Single-Stage Complete Repair versus Multistage Repair of Tetralogy of Fallot with Borderline Pulmonary Arteries

Background: Tetralogy of Fallot is the most common cyanotic congenital heart defect. Borderline pulmonary anatomy has been associated with a higher risk of mortality and morbidity. Strategies to manage this condition—namely, single- or multistage repair—have long been debated. Objective: The overall outcomes of patients with tetralogy of Fallot with borderline pulmonary arteries (McGoon ratio 1.3 to 1.7) with regard to the need for a single-stage or multistage repair and the outcome of each surgical management were evaluated. Patients and methods: A retrospective, nonrandomized comparative study designed to evaluate patient outcomes comprised 60 patients with tetralogy of Fallot with borderline pulmonary arteries who underwent surgery at the Cardiothoracic Surgery Academy, Ain Shams University, Cairo, Egypt, between January 2016 and December 2017. After gaining approval from the affiliated ethical and research committee, and informed consent of the guardians, the patients were assigned into one of two groups. Shunt group included 30 patients managed surgically by a modified Blalock-Taussig (MBT) shunt as a part of a multistage repair, and repair group included 30 patients managed surgically by single-stage complete repair. The medical records of the patients were reviewed, and data relating to age, sex, weight, and preoperative oxygen saturation were collected. All patients underwent preoperative echocardiography and multislice computed tomography (CT) with angiography. The follow-up was performed by echocardiography at discharge and at one month and six months after surgery. Multislice CT with angiography was performed in patients who received a shunt once the echocardiography showed acceptable pulmonary arteries. Results: The patients’ age ranged from 5 to 50 months with a mean age of 18.63 ± 9.15 (19.84 ± 12.34 for the shunt group and 17.43 ± 8.54 for the repair group). The weight ranged from 5 kg to 18 kg with a mean of 9.6 ± 2.53 (8.82 ± 2.79 for the shunt group and 10.41 ± 2.63 for the repair group). The mean preoperative O2 saturation was 68.95% ± 7.8% for the shunt group and 87.93% ± 6.18% for the repair group. The median McGoon ratio was 1.4 for the shunt group and 1.6 for the repair group, the difference of which was highly significant (P < .0001). The mortality rate in our study was 10% (10% for the shunt group and 10% for the repair group). The morbidity incidence rate was 26.6% for the shunt and repair groups. The ICU stay ranged from 2 to 31 days, with a median of three days for the shunt group (mean 3.61 ± 1.91) and four days for the repair group (mean 6.07 ± 6.63 days). The calculated P value showed a significant difference between the two groups concerning ICU stay. The postoperative SO2 significantly increased to a mean of 85.58 ± 7.05 in the shunt group and 98.14 ± 3.36 in the repair group (P < .0001). Conclusion: There was no statistically significant difference between multistage repair and single-stage complete repair regarding morbidity and mortality. Regarding ICU stay, patients in the single-stage had a better outcome. A McGoon ratio of 1.5 can be used as a guideline in the decision-making process.

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Surgical sequale of transabdominal preperitoneal approach versus Lichtenstein open repair in a rural setting

International Surgery Journal ◽

10.18203/2349-2902.isj20213125 ◽

2021 ◽

Vol 8 (8) ◽

pp. 2341

Author(s):

Chanthu C. Nair ◽

Karthikeyan E. M. J.

Keyword(s):

Surgical Site Infections ◽

Rural Setting ◽

Perioperative Outcomes ◽

P Value ◽

Transabdominal Preperitoneal ◽

Group Data ◽

Preperitoneal Approach ◽

Significant Difference ◽

Open Versus ◽

Repair Group

Background: The objective was to compare the outcomes perioperative outcomes of transabdominal preperitoneal approach (TAPP) versus Lichtenstein tension (open) free repair for adult unilateral uncomplicated inguinal hernia patients (including both direct and indirect hernias).Methods: The prospective study was conducted between July 2018 to August 2020. A total of 60 patients, 30 in the Lichtenstein tension free repair group and 30 in the TAPP repair group data were collected and analysed.Results: The mean age was 55 in our study. On comparing open versus TAPP, significant difference of p value ≤0.05 was observed in terms of surgical site infections, time to discharge, time to return to work and mesh related pain in TAPP. Operative time was shorter in open group.Conclusions: Laparoscopic transabdominal preperitoneal repair is a valid alternative to open traditional method with lesser morbidity to the patients.

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Tetralogy of fallot repair at a new centre in North India: our growing experience

International Surgery Journal ◽

10.18203/2349-2902.isj20205362 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4088

Author(s):

Mayank Yadav ◽

Sumit Pratap Singh ◽

Mohd Azam Haseen ◽

Shaad Abqari ◽

Mirza M. Kamran

Keyword(s):

Cardiac Surgery ◽

Tetralogy Of Fallot ◽

Postoperative Outcome ◽

Pediatric Cardiac Surgery ◽

North India ◽

P Value ◽

Aortic Cross Clamp Time ◽

Group I ◽

Significant Difference ◽

Group 2

Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease with complete surgical repair being its most appropriate treatment currently. Although in a developing country, pediatric cardiac surgery is not being practiced as frequently as the adult cardiac surgery either due to limited resources centres or surgeon reluctance. The aim of this study is to evaluate and compare the operative and postoperative outcome of the initial 50 patients with the subsequent 50 patients undergoing corrective surgery of TOF in a new cardiac centre.Methods: This is a comparative descriptive study performed at a single centre comprising of two groups of initial 50 and subsequent 50 patients who underwent complete surgical correction of TOF and compare their operative and postoperative outcomes.Results: The mean age of patients in group I and II were 82.4 and 74.3 months respectively. There was no significant difference in the preoperative characteristics of the patients of both groups. Among operative parameters there was significant improvement in the cardiopulmonary bypass time and aortic cross clamp time in group 2 with p value of 0.0017 and 0.0324 respectively. The requirement for transannular patch also came down in group 2 (p=0.016). Mortality in group 1 and 2 were 6 and 2 respectively (p=0.14), other postoperative characteristics were similar in both groups.Conclusions: With growing experience, proper planning and perseverance pediatric cardiac surgery too can be performed with acceptable results in a new centre.

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Single-stage correction, with extensive pulmonary arterial reconstruction, of a pulmonary arterial sling associated with tetralogy of Fallot

Cardiology in the Young ◽

10.1017/s1047951109991119 ◽

2009 ◽

Vol 19 (5) ◽

pp. 519-521 ◽

Cited By ~ 1

Author(s):

Onur S. Goksel ◽

Emin Tireli ◽

Ahmet Çelebi

Keyword(s):

Right Ventricular ◽

Tetralogy Of Fallot ◽

Pulmonary Arteries ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Single Stage ◽

Arterial Reconstruction ◽

Pulmonary Arterial ◽

The Right

AbstractPulmonary arterial sling, rare in itself, is even rarer when associated with tetralogy of Fallot. Successful single-stage correction of this combination, with extensive pulmonary arterial reconstruction, has been reported only occasionally. We describe our experience with an 18 month-old girl, showing that extensive reconstruction of both the pulmonary arteries and the right ventricular outflow tract can permit single-stage correction in selected patients, resulting in favourable physiology and anatomy.

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Assessment of pulmonary arteries in patients with tetralogy of Fallot

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2018-4-48-53 ◽

2018 ◽

Vol 22 (4) ◽

pp. 48

Author(s):

I. A. Kozyrev ◽

A. A. Morozov ◽

A. K. Latypov ◽

A. V. Vasilets ◽

N. A. Kotin ◽

...

Keyword(s):

Computed Tomography ◽

Tetralogy Of Fallot ◽

Surgical Management ◽

Conflict Of Interest ◽

Pulmonary Arteries ◽

Z Score ◽

Complete Repair ◽

Z Scores ◽

Left And Right

Aim. The study aimed to evaluate the size of pulmonary arteries in patients with tetralogy of Fallot during preoperative and intraoperative stages and to find out the influence of preoperative sizes on the surgical management.Methods. Between January 2015 and May 2018, 50 patients with tetralogy of Fallot younger seven months underwent primary complete or palliative repair. The data obtained from patients' files and include echocardiography, computed tomography and surgical reports. Dimensions of right and left pulmonary arteries were analyzed by calculating the Z-score and Nakata indices.Results. Z-scores of the left and right pulmonary arteries were significantly smaller by echocardiography comparing to computed tomography (p<0.01). Z-scores of left and right pulmonary arteries measuring by computed tomography were also smaller than the size measured during surgery (p=0.05). Nakata index according to computed tomography was significantly smaller (p<0.05) than this index calculated from surgical reports.Conclusion. In patients with tetralogy of Fallot, the size of pulmonary arteries according to the visualization methods is smaller than size measured during surgery. Intraoperative sizing of pulmonary arteries could influence surgical management, expanding indications for complete repair in some patients.Received 6 July 2018. Revised 24 August 2018. Accepted 28 August 2018.Funding: The study did not have sponsorship.Conflict of interest: Author declare no conflict of interest.Acknowledgment We would like to express our gratitude to Ya.A. Yermolenko for Figure 1 used in the article.

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STUDY OF THE PULMONARY HYPERTENSION AND PULMONARY VESSELS MEASUREMENTS USING COMPUTED TOMOGRAPHY

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v9.i4.2021.3820 ◽

2021 ◽

Vol 9 (4) ◽

pp. 1-9

Author(s):

Samia abdelgaum Fathelrahman ◽

Maha Esmeal Ahmed Esmeal

Keyword(s):

Computed Tomography ◽

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Main Pulmonary Artery ◽

Pulmonary Arteries ◽

Multislice Ct ◽

Ct Scanner ◽

Pulmonary Vessels ◽

Significant Difference ◽

The Right

The purpose of the study was to study the pulmonary vessels in patients with pulmonary hypertension using Computed Tomography scan (CT) This is a prospective ,analytical study. this study was conducted at Khartoum Hospital (Sudan); in the period between November 2020 - January 2021 a sample of (100) patients with clinically diagnosed as pulmonary hypertension was enrolled, their mean ages were (47.92 ± 19.03) years, the sample included both genders, (42) patients were females while (58) were males and their ages were ranged from (3 - 80) years old. (CTPA) scans were acquired, all patients were examined by using multislice (CT) scanner, the data collected by special designed sheet from findings and analyzed statistically by using an (SPSS) Statistics software package. The sample was directed to study the relationship of pulmonary hypertension with the presence of pulmonary vessels measurements; the patient's age and gender correlation with the pulmonary hypertension were investigated. The results find that the right and left main pulmonary arteries diameters changes were found to be significantly related to the presence of pulmonary hypertension, while there was no significant difference in the main pulmonary artery diameters measurements. The study concluded that CT for pulmonary artery plays an important role in the diagnostic evaluation of patients with pulmonary hypertension this due to it is easily accessible and excellent non-invasive method for the visualization and measurement of pulmonary artery and to know the possible cause of pulmonary hypertension.

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The immediate results of valve-sparing complete repair of tetralogy of Fallot

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2019-1-9-16 ◽

2019 ◽

Vol 23 (1) ◽

pp. 9

Author(s):

I. A. Kozyrev ◽

A. A. Morozov ◽

E. V. Grekhov ◽

I. A. Averkin ◽

M. L. Gordeev ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Tetralogy Of Fallot ◽

Conflict Of Interest ◽

Pulmonary Valve ◽

Early Postoperative Period ◽

Cardiopulmonary Bypass Time ◽

Complete Repair ◽

Z Scores ◽

Valve Sparing ◽

Repair Group

Aim. The present study aimed to evaluate the immediate results after the primary valve-sparing complete repair of tetralogy of Fallot. Methods. The study included patients with tetralogy of Fallot who were aged <6 months and who underwent primary complete repair between January 2017 and December 2018. According to the surgical approach, the patients were divided into two groups: valve-sparing repair and transannular plasty. Data were obtained from medical records and included echocardiography findings and surgical information. The dimensions of the pulmonary valve were assessed using Z-scores. Results. In total, 38 patients were included in this study. Among these, 25 (66%) patients were included in the valve-sparing repair group. The valve-sparing repair group had lower cardiopulmonary bypass time, epinephrine support duration, and pulmonary valve Z-scores than the transannular plasty group. Additionally, the valve-sparing repair group had a significantly higher postoperative pulmonary valve Z-score than the preoperative score. Conclusion. Valve-sparing complete repair of tetralogy of Fallot is possible in the majority of patients. Pulmonary valve preservation reduces cardiopulmonary bypass time and provides a more stable early postoperative period by reducing the epinephrine support duration.Received 13 March 2019. Revised 24 March 2019. Accepted 8 April 2019.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.

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PENENTUAN NILAI PARAMETER LIPOFILITAS SENYAWA 4-KLOROBENZOILTIOUREA DAN UJI POTENSIASI TERHADAP TIOPENTAL PADA MENCIT PUTIH (Mus musculus)

Sains & Teknologi ◽

10.24123/jst.v4i1.2290 ◽

2019 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Dini Kesuma

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Electronic Properties ◽

Mus Musculus ◽

Log P ◽

P Value ◽

Lead Compounds ◽

Significant Difference ◽

Central Nervous System Depressant ◽

The Central Nervous System

Synthesis of the 4-chlorobenzoylthiourea compound was carried out by acylating thiourea with 4-chlorobenzoyl chloride. The 4-chlorobenzoylthiourea compound will increase the lipophilic and the electronic properties other than the lead compounds of benzoylthiourea in order to, by expectation, raise the central nervous system depressant as well. The lipophilic would affect the ability of the compounds in penetrating biological membranes, which is highly dependent on the solubility of the drug within lipid/water. Log P is the most common method used in determining the parameter value. This experiment was to mix two dissolvents (octanol and water) which are immissible. The both levels of the compounds were carefully observed by a spectrophotometer UV-Vis. From the test, the result of log P value of the 4-chlorobenzoylthiourea compound was 2.32, while the theoretical log P value of the compounds, by using the π Hansch-Fujita method is 1.62 and the f Rekker-Mannhold method is 2.225. Consequently, the result of the test shows that there is a significant difference between the progress experiment and both theoretical log P methods. Moreover, in the test of the central nervous system depressant through the potentiation test to thiopental using mice indicates that the 4-chlorobenzoylthiourea compound have potentiation effects to thiopental compared to the lead compounds of benzoylthiourea.

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Employing Personal Reading Logs through Short Stories to Enhance Students’ L2 Reading Comprehension Achievement

International Journal of Modern Languages And Applied Linguistics ◽

10.24191/ijmal.v3i2.7643 ◽

2019 ◽

Vol 3 (2) ◽

pp. 1

Author(s):

Eliyas Sulaiman Mohandas ◽

Nik Mastura Nik Ismail Azlan ◽

Salwa Othman ◽

Muhammad Aizat Azhari

Keyword(s):

Short Stories ◽

Reading Comprehension ◽

P Value ◽

L2 Reading ◽

Reading Score ◽

Paired Samples ◽

Significant Difference ◽

Post Test ◽

The Mean ◽

L2 Reading Comprehension

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.

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THE ANALYSIS OF NURSING STUDENT SOFT SKILLS DEVELOPMENT BETWEEN LECTURE AND PROBLEM BASED LEARNING APPROACHES 2011

INDONESIAN NURSING JOURNAL OF EDUCATION AND CLINIC (INJEC) ◽

10.24990/injec.v1i1.45 ◽

2018 ◽

Vol 1 (1) ◽

pp. 1

Author(s):

Hilman Syarif

Keyword(s):

Nursing Students ◽

Nursing Student ◽

Soft Skills ◽

Comparative Method ◽

P Value ◽

Learning Approaches ◽

Soft Skill ◽

Student Centered Learning ◽

Hard Skills ◽

Significant Difference

Introduction: Student Centered Learning (SCL) is an effective method to develop student's soft skills and hard skills which are very important to support their successful carrier later. This research was conducted to identify the differences of developed soft skills between students who learn with PBL method and lecturing method. Methods: Descriptive comparative method was used in this study. The samples consisted of 15 students who learned with PBL method and 15 students who learned with lecturing method. The sample for this research was selected by random sampling method. Results: The result showed that the average of student's soft skills score in PBL method was 122.63, while student's soft skills score in lecturing method was 116.27. Discussion & Conclusion: There was significant difference of student's soft skills in PBL method and lecturing method (p value = 0.038; α = 0.05). This study recommends nursing program management, faculty of medicine at the University of Syiah Kuala keeps PBL method running and develops other methods which facilitate hard skills and soft skills are development. Keywords: nursing students, soft skill, PBL

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Perbedaan Penggunaan Antikoagulan K2EDTA DAN K3EDTA Terhadap Hasil Pemeriksaan Indeks Eritrosit

Jurnal Laboratorium Khatulistiwa ◽

10.30602/jlk.v1i2.147 ◽

2018 ◽

Vol 1 (2) ◽

pp. 114

Author(s):

Wahdaniah Wahdaniah ◽

Sri Tumpuk

Keyword(s):

Screening Test ◽

Venous Blood ◽

The Body ◽

Ethylene Diamine ◽

P Value ◽

Cross Sectional ◽

Significant Difference ◽

Ethylene Diamine Tetra Acetate ◽

The Difference ◽

Index Value

Abstract: Routine blood examination is the earliest blood test or screening test to determine the diagnosis of an abnormality. Blood easily froze if it is outside the body and can be prevented by the addition of anticoagulants, one of which Ethylene Diamine Tetra Acetate (EDTA). Currently available vacuum tubes containing EDTA anticoagulants in the form of K2EDTA and K3EDTA. K3EDTA is usually a salt that has better stability than other EDTA salts because it shows a pH approaching a blood pH of about 6.4. The purpose of this research is to know the difference of erythrocyte index results include MCH, MCV and MCHC using K3EDTA anticoagulant with K2EDTA. This research is a cross sectional design. This study used venous blood samples mixed with K2EDTA anticoagulant and venous blood mixed with K3EDTA anticoagulants, each of 30 samples. Data were collected and analyzed using paired different test. Based on data analysis that has been done on MCH examination, p value <0,05 then there is a significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value. Then on the examination of MCV and MCHC obtained p value <0.05 then there is no significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value.Abstrak: Pemeriksaan darah rutin merupakan pemeriksaan darah yang paling awal atau screening test untuk mengetahui diagnosis suatu kelainan. Darah mudah membeku jika berada diluar tubuh dan bisa dicegah dengan penambahan antikoagulan, salah satunya Ethylene Diamine Tetra Acetate (EDTA). Dewasa ini telah tersedia tabung vakum yang sudah berisi antikoagulan EDTA dalam bentuk K2EDTA dan K3EDTA. K3EDTA biasanya berupa garam yang mempunyai stabilitas yang lebih baik dari garam EDTA yang lain karena menunjukkan pH yang mendekati pH darah yaitu sekitar 6,4. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan hasil indeks eritrosit meliputi MCH, MCV dan MCHC menggunakan antikoagulan K3EDTA dengan K2EDTA. Penelitian ini merupakan penelitian dengan desain cross sectional. Penelitian ini menggunakan sampel darah vena yang dicampur dengan antikoagulan K2EDTA dan darah vena yang dicampur dengan antikoagulan K3EDTA, masing-masing sebanyak 30 sampel. Data dikumpulkan dan dianalisis menggunakan uji beda berpasangan. Berdasarkan analisis data yang telah dilakukan pada pemeriksaan MCH didapatkan nilai p < 0,05 maka ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit. Kemudian pada pemeriksaan MCV dan MCHC didapatkan nilai p < 0,05 maka tidak ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit.

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