approval of the study. It is comparing two different modalities for repair of urethrocutaneous fistula that has developed after hypospadias repair. Our study was assigned on a randomized basis method according to a 1:1 ratio and patients underwent either multilayered closure using dartos facial flap or using cyanoacrylate glue as an interpositioning layer before suturing of the dartos flap for the closure of the urethrocutaneous fistula. All cases were divided into 2 equal groups, 20 cases each. The cases were distributed randomly into the two groups. Results the success rate was higher for patients using cyanoacrylate glue as a protective interpositioning layer as 16 patients (80%) were successfully repaired and 4 patients (20%) developed a recurrent fistula. However, there was no statistically significant difference between 2 groups p-value was 0.465. Conclusion there was no statistically significant difference in adding cyanoacrylate glue to multilayered closure of urethrocutaneous fistula after hypospadias repair. However, cyanoacrylates showed that they are a favourable additional protective substance and they resulted in a high success rate without adding any surgical complications.

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