Radmehr H, , ,
Volume 59, Issue 2 (5-2001)
Abstract
Valvular and coronary artery disease are among the most important causes of disability and death in the world and Iran as well. Every year, half a million death because of these diseases is reported in United State. The incidence of degenerative and valvular diseases of heart is increasing. Considering the industrialization of our country, the incidence of these kind of problems are increasing as well. In this study, there is an attempt to recognize the causes of cardiac surgery. We conducted a retrospective study in 915 cardiac surgery patients (630 CABG and 285 valve replacement) from 1374 to 1377. In CABG patients, there were 46 cases of reoperation (78.3 percent male 21.7 percent female). The most reoperations for bleeding was less than 24 hours in 90.3 percent. In valvular patients the causes of reoperation were: A) Valvular complications (female/male=3/1), B) Non valvular complications (female/male=1/3). The most common nonvalvular complication was bleeding (66.6 percent). The most common valvular complication was bioprosthetic valve degeneration. The meantime between two operation in valvular complications was 11.8 years. In all cases (915) the incidence of bleeding was 3.8 percent, mediastinitis 0.8 percent, cardiac tamponade 0.8 percent and GI bleeding 0.5 percent.
Radmehr H,
Volume 59, Issue 3 (6-2001)
Abstract
Valvular and coronary artery disease are among the most important causes of disability and death in the world and Iran as well. Every year, half a million death because of these diseases is reported in United State. The incidence of degenerative and valvular diseases of heart is increasing. Considering the industrialization of our country, the incidence of these kind of problems are increasing as well. In this study, there is an attempt to recognize the causes of cardiac surgery. We conducted a retrospective study in 915 cardiac surgery patients (630 CABG and 285 valve replacement) from 1374 to 1377. In CABG patients, there were 46 cases of reoperation (78.3 percent male 21.7 percent female). The most reoperations for bleeding was less than 24 hours in 90.3 percent. In valvular patients the causes of reoperation were: A) Valvular complications (female/male=3/1), B) Non valvular complications (female/male=1/3). The most common nonvalvular complication was bleeding (66.6 percent). The most common valvular complication was bioprosthetic valve degeneration. The meantime between two operation in valvular complications was 11.8 years. In all cases (915) the incidence of bleeding was 3.8 percent, mediastinitis 0.8 percent, cardiac tamponade 0.8 percent and GI bleeding 0.5 percent.
Aarabi M.u, Meraji M, Mortezaeian H,
Volume 65, Issue 4 (7-2007)
Abstract
Background: Tetralogy of Fallot is the most common cyanotic congenital heart disease. The systolic and diastolic function in both ventricles is altered even after successful corrective surgery for this defect with a transannular patch. Pulmonary regurgitation, a common complication after this treatment, is usually well tolerated in childhood. The aim of this study was to assess the combined diastolic and systolic function of both ventricles using the Doppler-derived myocardial performance index (Tei index) in patients who underwent surgical repair of tetralogy of Fallot using a transannular patch. In this article we discuss the impact of pulmonary regurgitation on right ventricular function and clinical outcome, the role of echocardiographic imaging, and current management strategies for patients with pulmonary regurgitation after this treatment.
Methods: Sixty eight patients with tetralogy Fallot were studied in Shahid Rajaie referral Cardiovascular Center during 2003-2005. The studied population, 36 male and 32 female with a mean age of 7.5±4 years and a history of corrective surgery for tetralogy of Fallot using a transannular patch. These patients were randomly selected and assessed by Doppler echocardiography.
Results: Fifty-seven patients (84%) had mild to moderate pulmonary regurgitation, whereas 11 patients (16%) had severe pulmonary regurgitation. Right ventricular Tei index was significantly increased in patients with severe pulmonary regurgitation compared those with mild to moderate pulmonary regurgitation (0.54±0.18 vs 0.24±0.11, P<0.01). Left ventricular Tei index was increased in patients with severe pulmonary regurgitation compared those with mild to moderate pulmonary regurgitation (0.46±0.22 vs 0.32±0.14, P<0.05).
Conclusions: The findings of this study suggest that pulmonary regurgitation is a serious complication after repair of tetralogy of Fallot with a transannular patch. Delaying surgery in such patients risks irreversible ventricular function.